Before this expanded into an epic, this was just going to go into MPSIMS. But right now, I feel like I’m going to cry or scream or stab someone in the eye.
I have two kidney stones, both very large – a two-centimeter stone in my left kidney, a one-centimeter stone in my right. Both are starting to block off urine flow.
I have health insurance, oh yes I do. Through my temporary agency, no less. I pay $20 a week – a WEEK – for this stuff, but it has its up-sides. Doctor’s visits at $15 copays, inexpensive generic prescription-filling.
Of course, if you actually need to get a procedure done you’re boned.
This crippled, castrated insurance plan will pay out up to 80% of outpatient and inpatient procedures. Sounds great, yes?
Only they have limits. They will not pay more than $1250 for outpatient procedures or $5000 for inpatient. This means that even if I get run over by a truck I’m mostly screwed.
So, I say to myself. I need two lithotripsies. Combining doctors’ fees, anesthesiologist fees, and vendor fees, this is going to cost in the neighborhood of $15,000 per procedure. Assuming all goes well and they get the entirety of the stone out, which is not very likely. Especially for the larger of the two stones.
But this is life threatening, you say. Surely the hospital is required to help you if the problem is life threatening.
It doesn’t look like they will. Every place I’ve talked to – surgical centers and hospitals – requires half of the cost of the vendor fees up front. Half. For the cheapest place I found, they require no less than three thousand dollars in their hands when I walk through the door. This is for ONE procedure. Then I have to pay the other four thousand in two more payments.
There’s a lithotripsy machine in this network of hospitals on the south side, but apparently it’s thirty years old and not very good.
My doctor’s office has been very helpful. Every single other wretched person I’ve spoken to has been quite glib. Yes you need to give us three, four, five thousand dollars when you walk in. But we’ll give you a 20% discount if you bring in the whole amount at once!
Thanks, guys. Me, with my twelve dollar an hour admin assistant job, I have thousands of dollars just sitting around. I sleep in a big pile of it. After all, that’s why I don’t have decent insurance. I just have All! This! Money! :rolleyes:
So I’ll have to get the more dangerous, probably more expensive procedure – a ureteroscopy (spelling? ehh?). This merry jaunt involves the doctor sticking a camera and a laser up my wee-hole, lightsabering off bits of stone, and tugging them down my ureter. Hey, it might just not cause permanent damage!
I’ve been calling people all week long, people who seem to never be at or near their desks. I understand they’re busy, but I’m afraid for my life, and they’re supposed to help people. They’re damn well supposed to at least ACT like they’re sympathetic while they’re telling you that this possibly lifesaving procedure? Yeah, they’re not going to perform it because you don’t have the cash.
If I were dishonest, if I never intended to finish paying this debt, I could just tell them to put it on my insurance. Two, three months from now, when that company has decided they will pay $25 or so, I could just pay the hospital ten bucks a month until the day I die.
But I’m not dishonest. I’m trying to do things right. I’m trying not to be one of those statistics, one of those people who uses the ER as their own personal doctor’s office, one of those people who plays the system, one of those people who bankrupts hospitals.
The only helpful people I’ve talked to – apart from my parish nurse, who gave me the first numbers to call – have been my actual urologist and a very sweet financial counselor at the hospital in the south of town. At the hospital that really can’t help me. At least she sounded like she wanted to.
I feel like throwing myself in front of a bus. It would probably be more productive than banging my head into the metaphorical brick wall that is the hospital billing department.