LilySlim Weight loss tickers

LilySlim Weight loss tickers

Wednesday, October 6, 2010

Hanging in There, Sort Of

Today the first bathroom contractor stopped by to give us an estimate for fixing the shower.  A few years ago, we had the same company install the same system into the house we lived in at that time.  The cost was about $2,200, which seemed like a lot of money at the time but they did great work, the bathroom looked beautiful, and they were very professional from start to finish.  I was looking forward to having them fix my shower.

Well, times have changed.  The same system this time around started at over $5,100.  Yikes! There was a discount for this and a discount for that but the total estimate was still over $4,000, well above what I was willing to shell out, the current medical situation not withstanding.  And that price expires at the end of October. So I came up with my own low cost, low tech solution.  I know it won't last long, but at three bucks a roll for duct tape, I can replace it as often as I need to until I get my buns back to work.  Even then I'll take a pass on the five thousand dollar shower system.  That's just out of line. 

As an aside: Walker and I are not married, and the house we live in was purchased by me.  For some reason, when we have contractors in, they want to speak to Walker.  I call for the appointment, I greet them at the door, I sign the contracts, and I pay the bill.  Yet when they're writing estimates and doing the work, they want to deal with Walker.  I understand as well as he does the work that needs to be done, the materials used, et cetera. I'm not just the girly girl waiting for the workers to leave so I can decorate.  Whether they like it or not I butt in when I have questions or concerns.  Frankly, it seems to piss them off.  I don't care.  When I am paying for their services, I am the boss.  The salesman here today didn't push me aside but then, Walker wasn't home.  When they called yesterday to confirm the appointment, the man I spoke with asked twice if I was the sole homeowner.  When I confirmed, twice, that I was, he flat out asked me if I had a husband.  I almost canceled on the spot.  Women may have come a long way, Baby, but someone forgot to tell that to the contractors of America.

Anyway, after the shower guy left, I called my insurance company.  There are no radiation oncologists in my insurance network within at least 75 miles of my home.  To see the radiation oncologist at my regular clinic, I needed to get a "gap extension" to be billed at in-network rates. After many department transfers and much frustration I received the bottom line: my policy does not allow gap extensions, and I will be responsible for any non-covered charges plus ten percent of all fees plus anything priced above what my insurance company deems "reasonable and customary" for each service.  I need a consultation plus a care plan plus thirty treatments.  Even at ten percent, those charges will add up fast.  That is in addition to the out of pocket charges I have already incurred for 2010.  There is no maximum limit for out of network charges.

This whole situation is compounded by the fact that in 2008, I went out of network to Mayo Clinic for treatment of a uterine fibroid.  Mayo offered treatment options not available locally.  At that time I had a different insurance company that did approve my visit to Mayo; however, when the bill came the insurance denied the claim.  After a lot of appeals and other BS, I ended up stuck with about 90% of that bill.  I worked a deal with Mayo where they discounted the charges and I paid it in full, but one of the terms of the deal was that I was not eligible for further financial assistance from Mayo, ever.  I figured, okay, they're not local, I have two options in town,  I won't need to go back there again.  Little did I know.  The radiation oncologist I have been referred to works in my town, but he's employed by Mayo Clinic.  Mayo leases space in my local clinic and runs it as a satellite of their facility in Minnesota. 

 I really want to keep my attitude positive as I continue on this journey but it seems every day gets more difficult.  I could really use some good news about now.

1 comment:

  1. I can't believe the insurance company won't work with you. Have you tried asking the radiologist if they will work with you as an in-network doc for this? I'm not sure but I think they can do that. Also try livestrong and see if they can give you some monetary support for your radiation co-pays or the out of pocket expense you are going to face. You can contact them online or by phone. Good luck