Covering your Coverage
Springtime, the season of my birth, wrecks me fiercely.
As the planet tilts during the weeks surrounding the equinox, my health goes a little haywire, especially in the allergy and breathing department.
With COVID-19 in the background, anything lung related feels like something that has the potential to become a life or death crisis.
Late March, I had a life or death crisis. Trying to keep my already persistent asthma at bay, I started a new medication for a different health issue before bed, and about an hour later, my breathing symptoms took a bad turn.
Not only was I struggling to catch a breath and fighting chest tightness, my heart was racing. The following six hours, I zigged and zagged between one hour naps interrupted by heart palpitations that woke me gasping for air.
“Is this a wicked asthma flare up or the new meds?” I asked myself, now up and out of bed at 4 a.m. taking hits off my rescue inhaler and reading the package insert of the new medication.
Working in pharmaceuticals, I know that anything can be an adverse event and should be taken seriously, so I took the symptoms seriously, woke my wife to tell her I was driving myself to the ER, and then left.
The ER was how you might expect it during a pandemic: uber-sterile and staffed by weary yet ever-friendly healthcare professionals—god bless those frontliners.
Vitals, bloodwork, and a chest X-ray later (they had to rule out a heart attack since I’m of a certain age), I had calmed. My breathing had stabilized. I was exhausted, but there was nothing they could do, and the doc couldn’t say whether it was an allergic reaction to the new drug, asthma, or whatever.
I went home, but before that, I paid the copay with my healthcare savings account card, feeling confident insurance would cover the rest.
Weeks later, I learned that insurance indeed paid, a portion that is, of the $7,000 charge. After all the insurance coverage, I was responsible for over $1,000.
I called my insurer and they said a couple things that probably no insurer should ever say:
“It was so expensive because you haven’t met your deductible for the year.” (beat) “But looks like you have now.” (Chuckle, chuckle). The representative seriously laughed.
Followed by: “It’s better to go to the ER later in the year because you’ve already met your deductible. So, next time, try to go later in the year, or just go to Urgent Care.”
Okay, so the entity I pay over $1,000 to already each month in premiums is now advising me when to go to the ER?
That’s healthcare for you. They care when it’s healthy for them.
Moral: take care of you. Listen to your body. Do what’s right. Dispute. Invest in health so you might avoid “healthcare” in this country.
Epilogue: I’m working with a third party to pay this expense down. I wasn’t able to get a break. I am also working toward establishing my own insurance: prevention.