It's the Most Wonderful Time of the Year

It's that time of year again. I don't mean the turkey and dressing, or the shopping or the feeling of love for everyone, except the jerk in front of you who steals the last parking spot at the mall.

No, it's that confusing time that you have to decide what health insurance you want to select for next year. At Alaska we call it Open Enrollment.

Last year I selected the regular PPO (not sure what PPO stands for). This meant that I paid $25 copay every time I went to the doctor, the dentist or the eye guy. I forgot what eye guys are called. I also had a $300 deductible, which means I had to pay the first $300. Then the insurance kicks in and pays 80% of everything else. It gets kind of confusing, not sure if the $25 copay goes towards the deductible.

They also have this thing called a Flexible Spending Account. This is an account that I can put pre-tax money into every pay day. I can use this money for copays, and other approved medical services. Doing no research I sign up to put in $50 per pay day. This is a total of $1300. You have to spend the money in the calendar year or you loose it. At the beginning of November, I check to see how much I have left. Imagine my surprise when I discover that I have only 2 months to spend $800.

As most of you know, of all my senses, my hearing is the worst. I can barely hear anything out of my left ear. I'm thinking that $800 just might buy me a hearing aid. This was a huge decision for me as I'm kind of vain. I know that's hard to believe for a lot of you.

Being a little naive, I figure I'll just go to the store or online and order a hearing aid. Did you know that you actually need a prescription? I google hearing aid prescription and I find out that an audiologist writes the prescription. I look up audiologists and find one near my place on Capitol Hill. I make an appointment and take the day off.

After signing all the forms you have to do when you are a new patient, they want my $25 copay. I'm now down to $775. The first thing the audiologist asks me is if I have seen the ear, nose and throat specialist?
No
Well you have to see them first. Luckily for me she has some sort of relationship with the ear, nose and throat doctor across the hall, and sends me over there.

Of course I have no appointment, but after I pay another $25 copay ($750) they squeeze me in. He looks at my throat, my nose and my ears. This is why he must make the big bucks. He
doesn't say much except to tell me to go back across the hall and get a hearing test.

I'm a little perturbed and I'm daring for someone to ask for another copay. But I guess your second visit in one day is free. I spend about a half hour taking the test. Then she tells me that I have to go back across the hall as the ear, nose and throat doctor will go over the results.

Again, no appointment so again I'm squeezed in. He looks at the results and tells me that I have hearing loss in my left ear!
4 years of medical school and 4 more years of residency to tell me that I can't hear out of my left ear.
OK, write me the prescription and I will be on my way.

Not so fast, he says. This type of hearing loss can be genetic or caused by a brain tumor.
What?
Yes, about 2% of this type of hearing loss is caused by a brain tumor.
OH, well 2% isn't bad.
You don't understand, we used to think it was 1 in 10,000. But we discovered it's actually 2 in every 100.

Why does 2 in a 100 sound so much worse than 2%? I started imagining all sorts of scenarios, none of them very pretty. A brain tumor would explain a lot of things besides the hearing loss.

He tells me that I need to get an MRI to rule out the tumor. They call the Radiologist place and make an appointment for me in about 10 days! What if I die in those 10 days?

Those days were very scary and I was a nervous wreck. I didn't tell a lot of people - I mean there was a 98% chance I was fine.

I took another day off work and went to the MRI place. I was in the waiting room and I counted everyone waiting. There were 49 of us waiting. This meant that one of us had a brain tumor. I just knew it was me.

There was no copay for the MRI but they told me they would send a bill to cover whatever the insurance wouldn't pay. After the MRI, they gave me a CD and I was to take it back to the ear, nose and throat doctor. It was about 2 blocks away and it was a very long walk.

Once I got to the doctor they wanted yet another copay. $725 left if you are keeping track. With no fan fare the doctor simply says you don't have a brain tumor.
Whew that was a relief. I expected a little more excitement on his part. No, brain tumor you simply have a loss of hearing in your left ear. After all the stress I wanted to scream at him
JUST GIVE ME THE FUCKING PRESCRIPTION.
Of course what I said was,
Can I have the prescription?

No, I don't write those prescriptions, you need to go across the hall and have the audiologist write it up!
I get up and say I'll go now.
OH, she doesn't work on Mondays. You will have to make an appointment for another day.

This will take another day off and another copay ($700).

Also I learn about the math of insurance companies. They pay 80%. Not of the actual cost, but what they think it should cost. I just got the bill for the MRI and my portion is $399. Now I only have $301 left. And another bill from a Laboratory for something called an Inner Ear Ag and and FTGA/Abs and a Draw fee. This bill was for over $400. My share is $44.68.
I'm down to about $250 not enough to buy a hearing aid.
But it's still a lot of money to spend on medical supplies in the next couple weeks.
I guess I will have to go to Costco and buy a life time supply of Q Tips.

No wonder health insurance is so expensive, and I just bet that the jerk that stole your parking spot at the mall is somehow related to the health insurance industry.

Bottom Line: I'm lucky I have no brain tumor.
Have a Great December,
Happy Hanukkah
Merry Christmas
Happy Islamic New Year
Kind Kwanza
Beautiful Boxing Day
Happy New Year
and a Festive Festivus (the holiday for the rest of us)
Peace

Until Next Time - Wise OUT