Insurance baffles me. As though all the intricacies of in-network and out-of-network and referrals and different levels of deductibles aren’t enough, our insurance company has now decided that if a doctor charges more than they think he/she should, they just don’t have to pay. Do we have that option too?
We finally got the bills for our hospital adventure in New York a couple months ago (You can read about it here) and the grand total actually came out to just about what we had randomly ballparked as our expectation. Great, right? However, looking at the bills we learned that all of the essential stuff (6 hours in the hospital, a bunch of tests and lab work and monitoring, IV, medicines, doctor, nurses, etc) combined to only 1/5 of the total, so dramatically less than we had guessed. The other 4/5? That was the surgeon who came in for 2 minutes completely unnecessarily and did nothing. The insurance company decided he charged more than “other doctors in the area” (as though we had a choice in the ER!) so only covered a fragment of his cost, and that at a reduced rate, leaving us with the rest.
And I know I shouldn’t complain because the total is around what we expected, but it is just so frustrating! And I feel so helpless.
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