Healthcare woes

[Jennasis]

Rather than vent ( I'd love to vent) I figure maybe asking for ideas would be a better use of my time. What do you do when you have a healthcare need, and you have insurance, but your insurance coverage is such that a BIG chunk of change for a procedure would still have to come out of your pocket and you are barely scraping by?

DH is in agony. His shoulder is pretty messed up. He had seen his orthopedic doctor about 6 months ago and was told that if the condition persisted or worstened, he would need an MRI to confirm what the doc suspected might be the problem. Well it's persistant and worse. So DH called and set up an appointment for the MRI.

$1500!!!

Our insurance only covers a bit of it (insured with BC/BS through DH's employment) and it would leave at best a $750 chunk for us and at worst possibly close to $900, out of pocket.

We don't have that! We have CareCredit and we could (God help us) finance the procedure. We just today paid off the crown/bridge DH had done a a year and a half ago. And if DH needs surgery????

I guess this is a bit of a vent. DH said on the phone a while ago that "I guess I'll just live with the pain."

Meanwhile, my back is completely a wreck and I need an MRI and possibly surgery too. I WILL live with the pain.

I'm just feeling sorry for myself right now. Could use a boost. Poor DH...he busts his butt (and shoulder) and does so much. I hate to see him suffer.

 

[Stitchfans]

Hear ya. I just paid off our bill from the hospital which was over $2000.00. Insurance paid their part and that was our end. The doctors bills were smaller but once we paid them off it was about another $1000.00.

Guess if you don't want to be in pain and want to get well you just have to make payments and hope for the best. Hope it all works out ok for you.

 

[Pakey]

I paid $16,000 out of pocket 2 years ago for part of one of my chemotherapy drugs.

You do what you have to do.

 

[Pea-n-Me]

I would go back to see the orthopedic doc and explain the situation - first. Maybe he can re-think it and see if there's anything he can do short of doing an MRI or surgery based on the history of the problem and his current symptoms. Sometimes they can tell what's going on if symptoms are classic, or at least he'd be able to recommend a pain management regimen.

None of it's an exact science, though. My DH hurt himself this winter. ER doc he saw when he couldn't move his leg diagnosed a strained ligament. Long story short, our own doc ordered an MRI and it showed two bulging discs in his spine compressing the nerve to his leg. A far cry from a strained ligament. He's had a steroid injected directly into the nerve sheath and he's a lot better.

So I guess you have to decide if it's worth it to spend the money on the MRI. Maybe there's some way you could find one that's cheaper somewhere, or the doc knows a way to help lower the cost? Wish you luck.

 

[hiwaygal]

Personally...I would bite the bullet, and have the procedures/surgeries necessary to lead a pain free life. Talk to the providers and hospitals and tell them your situation, ask them about making payments (usually interest free) and get the medical care you need.

Life is too short to waste it being in that much pain. Finances may get better in the future but whatever is causing the pain may get so bad that the surgeries won't really help it. There could be permanent damage.

It's a tough choice, but I firmly believe that you should not have to live in pain.

 

[tar heel]

Your insurance sounds like mine. It's good for basic preventative stuff and for the catastrophic illness. It's the inbetween stuff -- MRIs, xrays, outpatient surgery, even a colonoscopy -- that cost big time. I'm not sure but I think my co-pay on an MRI would be in the $1,000 range, so I understand totally.

 

[cteddiesgirl]

Be happy that you at least have some insurance.


You could be worse off and not have any insurance at all.

 

[Jennasis]

Be happy that you at least have some insurance.


You could be worse off and not have any insurance at all.

Too true.

When Dh comes home we'll have a nice rational chat about everything. My suggestion off the bat was to go back to the ortho and see if he would even recommend an MRI now. If it's inflammation, maybe a course of steroids would quiet things down, or maybe he has another imaging place that does it cheaper. Or perhaps they can discuss painmanagement if he doesn't think DH is surgical right now.

When I was paying OOP for insurance (oddly ALSO blue cross), EVERYTHING was covered...I had an MRI when I was suffering from chronic daily headaches and it was completely covered. My monthly payment for that covereage was $150.

Whomever said that our coverage is fine for either basic preventative stuff (like today's visit to the Dermatologist for the rash on my arm) or the, God forbid, catastrophic injury or illness, was right.

 

[C.Ann]

Too true.

When Dh comes home we'll have a nice rational chat about everything. My suggestion off the bat was to go back to the ortho and see if he would even recommend an MRI now. If it's inflammation, maybe a course of steroids would quiet things down, or maybe he has another imaging place that does it cheaper. Or perhaps they can discuss painmanagement if he doesn't think DH is surgical right now.

When I was paying OOP for insurance (oddly ALSO blue cross), EVERYTHING was covered...I had an MRI when I was suffering from chronic daily headaches and it was completely covered. My monthly payment for that covereage was $150.

Whomever said that our coverage is fine for either basic preventative stuff (like today's visit to the Dermatologist for the rash on my arm) or the, God forbid, catastrophic injury or illness, was right.

--------------------

This sounds like the best option.. (I have lousy coverage too..) There may be a less expensive way of getting to the root of the problem - just remember one thing: When they do know for certain what the problem is, left untreated it will only get worse - and more expensive..

Hope you can work something out with all involved..

 

[Kath2003]

I'm so sorry. I don't fully understand how insurance works over there, and obviously I am pro-UHC, but I don't think it's fair that anyone should have to live their life in pain. I hope you find a solution to your dilemma soon.

 

[Handbag Lady]

Gosh, I'm sorry you are in this situation. I would go back to the doctor and see what they say to do. Even if it is an MRI, find out if they can do payments on the difference between the insurance coverage and what you owe, and then also explain to the people doing the MRI that most of this is out of pocket. Some places do have different prices for insurance vs. no insurance and maybe the billing agent knows some tricks to 1) get the procedure paid and 2) reduce what you owe for it. Like a cash discount or what have you.

 

[cteddiesgirl]

Too true.

When Dh comes home we'll have a nice rational chat about everything. My suggestion off the bat was to go back to the ortho and see if he would even recommend an MRI now. If it's inflammation, maybe a course of steroids would quiet things down, or maybe he has another imaging place that does it cheaper. Or perhaps they can discuss painmanagement if he doesn't think DH is surgical right now.

When I was paying OOP for insurance (oddly ALSO blue cross), EVERYTHING was covered...I had an MRI when I was suffering from chronic daily headaches and it was completely covered. My monthly payment for that covereage was $150.

Whomever said that our coverage is fine for either basic preventative stuff (like today's visit to the Dermatologist for the rash on my arm) or the, God forbid, catastrophic injury or illness, was right.

I hope all goes well and you can get those problems taken care of fairly cheaply.

I'm so sorry. I don't fully understand how insurance works over there, and obviously I am pro-UHC, but I don't think it's fair that anyone should have to live their life in pain. I hope you find a solution to your dilemma soon.

Unfotunately, because of things like this, many people who do have insurance still go through life with pain and very little help for it bacause they can't afford the out of pocket costs.

 

[JessicaR]

If you have health insurance, you will usually pay a lower price for an MRI if you go to a facility contracted with your insurance company. Call around and price shop. When you call get the price for the radiologists fee as well as the fee for the actual procedure. You will find that they don't all charge the same fees.

Usually they offer 'cash' prices at a considerable discount for those that don't have insurance. Payment plans are also usually offered.

x-rays are a good and cheaper first course but unfortunately don't detect inflammation and soft tissue issues. Do they think its tendons or muscle and thats why an MRI is wanted? Ultrasound scans can be considered sometimes too and are cheaper. MRI of the shoulder can detect rotator cuff tendon tears.

Being in constant pain is so debilitating and no way to live. Do everything you can to treat this sooner rather than later.

I hope you both get some relief!