I had a long, long post regarding medical and insurance drama I’ve been dealing with for the past month and a half, but I just cannot get myself to click ‘publish’. For now, here’s an example of what we’re dealing with.
DS2 was sent for a speech evaluation. He’s only 2, but the concern was regression. At 9 months he was speaking in sentences, at 17 months he completely stopped, and seemed to develop his own language. Now just after 2 he’s starting with words again.
I didn’t care for the therapist, or the way she conducted the evaluation, and found her to be very condescending towards me, especially when she realized my son is very good at ASL, as am I. She questioned how I could possibly know American Sign Language. My best friend is deaf. 🙂
Anyway, she insisted he needed therapy, twice a week, for three months. Told me to schedule it with the front desk as we left. Here’s where it gets fun!
My co-pay for speech therapy is $90. That’s expensive enough for us! The visit fee is $370. That’s $370+$90=$460*2=$920 PER WEEK – wtf!!!! We don’t even make that much per week! I could feel my heart begin to race, the anger growing, my eyes swelling with tears out of frustration. What the hell is the point of health insurance? Please, someone, help me understand!!
The front desk lady certainly didn’t help with the following exchange:
Her: It’s too bad you have private insurance.
Me: Why is that?
Her: Our self-pay fee is only $60.
Me: Wait, what? $60 co-pay? What does a session cost?
Her: No, just $60, it’s a flat rate per visit.
Me: Well then I don’t have insurance!
Her: Sorry he’s already in the system since it was a referral, we’re unable to change it to self-pay.
I received a bill in the mail for the speech evaluation. $765. For 30 minutes. I called their office and they stated insurance didn’t cover it. I called insurance, they said it was not covered, because it was not treatment for a diagnosis. I tried to explain that the point of the evaluation was to determine a problem, aka diagnosis, and get help. Nope. No diagnosis, no evaluation, but no diagnosis without an evaluation. Isn’t that interesting.
Makes you feel really good paying hundreds to thousands per month in health insurance premiums, only to get have high deductibles, and low coverage. Meanwhile those without can get a cheap flat rate.
I am battling this same issue over, and over again. Every day I make 3-5 phone calls to specialists, insurance, doctors, etc. It’s a nightmare. I canceled speech. It didn’t feel right to begin with, then the cost just sealed it for me.
Physical Therapy is a must, and unfortunately we’re having the same cost issues. Also insurance limits the number of visits per calendar year to 20. Which is absolutely ridiculous for a child born with a birth defect that affects his feet, legs, and ability to walk.
$920 per week! I mean REALLY!!!!!!!! Are they nuts?!