Quick recap of my insurance experience prior to the sleep clinic

As I have stated over and over and over again on this blog, sleeping doesn’t come easy to me. In fact, it has wrecked havoc on so many areas of my life.

Ex, Sleep Deprivation- http://bit.ly/1nIClSa , Demons Come Out at Night- http://bit.ly/1kpf5Dw , Living in Chronic Pain Prt 2- http://goo.gl/AKWOLn

So given all of those things and the fact that sleep is important for any healthy human being, I decided that I needed to make an appointment at a sleep clinic just to see if there was something else going on. I also needed desperately to feel like I was doing something to help myself and my situation.

Once I found a place I liked that was close to me (aka didn’t seem like it would be triggering,) I called my insurance company to see what the deal was. I have a $3,000 deductible and once I reached that, they would pay 30%.

That is ludicrous and I know that I have it a lot better than most people.

As a quick side note, a few months ago my mom made an appointment for a physical and while she was there she asked her doctor if he could quickly check something with her hand since it had been feeling off for some reason. {Thankfully, it was nothing}

My mom got a huge bill following that appointment because they viewed her visit as a “sick appointment” instead of just a physical (which they supposedly cover 100% of the tests they approve.)


I just don’t understand it. They cover you if you are well but if you are sick or need help of any kind they charge you? So anyway, that is my little venting session about insurance.

I was fortunate enough that the sleep doctor I saw is only requiring office visits which is just a regular specialist co pay. So I will be able to go back thankfully! {Productive Appointment: http://goo.gl/OBFXSR }

I know we all have tons of these insane stories! Feel free to share :)


PS, I apologize the shortened URL links look bizarre. Apparently the computer thinks I am a robot since it takes so many tries for me to prove otherwise ; )

  • https://plus.google.com/108728051778304814354 Matthew Dobos

    Very typical experience, and it’s only getting worse it seems. When I had my last flare up in 2012 I discovered how bad my company’s insurance plan was- small company. Once recovered, i quit and work for myself for now, until I find a good spot. During my hospital stay I was billed $11,000 for a CT scan and my insurance capped this service- I was billed for over $10,000 for the part insurance didn’t cover. Working for myself I bought the best plan I could find on the individual market- which stinks. 20% Coinsurance- not as bad as others, but coinsurance is just wrong. Problem is the coinsurance only counts for services/products that are covered to begin with. If I use a provider out of network, I pay 50% until my deductible is reached, then I pay 20% after that. However, Pentasa which costs me $633/month is not covered. If I ever need a biologic, those are not covered so I’d be very screwed- those are over $50,000/year out of pocket. In my area, large company plans offer the best coverage, but I think even then they use coinsurance. Anytime you see coinsurance, you first need to find out if the service/product is even eligible and I’ve found that very hard to figure out sometimes.

  • Jodi

    precisely why our system needs to be overhauled. the insurance companies run the health care system and everyone else has to play along. No one wants to give insurance to anyone who needs it- they might actually have to help someone and spend some $$$.It is why doctors take 5 minutes with patients and move onto the next one. They need to see volume in order to make any money or get reimbursement for services. I see it everyday at work.. pressure to cram as many people in as possible and unfortunately what suffers is the care…
    don’t get me started…..I’m glad at least, you found a provided who you liked and who took time with you..

  • http://motorcyclesbooksandfuctose.com Kenzie – Motorcycles, Books & Fructose

    My old insurance company tried to charge me several thousand dollars in copayments for my hospital stay in December. When I called and asked about it even the representative I talked to didn’t even know why I was being charged so much.

    • http://risaroo86.wordpress.com Marisa Lauren

      It is outrageous. That is why it is always so important to question it even though it is such a pain in the as* and time consuming.

      • http://motorcyclesbooksandfuctose.com Kenzie – Motorcycles, Books & Fructose

        It is very time consuming. But in this case it was worth it. I now only owe several hundred dollars instead of several thousand. I just want to know how that happened.