Medical Insurance

Medical insurance is very expensive these days. Everyone knows that policies available from ggencies aren't comparable to those provided from employers; and this, when employers don't provide insurance that's as good as it used to be. It's great that COBRA coverage is a possibility, but for many of us, when healthcare, rent and student loans have the same dollar obligations, healthcare is the one to go. My friend just went to the doctor before paying her COBRA and, rather than paying the premium, opted not to have insurance and just pay massive amounts out of pocket. In her case, the premiums in total were about the same as the payments and she has now gone to her husband's insurance.

If you have a job that provides benefits, be thankful; I'm still paying on a medical bill incurred when I had crappy insurance that paid, in total, $300 for emergency visits. That paid for the doctor, in one capacity; however, he was wearing a couple of hats that evening and ordered a couple of tests. I'm on a payment plan, since the bill was large enough that there was no way I could pay it off immediately. Fortunately, the provider is reasonable and makes payment plans for those in my position. If I earned less, there was a possibility of a reduction in the bill, which is great to know for the future.

Meanwhile, I have insurance now. The problem I recently had was that I had a choice of plans and when I reviewed them, it appeared that I would be able to use the clinic I had most recently gone to and, much more important to me, keep my opthamologist. Because there was nothing indicating I needed a referral for such visit, I made an appointment and went.

Imagine my horror when claim was rejected on the grounds that it was out of network. The bill isn't tiny. Prior to choosing a plan, I had reviewed the webpage and it showed my opthamologist. It turns out that the plan is organized in such a way that I must first choose a clinic and only use the opthamologist linked to that clinic. But you don't know that until you're on the inside. When I called, much to my surprise, after explaining the situation and telling the rep. that I had no way of knowing my opthamologist wasn't an option and, furthermore, I would never have chosen their insurance if I had known, she said they'd pay for it; it turns out that there was no way for me to know my opthamologist wasn't an option.

I have changed clinics to the lone option linked to my opthamologist, which is a bit frustrating, though I was told that I can change clinics once a month and that I could wait until it's time to go to the opthamologist again, switch for a month and then switch back. I opted not to do so as that seems like something that would trigger a change in policy. I have been going to the same opthamologist, who is also an eye surgeon, and would prefer to continue to do so, so I am happy with the new clinic. It's as convenient as the old one.

If my primary care physician hadn't retired a few years ago, I might feel differently, though as it is, it should be fine.