This morning was spent trying to parse the health plans off the Exchange. I have resigned myself to the cost plans ranging between $1,000 – $1,200. There is really no choice, unless you are willing to pay a large deductible. We’ve had AETNA for three years and every year AETNA plays this fun game where at the end of the year it informs us that the plan is no longer available and they are enrolling us in a new similar plan. The first time they did it, I chucked it up to the whole Exchange thing being new. The second time they did it, I was annoyed, but not as annoyed as when Kid 1 had an appendicitis scare.
Previously, we paid flat $400 per ER visit. In the past three years we’ve been in ER four times. We have awesome active children who play sports. Our ER visits are usually “she hit her head” or “she hurt her eye.” This particular one was because Kid 1 reported sharp pain in the stomach around navel and then attempted to lay down in the hallway on the cold tile floor, because she just “had to rest a second.” I took her to urgent care. They said it was likely appendicitis, go to ER. Two hours later, a nice doctor walked in and said, “No, not appendicitis. The tests looked good, but there is thing stomach thing going around that produces symptoms similar to appendicitis, and we’ve seen several people with it. Go home, you’ll be okay.”
I did the whole my child isn’t dying exhaling thing. As I lingered to pay my bill, I got an unpleasant surprise. It was $500 + $1,400. I paid it and called the insurance. Apparently, when they did the whole new similar plan thing, they neglected to mention that we now shouldered the ER costs. The costs were adjusted from 7K, and the $1,900 was the new pricetag. This is my fault for not going online and pulling up the name of the new plan and reading all the benefits. Fool me once, shame on you. Fool me twice, shame on me. So in an effort to avoid ending up with yet another “similar plan,” I went back to the exchange.
I am reasonably intelligent woman. After reviewing everything, I am so damn confused, I can’t even tell you. Do I go with Blue Cross Blue Shield of Texas, who has crappy reviews online, offers an HMO, has higher coinsurance rate of 30% but more programs, or do I go with United Healthcare EPO, which has lower coinsurance of 20% and is a nationwide company vs a conglomeration of smaller insurance particular to Texas as BCBS, who also has crappy reviews online and requires pre-approval for all of the treatment? Or do I go with Humana? Does my doctor even take Humana? If we are traveling and we have emergency care, who will pay how much? My eyes glazed over, I hit information overload, and then I decided to work on the plot for Kate 9 in self-defense.
At least we can get insurance. Yay for that. 🙂