TRIAL #4

TRIAL 4-

Insurance….enough said. You don’t even need to continue reading…haha!

I will start by saying that I am SO mad at MYSELF and dang insurance can sure suck! Sean’s employer was changing insurance companies the first of the year, so I thought I would look at all of my options. I decided to switch myself to a plan which I thought was the SAME EXACT plan through Medica (word for word it was named exactly the same) that Sean had previously (especially since I knew everything up to this point with this CDH1 gene has been covered and they know the ins and outs of what’s going on). Looking through the benefit booklet, they were EXACTLY the same plan (like I said, even the plan name was called the same darn thing). Working with insurance currently and being that I used to work for an insurance company, I kind of know the ropes. HOWEVER, I did not realize you could have the SAME exact plan to a T, but the deductible and out of pocket maximum could be different….drastically different. When I called to talk to the radiology department about my upcoming MRI, they let me know that I would owe $500 out of pocket the DAY of the MRI since I have a $1250 deductible. I was like…wait wait wait…that can’t be right. It should be a $500 deductible (that’s what I knew of Sean’s plan, anyway). So, I called Medica to find out that they have a few different plans which are exactly the same no matter who takes them out, but the deductible and out of pocket maximum can vary. HOW DUMB!!!! What I know of insurance companies that I work with are that if they have ANY change…the deductible is a little bit different or something is just a tiny bit off, they get a WHOLE NEW PLAN…WHOLE NEW PLAN NUMBER …WHOLE NEW PLAN NAME and everything!

SO…this was on January 15th. I had Sean get in touch with a lady from HR at his work to see if there was any way to get be BACK on his plan….his NEW plan…that would still have a $500 deductible and $3000 out of pocket maximum vs. what I signed up for which is a $1250 deductible and an almost $7000 out of pocket maximum. Of course, we are being given the run around and making it seem like it’s a BIG deal to get me added back to his plan. Although, when I talked to the new insurance company (BCBS of ND), they made it sound like it would be NO big deal especially since we were only half way through the month and they just signed on as of 1/1/16. Well, forms and application were submitted last Friday from the HR dept. and I’m waiting to hear back. I plan to keep BOTH insurances, if possible, only because it will truly be beneficial with ALL that’s going on. HOWEVER, if I can’t get added back onto Sean’s plan, then EVERYTHING (MRI included) will have to wait until NEXT YEAR when I can be added back with open enrollment since there is NO WAY I’m going to pay $1250 for a deductible and almost $7000 when I could just do $500 and $3000. Thank goodness all of this is somewhat elective and I’m not in an emergency situation (knock on wood)!

I am scheduled THIS Friday for my breast MRI and then have my BIG Mayo trip with the endoscopy, meet with my GI doctor and the surgeon in March. I just really hope it doesn’t mess it all up. ALL IN ALL….READ EVERY SINGLE LITTLE EVERYTHING of insurance stuff….or anything for that matter! I know better, but with ALL that’s going on right now and everything I have to think about (our house being on the market (dumb idea with everything else going on), my sister having a baby soon, this surgery coming up, all the appts that go with this) I think I just bypassed it and ultimately it is my own fault. On the flip side, I COULD REALLY USE SOME PRAYERS RIGHT NOW. I really wanted to get this done and over with and if I have to dwell on it for another year….UGH. I just don’t want to! I know that whatever happens is God’s way of showing me the road, but dang….it’s hard when things just don’t go quite as what I have/had planned, but they say everything happens for a reason, right??