Monday, January 16, 2006

$1400 Orthotics (An Ode to Healthcare)



As many of you know, Brad's spinal cord is a little short, which means his feet and ankles are a little weak and lack some sensation. As a result, he gets to wear these lovely orthotics for the next nine months. He's adjusted quite well to them and wears the orthotics and regular shoes (three sizes too big!) over them all his waking hours.

Right now we're on Blue Cross Blue Shield (my employer's health care company), and we did not have to get a referral for these shoes. I just went to Alliance Orthotics, and they plastered up Brad's legs and sent us home (no co-pay). Then they called us back when the shoes were ready, fitted them, and set us home again, telling us to call with any questions. No co-pay, no bill. I received the Explanation of Benefits (EOB) from BC/BS the other day, and it turns out the orthotics cost $1400! And we don't have to pay anything for them! I am SO very thankful for our wonderful health care. Even though the premiums run us $6,000 per year for our family (and that's WITH employer an subsidy!!), BC/BS has been wonderful. Not once did I pay for a doctor's visit while I was pregnant. We didn't pay for anything in the hospital when Brad was born. We paid nothing for his surgery.

In 2005 the three of us ran up $51,451.09 in medical expenses. Cost to us in terms of copays? Less than $1100. How much am I thankful for our wonderful health care? THIS MUCH!

So we're switching health care companies to MAMSI, which Doug's employer provides. That's an HMO, which goes by the somewhat misleading name of 'Optimum Choice Inc.' You get to choose a primary care physician. And that's the last choice you make...your specialists, your treatment...it's not your choice. It's MAMSI's. Why are we switching? Because doing so will save us $2,200 per year in health care costs this year. And because MAMSI will pay for 50% of the fertility treatments that I've been undertaking (BC/BS will only pay for diagnoses, not treatment, of infertility).

And you know what? MAMSI doesn't cover orthotics. We would've had to pay for those shoes ourselves. Or, we could've declined to get the shoes, and MAMSI would've paid for the necessary SURGERY years later to correct the bigger problem that the shoes will correct!

It's at times like these when you just have to keep saying, 'I'm saving lots of money. I'm saving lots of money.' And, 'We can switch back after I get pregnant. We can switch back after I get pregnant.'

Seriously though, our medical expenses this year have made me very thankful for our health care, and very thankful we live in the United States where such excellent care is available.

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