Thursday, August 18, 2011

More Insurance Frustration

I am so totally ignorant about insurance! I can't believe I can be this ignorant. It's not from lack of trying. I'm trying so hard, it's killing me. I'm so ignorant, I don't even know what questions to ask.

I did find out that I qualify for Healthy Families. It covers EVERYTHING!!! BUT.... and it's BIG but.... I'd have to ditch my Kaiser insurance, in writing. It's tempting, but.... What if I earn too much in 2011 and get kicked off it in 2012? What if the program runs out of money? If I ditch Kaiser and need it again, guess who has to go through medical review again? Guess what Kaiser can then legitimatly charge me? A fortune!

So, remember that pediatrician visit a couple weeks ago and the blood test? Well, the labs tests aren't considered part of the preventive health care so I'm being billed for them - ALL, to the tune of over $500 and some are still pending, AND the visit to the orthopedic specialist hasn't even shown up yet on the bill.

Being a person who needs to know what to expect for my budget, I call member services to ask for a list of services and their costs. I am kindly directed to a list. Feeling optimistic, I go through the steps of finding it online, etc... Guess what? It's a VERY, VERY, VERY basic list that doesn't even have MRI on it. Guess who needs an MRI?

How does one get accurate information? How can I get a simple questions answered accurately, like these,

How much is the visit to the orthopedic specialist going to cost?
Where can I go online to find out how much the MRI is going to cost?
Why can Kaiser bill the State of California but not the county of Alameda?

On the positive side, there are several people to their best to sort this all out. It's taking time, however. Meanwhile, I'm still paying for the things my daughter needs right now that can't be put off. CCS will pay for it, but only after I give them proof that Kaiser won't. This is taking so much time that I'm about to send a FAX to the lady at CCS and it's after midnight!


Nicole said...

I'm so sorry you are dealing with this, and I know it is hard decision. With regards to the cost of the MRI, it will depend on if she requires anesthesia....Our son had an MRI with anesthesia (4 years old) and we had the bill from the anesthesiologist, the actual MRI, etc and it was HUGE (like over $9,000). Now in our case, our insurance covered it 100% but I still saw the Explanation of Benefits...I think you can call the dr. office who will be ordering the MRI and they should be able to put you in touch with someone in billing at the hospital who can tell you how it will be coded and the cost... GOOD LUCK! Nicole

Anonymous said... Maybe this will be useful for you.