Working for an employer that provides healthcare benefits is a top priority for many American adults. But when you actually need to use your benefit, it could cost you an arm and a leg. Literally.
I’ve had chronic back pain since I was a teenager in high school. It would only flare up every now and then and it was usually during cheerleading when I was tumbling on the gym floor at a basketball game. By the time I was 20 I had regular appointments with a pain manager (he looked like Ray Liotta) receiving steroid shots and undergoing two procedures: discogram and nucleoplasty. But it was OK. I was a Tricare retiree dependent. A $10 co-pay was about all I paid back then.
Here I am, in my mid-30s (I shudder just typing that) and I am going broke because of medical bills. Never mind that I pay $86.15 every two weeks (or $2,239.90 a year) just to carry my medical health insurance. Dental is separate. Every doctor I see I have a co-pay ranging from $30 to $45 dollars. No biggie, right? Well, when you have chronic back pain, you have a lot of appointments hoping to find the “cure” in order to live a normal life. And most of those appointments require the $45 co-pay because I am seeing specialists. It didn’t seem like a problem because I was going to get an answer, we were going to fix it, and I wouldn’t need to see the doctor anymore. Easy day!
Ha! Nothing comes easy for me. It’s like the universe put me on the planet to see just how much I could juggle, take on, or deal with before asking for help. Well Almighty Universe, I’m pretty damn stubborn. Bring it.
Oh, he brought it!
The back pain I had in my teens and twenties has NOTHING on the chronic, quality of life sucking, pain I’ve had for the last 4 years. When I went to my primary care manager about the pain, she put me on prednisone. It worked for a couple months. But before I knew it, I was back to see her. She gave me another prednisone pack, and this time I felt no relief. This was the start of a long, painful, and expensivel love-hate relationship with my health insurance company. Here’s a quick look at what the last 4 years has entailed:
Primary Care Manager Referral to Orthopedic Doctor (lasted about 6 months)
- Physical therapy
- Nerve testing
- MRI with contrast
- Steroid shots (every month)
- Prescription for Mobic and Gabapentin
Chiropractor (lasted about 2 months)
- Snap, crackle & pop
- Insurance didn’t cover this. Each visit I paid in-full. And I was going twice a week (per the chiropractor’s advice). The only pain relief was the day after. It was getting too expensive to maintain.
Orthopedic Doctor referred me to Pain Manager
- Went to original consultation, paid co-pay, got a big fat bill (over $300) in the mail for a 15 min appointment. The culprit? I was referred to a doctor out of network.
Side Note #1: I DO NOT work for the insurance company therefor I do not understand the ins and outs. However, each pay period I make a payment to ensure I am covered. I rely on my medical providers to ensure they are sending me to in-network providers. Silly me.
Side Note #2: I received a big fat bill from the imaging center for my MRI and MRI with contrast. Well, they were in-network, but insurance doesn’t cover it all. I owed a little over $1,200 for the two images. GREAT!
Side Note #3: I called my insurance company and found an in-network pain manager. And now I have been with his office for over 2 years. I call him Dr. McHottie. (just not to his face)
In-Network Pain Manager
- Required drug testing every year (I’ve had 2 so far) due to opioid crisis.
- Spinal Epidural Injections – these were every 2 months unless I needed one sooner. It was rare they lasted longer than 2 weeks. One day, I got a phone call from the pain managers office saying my insurance company denied future injections. Why you ask? Because they said so. My doctor called and tried to get them to approve me, and their compromise was approving four in a calendar year. And at the time, I had 6 more months to go. Oh thank you Mr. Insurance King who sits at a desk in Texas and decides what is best for me!!!! How can I ever repay you?? Oh wait…. I am paying you.
- MRIs x 2 (yup, had to pay for these too)
- Compound pain prescription (FYI – does not work at all! Don’t waste your money.)
Side Note #4: A year after my first drug test I received a bill from a laboratory saying I owed them $170. That’s when I found out I had to pay for those too! I am currently waiting for the bill of the most recent one.
Finally, the day came that I had a follow up with Dr. McHottie (back in November) and I couldn’t hold back the tears. I was in pain. So. Much. Pain. I was miserable. I was in a wonderful relationship and I couldn’t enjoy life because of the pain. Jason would have to help me out of bed. Think of the show “My 600lb life” except I’m only 130lbs. I couldn’t get up without help. I was crying all the time. I was mad. I was feeling sorry for myself. I am in my mid-30s and was worse off than most people double my age. Betty White could run circles around me! I just couldn’t sit there and act like I was OK anymore. He referred me to a French-Canadian Neurosurgeon in Greenville. (I don’t know why I mentioned French-Canadian… maybe because it sounds cool.)
Basically, I am told that because of my L5-S1 bone on bone blah blah blah blah… (at this point, I don’t even know anymore) there is only one thing that will fix what I have: a fusion. Great! Awesome! Let’s do it! However, because of my age they won’t do it. WTF!? Are you kidding me? If this is literally the only thing that will correct what is wrong with me than why the F#@K aren’t we scheduling a surgery date? Apparently, I would be back for another one in 10 years, and then another one, and by the time I am in my 50s I will have a bionic spine. But I was told that I would be a great candidate for the Spinal Cord Stimulator trial. He is going to refer me back to Dr. McHottie. Um, I mean, the Pain Manager. The last thing the neurosurgeon said to me was, “Oh by the way, keep working out because that’s the best thing you can do for yourself. Stay active.”
Thanks, mother fucker. Don’t you think that I want to stay active but it’s getting harder and harder to do so? But ok…. Thanks.
I didn’t actually say that…… out loud anyways. But I walked out feeling defeated and I started to cry again. I took the day off of work to travel an hour and half to a specialist, paid my co-pay and still had zero answers. And my bills kept coming in.
Back to the Pain Manager
We began the process for the Spinal Cord Stimulator trial. But the key here is that my insurance company has to approve that I am a candidate for the procedure. And, this is not a fix. It only masks the pain. And guess what!? I needed ANOTHER MRI. Not just ANY MRI will do. No, I needed a thoracic MRI. I also needed a psychological examination. Both were requirements for final approval. The trial would last for 5-7 days after the operation. I wouldn’t be able to shower that entire time. And I would need to keep record of my pain. If the implant gives me 70% or more pain relief during that trial period, I can have the permanent device put in which will require ANOTHER referral back to the neurosurgeon in Greenville (an hour and a half away).
Side Note #5: Have I mentioned that I have to use my leave in order to do all of this over the past 4 years?? Plus, as a single mom, I have to take leave for anything dealing with Landon. Yea….
Spinal Cord Stimulator Approved!
Good news… Mr. Insurance King in Texas must have been having a good day when my claim came across his desk because I was approved for the trial. Bad news….. I got billed the full amount for the psychological examination that was REQUIRED. I can’t win.
Side Note #6: I’m in the wrong business if I could charge $760 for an hours’ worth of psychological examination. If you’re reading this and want to go back to school…. Here ya go! This is the profession you need to explore.
At least I have a date for my trial in March. I’m still in pain every single day but I’m managing. Oh, and I have purchased reasonable shoes with comfort soles (who even am I anymore?) As for now, I continue making monthly minimum payments and when new bills arrive I add them to the pile. At this point, it’s comical to see how much medical debt I’ve accrued over the past 4 years.
Side Note #7: The only good thing about ObamaCare is that even if you only pay $25 a month, medical facilities HAVE to accept ANY kind of payment plan with zero interest. I have taken full advantage of that. My first MRI bill took over 2 years to pay. *insert evil laugh here*
When all this started, I decided to keep a log of when I make payments for medical bills/co-pays etc. So, let me put these last 4 years into perspective for you. Keep in mind this doesn’t include my yearly premium for health care coverage.
I might be broke, but at least I can say I’ve got my health……….