I was very interested to hear what President Obama would say about health-care last night on TV since my family has had such as close encounter with our nation’s health-care system recently. (Here is a summary the of the speech in case you missed it.)
With my brother in the hospital for more than 10 weeks this summer (he was finally released last Friday), we have had a very first-hand view of hospitals and how at least his health insurance company operates.
We were very lucky to have a fantastic hospital like Emory close by and also very lucky that Emory has a transplant coordinator team to help the patients through the entire process – including staying on top of their insurance companies.
That Emory transplant team (coordinators and doctors) worked hard to make sure all the procedures my brother needed were approved and would be covered. They were more aggressive with the insurance company than a regular person could probably be.
When my brother had to be taken in for a second heart surgery about two hours after the first the transplant coordinator cleared everything with the insurance company. She didn’t want my sister-in-law to have to even think about money or haggling with the insurance company at such a stressful time.
When my sister-in-law got some crazy bills telling her she owed far more than she did, the coordinator helped her review it and figure out exactly what she did owe.
Even with insurance, the transplant team encourages all transplant patients to fundraise to help cover medical expenses – mostly medicines. Despite comprehensive insurance, my brother is looking at $20,000 to $30,000 a year in prescriptions that he needs to keep his body from rejecting his new heart.
My brother and his wife kept joking that they were going to have to put his face on jars in gas stations to raise money. We ended up putting a link to his fund site on the private blog we used to inform friends and family of his condition. That has been very successful, so at least so far, no one is going to have to make crafts to pay for medicine (that is one of the suggestions transplant families get for paying the bills insurance doesn’t cover).
Elsewhere in my family ….
My father runs a very small business so my parents are self-insured. Their premiums were raised multiple times a year for many years. My father is finally old enough to go on Medicare and they were thrilled to stop paying his premium. I think some money does come out of his Social Security check toward the Medicare. They do have a supplemental insurance as well. They can’t wait until my mother is old enough to qualify for Medicare too!
Our insurance …
I have never had a problem getting the doctor that I wanted or the care that our family needed on our insurance. However, I do spend a lot of time double checking bills and calling the insurance company to tell them they have processed things incorrectly. My main complaint is that I feel like I have to follow them with a magnifying glass to make sure every bill is paid the way it is supposed to be! But I do feel grateful that at least we have good health insurance.
I have been aggravated that our company doesn’t pay for the children’s eye exams or hearing exams — unless something proves out to be wrong. This makes no sense to me. You need the well visits to keep from having problems. Oddly our dental insurance (different company) pays 100 percent for dental check-ups.
How would you rate the health insurance your family has right now? What else would you want or need from your insurance company? If you do not currently have insurance, how are you paying for medical treatment? What are you looking for in health insurance coverage? What would like to see in a healthcare reform bill?