[potatobroth]

adding to the comparison shopping point...

Last year while working for (and insuring) myself, I was sent to see a neurologist because of severe leg pain, muscle spasms and weakness in my legs. My $550/month HMO health insurance covered most of it, sans deductible. When it came time for an EMG (electro mumblemumblemumble-o-graph) my insurance wouldn't cover the test because I didn't go through the proper channels. Turns out, I needed my primary care physician referral, and not one from specialist that the prim. care phys. referred me to in the first place. How do they think I got there in the first place? Ugh. So now I'm out $1200 out of pocket because I don't know, I'm retarded like that and wanted the test results.

Fast-forward 6 months and I'm at a new job. This new job has benefits that come directly out of my paycheck. I made another appointment with the neurologist to see where things stood. He ordered another test and wouldn't you know it, my new insurance wouldn't cover a single penny of the office visit, the procedure, or hell, even the primary care phys. office visit. Seems that my new insurance carrier has a 'previous condition' clause in healthcare. If you've been seen for an ailment in the past 8 months while under the umbrella of another insurance, you're screwed. I went to the website to confirm but all I saw were smiling multi-cultural faces and old people. Then buried deep within, I found their claim. So now, I'm faced with the following options:

1) Keep TWO insurances for the 8 month gap. Problem is, if I had used my first insurance for the tests, then the 8 months would have started all over again. Sigh. I got them to admit this over the phone.
2) Wait out the 8 months before a follow-up visit. I don't know about anyone else but I put my health above most anything. I'm not waiting.
3) Pay for the tests myself and throw money that I've already paid both insurance companies down the drain.
4) Fight with credit bureaus and collection agencies as to why my dr. bills are unpaid.

I chose 3. Last years + some of this year's medical costs out of my pocket totaled ~$9500+. Thats RIDICULOUS for someone who is quite healthy aside from one or two common colds and a nerve concern (which turned out to be nothing major but still something necessary to have checked out.) $6600/HMO-yr. + $1200/test + $1200/second test + $200/specialist visit.

Now, what choice did I have as a consumer? Could I have told the original insurance company that I didn't want their business? Sure, but where does that leave me now? Could I have told my company that I didn't want their insurance? Nope, thats the one they offer to me. I would have had to pay even more for my old one. As a consumer, I was stuck between a rock and a rock. With a potential issue on my hands, I had to see a specialist. The specialist won't see me without insurance and the insurance companies won't insure someone that they suspect knows of an ailment.

Privatized insurance companies prey on the likes of me. They want me to pay their premium, and then pay out of pocket as well for tests that I don't want to wait on. If I make one false move, they deny coverage because well, they aren't me, and they don't feel the fear of a physician telling them, "we're going to test for muscle disease."