Outrageous!

1706/20th September 2021

It seems like a lifetime ago that I walked down to my favourite tree, just as new leaves were beginning to sprout. Indeed it feels to me that it’s been a long Summer.

Which is curious because mostly as I’ve grown older, time seems to fly.

Why is that, I wonder?

This afternoon a weather front seems to be moving in but these clouds can be very deceptive.

And on the subject of deception…

Here’s a little extract from my medical insurance:

.

An email the other day prompted me to take a look at my medical account. As the responsible person I am. Or like to think I am…

Medicare is something I started paying in to at age 17. Over the years, it amounted to a lot of money. Yet when I retired I signed up for additional coverage because Medicare would not be enough. The choices available were numerous and the plan descriptions were confusing enough to make one want to weep. So I sought advice.

Anyway, here we are. Exhibit number one.

Doctors, in my experience issue orders for MRI scans as if they are bags of candy.

As you can see, they are very expensive. Of the $7,925 here, Medicare agrees to be responsible for $243.23 (23 cents. Give me a break) However, for reasons unknown, in this case they decided to pay only $194.59 (again with the pennies!)

My plan paid $48.64 (they also play with pennies), the difference between what Medicare approves and what they will pay. Does anyone else think this is screwy?

In the right hand column, a letter A in a black circle. This is good news. It means the provider has agreed to accept the grand total of $243.23, writing off the remaining $7,681.77!

Great news for me. But here’s exhibit number two:

First of all, I take issue with the math, but let’s accept that the provider has been paid the grand total of $569.15. Top line, right column, letter A. Splendid.

Lines 2-5 letter B in black circle. This is the bad news.

What that says is that the provider in these cases has not accepted the Medicare assessment..

…therefore….am I to find $5,870.85 (let’s not forget the cents)?

Honestly? I’m not sure. This treatment goes back to April and I have received no bill to date, but it doesn’t mean none will be arriving.

From experience I know that the provider amounts are fiction. No one expects to get paid those amounts. I found this out when I attempted to pay cash for my father’s medical bills and no one knew how to handle it. He had cancer and no insurance which placed him in a whole different category of calculations. I should have been more savvy and asked a lot more questions but I was a tad stressed at the time. Dad paid a lot.

What I do know is that all of this finagling is outrageous. At the moment, I more or less still have my wits (such as they are) about me, but elderly people on fixed incomes having to deal with this sort of bullshit? It is a national SHAME.

And I just can’t wait to see what the hospital bill looks like…

5 thoughts on “Outrageous!

    1. I’m not surprised you don’t understand. I don’t think we are meant to. It’s all a big fiddle. I would love to know the truth behind it all. There are many many people in this country who worked hard all their lives and now in their old age they cannot afford the medication they need. I am not angry for myself (yet!) but for so many who really suffer in this “great” nation.

      Liked by 2 people

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