We have health insurance through my husband’s employer. We’re lucky to have that option, I’m well aware of that, but the rates keep going up and the coverage goes down. This affects every paycheck, visit to the doctor, and prescription we receive. After this weekends events, and a couple of previous situations, I’m a bit peeved…
First there’s the ridiculous chiropractor scenario. My husband and my boss go to the same chiropractor. My husband is insured and he pays our copay of $45 every visit. My boss is not insured (by choice, he’s cheap) and is only charged $25 per visit. While we pay to have insurance, we also pay more out of pocket than those not insured for services rendered. I thought it was just at this particular office, but it’s not.
Second scenario: My son needed his immunizations when he was a year old, but his ex-pediatrician was out of the medicines needed for months. She referred us to the health department to get him up to date. Since I have insurance, they were going to charge me $478 for four shots. They do not accept insurance. The lady in front of me, with four kids, two my son’s age, received shots for all four kids for $24. She was not insured.
Then this weekend we end up at the Children’s Hospital urgent care center. My son was coughing, wheezing, and having difficulty breathing. We paid our copay of $45 and spent several hours receiving breathing treatments and antibiotics after a 103.4 fever spike. He was released with four prescriptions. Amoxicillin, Prednisolone, Albuterol (inhaler), and an aerochamber mask.
Insurance refused to cover the aerochamber mask. It is considered ‘optional‘. Mind you, this was prescribed for a two year old. Obviously you cannot expect a toddler to properly use an inhaler without the mask attachment. Common sense, right? That plastic tube cost us $87. Eighty seven dollars!! Even the pharmacist was shocked that our insurance wouldn’t cover it. He stated those are prescribed frequently for small children and he’s never had the prescription be declined. Which he followed up with “well most are on medicaid, very few of our clients have private insurance”. Then I get home and find the same masks available online for $20-$35! *headdesk*
It just baffles me, and somewhat annoys me, that we pay a substantial amount of money per month for coverage and yet still pay more out of pocket for services than those with free (or reduced) government benefits. I guarantee you I will receive a follow up bill for the visit as well. We will be responsible for 30% – who knows what their fee’s are! I will be contacting our insurance and fighting them over the aerochamber mask coverage.
I understand people need healthcare, I am not against people being on government assistance depending on their circumstances, but there is just no balance with the system. Those of us who pay for it, end up being punished. We can’t afford it if the rates continue to rise like they have the last two years.
The kid is still struggling with his cough and wheezing, but the inhaler and $87 mask seem to be helping. We weren’t going to let $87 get in the way of our son being able to breathe! But what if someone didn’t have that $87??
Budget & the Beach said,
January 22, 2013 @ 11:22 am
I feel your pain about insurance. As a self-employed person I pay for my own out of pocket, and it still seems I end up paying a ton of money for things after the insurance adjustment. I have an injured shoulder, and I keep hesitating going in for appointments because I’m already on a limited budget an I can’t afford expensive treatments. I hate that health care feels like a luxury, not a necessity.
Angella said,
January 22, 2013 @ 1:41 pm
It really is ridiculous that people have to choose not to seek health care, because they can’t afford it. I think the entire system needs to be overhauled. The last two years our rates through my husband’s employer have gone up 62%. They take more per paycheck, but pay less towards services!
Kris said,
February 1, 2013 @ 7:46 pm
So I felt pretty bad when I couldn’t find a job because I was pregnant, and couldn’t get healthcare because no individual plans covered pregnancies…then I went on state insurance and it paid for everything. *everything*. I was shocked. And now that we’re back on an employer-sponsored plan and everything went back to being shockingly expensive, I can’t help but think wow. Healthcare was cheaper when I was unemployed. I got kicked off the plan a month after I gave birth though, because it really was only for those 9 months of pregnancy.
Angella said,
February 6, 2013 @ 10:01 pm
Damnit my wordpress has been sending all your comments to spam folder. I hope I didn’t miss any.
I understand people will need care, especially pregnant women, and I’m glad you had that coverage! But it is upsetting when certain people continue to pay $0 for care (and contribute $0 to society), while we struggle to afford co-pays, never mind the extra bills that keep showing up. Like my $991 LAB fee from my yearly ob exam. That is AFTER insurance. 
I’m at my wits end with it!