what if?

oh yeah.  what if?  what if we had a catastrophic year ahead?  what if teenage daughter broke her leg?  what if darling husband needed surgery?  we spent the last 3 weeks agonizingly dissecting the what ifs?  and one what if went unasked.  out loud.  what if i get sick again?  what if my cancer comes back?  what if what if what if.

the what ifs have been keeping me up at night.  we have been forced to ask because we are in the odd and dark world of trying to change our health insurance policy so that we don’t drown under the burden of purchasing it.  last year, we shelled out $2,000 a month for a ‘family’ policy (no one gives a shit that i only had one kid…i felt like someone should have been servicing my cat for that price).  we’re both independent contractors and all of my doctors were/are on oxford freedom plan.  none of them took oxford liberty – let alone other plans.  you could almost hear the secretaries hold their breath when the answer to what policy i held was: oxford.  before i could barely get the 2 syllables out of my mouth came the answer:  “we only take oxford freedom!  we don’t take oxford liberty!”  (you could hear the !!! ping at the end of each short but meaningful sentence.)  and 4 years post breast cancer diagnosis is not a good time to change your entire medical team.  so we have made concessions in order to remain with our oxford freedom policy.  but the financial burden became unbearable when, in december, i was told that the new monthly fee was $2,500 a month.  it was the absolute point of impossible.

and so we figured out some stuff.  we formed an llc – because we found out that having the company allows us to purchase a small business policy.  and then we went on the hunt.  insurance brokers; talk of hsa’s and hmo’s and out-of-network payments including deductibles and out-of-network payments excluding deductibles (i’m still a little fuzzy on these two but darling husband seems to have a handle on it.) 

my year has a set rhythm to it.  10 doctor visits are, essentially set.  and all are in-network.  3 major procedures (a bilateral mri, sonogram and mamogram) all of which are, for me, out-of-network.  but many of these plans cost a significant amount and then you keep paying in in-network deductible…many of them set at $2,000 more a year.  out-of-network deductibles climbing easily around $5,000-$7,000 more just for me.  my radiologist is out of network and she’s amazing.  caring, careful, loyal and very very good at what she does. 

my husband deserves a medal.  he waded through manila envelopes filed away in our basement trying to assess our past costs.  it had to be a nasty trip down a nasty memory lane to look at receipts for steroid prescriptions that made his wife stomp around feeling like her skin was coming off or the 4 different anti-nausea meds receipt gathered in everyone’s desperate attempts to get me some medication that worked to stop the nonstop hurling after the chemotherapy sessions.  and he kept going.  he added up numbers and crunched everything upwards and downwards and kept calling people who i would have hung up on but instead coaxed out answers that weren’t always immediately clear. 

in the end, we’re finally ready to make a pick.  a bit of an old-fashioned chinese menu:  one from column a and 2 from column b.  mine as a single with the best benefits and the lowest out-of-pocket payments and them together on a parent and child policy where we’ll be ok as long as neither of them go too far out of network.  or need major surgery.  i can’t help but feel that my worst fears are coming about:  as a family we’re not all together.  i’m once again by myself and husband and teenage daughter are tethered to each other.  i know that’s not really the case – but it feeds into all my old feelings of sitting by myself while the world just kept revolving and going on without me. 

what if?  what if?  what if?  and, for that matter, what if we couldn’t afford any of this?  so many can’t.  i mean it’s starting to really tax the system here (and by that i mean we’re struggling to pay it all out) but what if we couldn’t at all?  and the cat still has no health care.  what if? 

 

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5 Responses to what if?

  1. Laurie S. says:

    Bean, I would love to see you work this into something to be published beyond your blog. The ending is touchingly poignant and personal, but the rest of the story is agonizingly familiar to too many people. There are a lot of people who are just a life-event away from having to deal with similar horrors. Something has to change.

    wishing all the best for you and your family!

  2. Janet says:

    what nightmare bean, and yet like you said familiar and scary scenerio for many. Even when we were married Nico and Randy were insured together and I flew solo.
    This family plans are a joke if you only have one kid

  3. […] Read this article: what if? […]

  4. Kathryn J says:

    Oh Bean – we have gone through this too. For the last several years, we have had what they call catastrophic insurance coverage. I am not sure why the politicians in this country can’t put together a plan that will address this and why people are so resistant to changes in something that is obviously not working.

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