Going For The Throat: Confessions of a Health Insurance Neophyte
I’ve had health insurance of one kind or another my whole life. I’m fortunate for that, and I know it. But it wasn’t until my diagnosis with Hashimoto’s disease last June that I actually paid attention to my health plan. The good news is that not only am I paying attention now, but that it appears that my family’s latest health plan is a good one (I think…).
It’s not that I’ve never used coverage before–I am no stranger to doctors and hospitals. But in the past, my care largely fell into two categories: routine yearly health check-ups, and catastrophic/accident care. Yearly routine care was pretty much my annual gynecologist appointment, which usually went without incident. But, being an active individual who has been involved in relatively high risk activities for most of my life, I’ve had my share of, ahem, unforeseen health issues. There was the tibia fracture in 1993 slam dancing in the mosh pit at a Stuck Mojo concert. And then the freak-accident fall with my horse while just walking back to the barn (after successfully schooling some hairy cross country elements) that resulted in a concussion in 2002. The lacerated thumb ligament from a horse kick aimed at my face in 2004 occurred almost a year to the day after a young horse actually did land a kick right between my eyebrows–although both those incidents were covered by Worker’s Compensation. I wish I could say this was the extent of it, but, unfortunately whether due to known, calculable risks, or plain and simple bad luck and balance (hello, fractured metacarpal 5 from falling off my Dansko clog), I have had plenty of cause to actually USE my health insurance benefits more than I would have liked.
The Hashimoto’s deal is different, of course, and something to which I know you can all relate. I’ve now entered the realm of chronic disease. For most of us, once we have a diagnosis with an auto-immune disease, endure a thyroidectomy for cancer, or take that radioactive pill, we gain admission to a world where we, and our current and future insurance companies, know that we are gonna rack up some medical bills for the rest of our (hopefully long) lives.
While I was working at getting my diagnosis (which, like many here, took some time), I was too concerned with my health to research my health insurance. My husband (who actually has the policy) didn’t really know anything about it either. Up to this point in our lives, our health insurance knowledge consisted of “fill out these forms” with an HR person, which resulted in some sort of card to stick in our wallets. Over the years, through various employers, we’ve had Cigna, Tri-Care, Great West, and now a Blue Cross/Blue Shield (BCBS) plan–and to be honest I have not noticed any difference. When your employer has a deal with an insurance company, your options are take it or leave it–while individual health plans (ie, not employer-sponsored plans) may offer you more choice, it usually comes at significant cost.
So, empowered with the determination to really understand and get the most out of my health plan, I started with the most basic step–I visited their website. As predicted, this was not going to be easy. The website is huge–deeply layered with all kinds of information, of which I have barely scratched the surface. Once logged in, I could easily access my claim history information. In the last 10 months, my doctor visits and testing have cost just over $10,000, of which BCBS paid an “allowed benefit” (the agreed amount for an in-network provider) of just under $5,000. For this coverage, my co-pay was $200.00. OK, whatever. I want the REAL GOODS. What have you done for me lately?
Again, it’s not an easy website to navigate, but so far I have found some areas that I will be checking into deeper (and reporting back anything of note):
- They have a section with online tools and services, such as finding new doctors, estimated costs, and different forms and contact numbers. Eh, mildly interesting.
- OOOHHH! A section of discount options for “alternative therapiesÃ¢â‚¬ and fitness centers. A quick look reveals that with my insurance card I can get a 20% discount on acupuncture, pilates, somatoemotional release (I don’t even know what that means), nutritional counseling and dozens of other programs. Wow, who knew?, Not me!
- Another section has an exhaustive “Wellness” area. On a brief tour it is less than impressive: weight management has food diaries, exercise logs, fast food restaurant nutrition data (as if?), healthy weight calculators, etc. The nutrition portion is just as bad. Looking at the children’s nutrition section, one of the many articles has 5 fresh lunch ideas for kids. One of these is called a “Bacon Cruncher”. Your honor, I rest my case.
Admittedly, I have not delved too deeply into the website’s resources. I would assume, however, that I am not the only person who does not have hours to waste spare, either. Regardless, I would give the additional “wellness” resources a C+. The information is hard to find, not necessarily helpful, and in some cases, not necessarily correct. But, it is there–a health insurance company’s attempt to prevent disease through healthy living? Call me a skeptic, but for now I think it may just be lip service.
Check it out yourself, let me know what you think:, www.carefirst.com.
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Tags: confessions of a health insurance neophyte, Dear Thyroid, Going for the Throat, health care, health care reform, Health Insurance Issues, insurance and chronic illness, insurance reform, Written by Robyn Davis Hahn Editor-In-Chief Health Care