Real Numbers

This is a segment of theteet.com called Real Numbers.

In Real Numbers, we round to the nearest whole number to tell you how bad our health insurance plan sucks. Well, my insurance plan. Seth’s is much more tolerable.

Hi. Have we met? I have a $3,000 deductible. It was $1,000 until June 1, when my employer decided that although it would be more honest, it would look mean to simply do away with “benefits” all together — so they faked it. They tripled our deductible, doubled our co-pays and the amount we contribute to our plan also increased. We pay $90 a month for this privilege. However, doing the math, it literally might be more economical to be uninsured.

So, we had some ER visits and weird boob issues earlier in the year, (That cute little pink ribbon they put in my boob, by the way, cost $700.) which racked up a significant amount of medical bills before the SHITTY health plan went to ULTRASHIT on June 1.

By then I had met my deductible, which meant that after Steter and I put down a grand toward my malfunctioning ladyparts, we were responsible for only 20 percent of our medical bills for the year on out. When you’re anticipating $8- and $10,000 bills, mind you, 20 percent is still a lot. But whatever. We were managing.

After you meet your deductible, there is a $3,000 “out-of-pocket” maximum that you pay under your plan. Meaning the 20 percent match you pay would never be more than $3,000.

I had racked up $400 toward my out-of-pocket expenses that I assumed (as did my HR rep) would count toward my new-and-improved $3,000 deductible when the ULTRASHIT plan went into effect June 1. It does not.

“Those are two different buckets of benefits,” said some rude rep named Janet who claimed to be on my team but actually is not.

Apparently Medical Mutual is incapable of pouring one bucket into another bucket.

So I have to pay $2,000 in bills like, RIGHT NOW, because the OBGYN says our delivery needs to be paid in full before it actually happens.

In Franklin County, the average normal vaginal birth costs about $8,000. So, assuming Tot Two has a perfectly normal, smooth-sailing exit out of the birth canal sans a baby blink or cough, we’re looking at another $1,600 in matching costs after we’ve paid our deductible.

Because I haven’t even counted the $400 ultrasound we had Tuesday. And God Forbid they give me another ultrasound or any kind of blood tests between now and December.

At this point, I’m thinking that I won’t have an epidural — because it will be cheaper. Maybe I should seriously consider a home birth or a midwife or something to get Tot Two out on the cheap? (A note to everyone: I’m joking. Sort of.)

But seriously. Giving birth is a pretty basic, routine part of healthcare, and it shouldn’t put you under. I can only imagine the poor people in my company who have or had, like, cancer. And in addition to the bills, they have to shoulder the burden of guilt, because our reps blamed them outloud when they made those drastic changes in our health plan earlier this year.

Classy.

I am mad because healthcare sucks, and the only thing that sucks worse than my healthcare is my insurance company. And the only thing that sucks worse than insurance is … well … I don’t want to name names. But let’s just say that they overpaid for a house they couldn’t afford anyway, set a few of the rooms on fire and continue to wonder why the value of the home has not increased.

“BUT why don’t you just switch to Seth’s plan,” some might ask.

Hilarious note: Seth has an HSA component, which includes an intentionally high deductible in exchange for other freebies designed to encourage preventative care, but his deductible is still lower than mine! HA!

Seth’s insurance won’t accept me onto the plan unless it’s Jan. 1, or I suffer a “qualifying event.”

Getting fired WOULD be a qualifying event. Hint, hint. We have yet to determine if “Being effed when you probably should have anticipated it,” is a qualifying event under Medical Mutual terms.

Maybe Tot Two will be four weeks overdue!?

As a huge disclaimer, this post is not intended to solicit donations. Not yet, anyway. I’m just ranting about healthcare and the private sector and insurance companies. You know, the usual. We will be fine as long as we’re able to rant. So, please. Please. Please put your checkbooks away :)

As Kittycakes said, Can someoneget Barack Obama on the horn? STAT!

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  • Steve

    Dude, move to MA. I can’t say it any more plainly than that.

    MA. Universal healthcare. 100% prenatal care coverage because it is a state law.

    You can live with us until December and then move back.

    100% covered + no deductible + one $20 co-pay = healthy baby.

    Seriously think about it.

  • http://elephantsonbicycles.com andrew

    Thanks so much for posting this. Sorry up front for the anger in my response, I’m just so sick (pun intended) of the numerous people using tired arguments against socialized medicine in our country. Especially the “friend of a friend” arguments…

    First of all I don’t know a “friend of a friend”… I know real people, Canadians, Brits and French all of whom are good friends of mine. I lived in Canada for a brief period as well. So let’s start with this link:

    http://elephantsonbicycles.com/?p=1113

    Yes, the US has fucking fantastic healthcare plans…

    Now let’s talk about my friends. Particularly about the Canadian ones who got 6 months off after having their baby, who go to the doctor whenever they feel they need to, that cover all of this in their taxes instead of worrying about paying for it out of pocket. By the way, when was the last time you saw the Canadian populace or government up in arms about how fucked up their healthcare system is? Sorry I couldn’t talk about my “friend of a friend of a friend who had to go have a baby in Buffalo or whatever”… I guess I’ll just have to stick with my actual friends.

    Let’s go to the UK then. My close friend Cy who has MS wants to move to the US because he really likes a lot of us and likes the entrepreneural spirit of the US. Do you know why he doesn’t move here? Oh, because his MS means that he actually gets healthcare in the UK whereas moving to the US and starting his own business would require him to go through the nightmare of having a “pre-existing condition” when he tries to get health insurance. In other words, he can’t move here because his healthcare in the UK is way better than what he could get in the US.

    Finally, my father worked through retirement as a school teacher. He’s fought cancer for about 8 years now and is sadly about to lose that battle. He is also almost at his $1M lifetime limit which means that when he dies he will leave my mom with no insurance because insurance companies don’t give a fuck about whether or not you are leaving a partner behind who hasn’t reached retirement age.

    These are stories of our current healthcare system. We are lagging behind the rest of the developed world in terms of caring for all of our people. Anyone arguing against universal healthcare is misguided at best and selfish (and misguided) at worst.

    That is all.