Why I Despise my HSA – Part Four
Posted by eemilla on February 6, 2011
Dealing with the global billing package is working against us again because we decided to change providers. I initially went to the obstetrician because when I called the midwife last year to see if they contracted with my health insurance company they didn’t, and out of network benefits have a higher deductible and coinsurance. However after three visits with the obstetrician, I decided to at least explore the increased cost of out of network care only to find out the midwifery practice had begun working with my health insurance company. The first visit at both the OB and the midwife left us with a payment schedule, so we have already paid the OB practice a few hundred dollars towards our estimated share of the global package, and they have yet (after about two months of being aware of our transferring our care and a phone call requesting it) sent a statement of our account. I called back with my health insurance statement in hand, and after two more phone calls they issued a refund check, which includes treatment they billed for that I never received.
As previously stated I have a real problem with the uninsured subsidizing the health insurance companies. I understand statistically the insured are healthier than the uninsured (due to obtaining preventative care and getting early diagnosis and treatment), and I understand the benefits of buying in bulk; in most cases I support it (we’re members of the French Broad Food Co-op, and I used to belong to Sam’s Club). However, it is morally devoid that people trying to take care of themselves should subsidize companies that basically have monopolies; over 70% of health policies in North Carolina are with Blue Cross Blue Shield, and they even promote themselves as having the largest market share in the state. According the NC Department of Insurance, in 2008 United Health Care ranked second for NC policies with less than 13% of the market. In 2009, the CEO of BCBSNC earned almost $4 million all the while raising premiums for policy holders in a down economy, and BCBSNC is a non-profit (although thankfully not tax exempt). Both my husband’s and my premiums increased from 2009 to 2010 and again in 2011 (I sincerely appreciate my employer not increasing my portion of my health insurance), and we can only expect another increase next year plus what we will have to pay for a third policy for our little one (as it is prohibitively expensive to add anyone to my plan, and we are probably not going to do an HSA with the kid). In 2004 the Kaiser Family Foundation found that the uninsured paid about a one-third of the cost of their medical care, leaving the rest to be paid by charity, federal, state, or local governments, or the providers, and in 2008 Families USA found little had changed. However, the uninsured is billed double (in most cases based on numerous personal experiences) what most insurance companies are billed.
Before this year, I would have thought an HSA/HDHP would have been fine for a child too since most of the visits would be for wellness check-ups and vaccinations (although we might be struck with the new parent urge to rush to the doctor at every little “symptom”). However, in reviewing my policy there is no mention about the global billing package so what surprise might be waiting for us for the little one’s care? My policy does state that “all maternity-related medical services for prenatal, postnatal, delivery, and any related complications” are covered, and when I refer to the Schedule of Benefits I find that in network services are the same “as those stated under each Covered Health Service category in this Schedule of Benefits except that an Annual Deductible will not apply for a newborn child whose length of stay in the Hospital is the same as the mother’s length of stay.” The term “global billing package” is absent from the definitions section of my policy, too.
In shopping for health insurance it is impossible to know what you are truly purchasing because even though the marketing material might imply or explicitly state one thing the policy will always supercede, and until the policy is purchase I don’t know of a single insurance company that will provide a copy of the policy for perusal.
To be continued.