Healthcare Shock and Awe - Insurance Not Always Enough

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I am in my 11th month recovering from major spinal surgery. I was in the hospital five days, spent about six months in a back brace and had to deal with all of the things people who have major surgery deal with.

In addition to the numerous drugs prescribed (some of them very good), I had repeated X-rays, lab tests, the walker, the brace, a bone growth stimulator and a host of other things to pay for.

Insurance covered some of the cost.

Let me repeat - some of the cost.

When all was said and done, after the insurance company paid “their share”, my out of pocket was over $80,000.

Let me repeat, after the insurance company paid it’s part, mine tab was $80,000 (give or take a few pennies).

Not that the figure I just quoted is accurate. I’ve been going round and round with the insurance company about what they are supposed to pay versus what they did pay.

Some things they just didn’t pay.

Not everything was 80/20. On some things they paid 70%… or 50%… or 40%. 

Because I lived in Elk City at the time and had to come to Oklahoma City for the surgery, some of the services I needed were declared "out of network" - in some cases after the surgery.  It didn't matter that my hospital, for that matter any hospital in western Oklahoma, didn't offer neurosurgery, "out of network" seems to be the insurance company's mantra.

It didn't matter that they gave pre-approval to the surgery.  Health insurance companies can always change their mind after the fact - and often do.

Trying to figure out my bill was hell. Now I have a health insurance billing specialist working through the bill.

And I have to pay for that.

And it’s just not one bill to one place. There’s a surgeon, cardiac doctor(not sure why), anesthesiologist, hospital, imaging center, brace manufacturer…. The list goes on.

My message is simple, if you think health insurance will save you when you get critically ill or injured, guess again.

The nightmare isn’t having the surgery, it’s dealing with its aftermath.