Them: So, two separate reps from your insurance told me it's *actually* gonna be $500 for this CT scan, *plus* a 50% coinsurance Me: So... you're actually not in my insurance plan, is what you're saying? Them: ...Yes? Me: Kthxbai
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Me: Dear insurer, can you please help me find a CT scan imaging co that's in my network? Them: Sure. So you know that's a $400 copay, right? Me: My plan info here says $300. Them: Is that 2020 plan info? Me: I mean, your website gave it to me! So it's [looks] ... from 2015
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Me: Dear insurer, why is your copay on my plan $100 more than the self-pay rate for a CT scan? Them: We can only vouch for our negotiated rate. That's why I tell people, if self-pay is cheaper, don't use the insurance. Me: ... Them: ... Me: That's... Them: ... I know, right?
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Me: So I guess the place I'm scheduled for -- Broward Health Imaging on Andrews -- isn't in plan, since they say it'll cost $500 plus 50% coinsurance, so can you please send me a list of in-network providers for this CT scan? Them: Sure thing, we'll email it Me [opens email]:pic.twitter.com/xxyW8KXCw8
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At this point I'd just pay 300 bucks for a thickly accented Austrian to tell me "Eet's naht a tumor"
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Me: Dear insurer rep No. 2, can I get an in-plan CT scan at Broward Health? Them: Well, they're in your plan Me: Great! Them: Buuuut they'll bill you as a hospital outpatient, so you're on the hook for coinsurance, let's find you an independent in-plan imaging office Me: ...
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Them: Whoa did someone tell you a CT scan would be $100? Me: Yes! My ENT, when they got approval from you guys for the imaging Them: Yeah no, $100 is for *X-rays*. Which *also* means your *CT scan* is not approved. Whew, good thing you didn't go to that appointment! Me: ...
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Me: So why should I do this for a $400 insurance copay and not just self-pay $300 around the corner? Them: The copay covers everything at an approved imaging center. Does the $300 self-pay, or is radiology and disk space extra? Me: I... dunno? Them: Me neither, I'm just asking
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Upshot: Scheduled a CT on Monday with someone in plan that I have been told is insurer-approved for $400. And I got this far *only* because I'm an insistent asshole with time on his hands who's been professionally trained to listen carefully, take notes and ask pointed questions!
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Update to this thread: A journalist contacted me for additional thoughts on my (pretty standard, really!) situation, and on US health care in general. Sharing the latter here for max visibility.pic.twitter.com/ywEOyGtxro
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An elegant and memorable summary, and a fascinating tidbit of personal and political autobiography. Thank you, sir, for both.
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