Wednesday, March 21, 2012

Pros & Cons - Shriners vs. Private Insurance...

For those who don't know, five and a half years ago, our middle daughter, Robyn was born with bilateral club foot. We were in shock and we did the whole "why me/us?" guilt trip thing, then we got to work trying to get her feet corrected so that she would "not remember" the trauma, according to the Doctor, which is a BIG laugh, by the way, she remembers!
Anyway, initially, when Robyn was two weeks old, we thought, that since we had private insurance, why not get things taken care of right away. So, we did, with weekly trips to Boise, two hours away, with a screaming and sore baby. Then it tapered to twice a month trips, several series of casts on both feet then a series of braces, with three surgeries. We are at the end of our journey as far as the pain and the trips to the "big" city for Doctor visits goes.
We could have instead, waited for approval from the Shriners organization, driven four hours each way to Salt Lake City, and seen their Doctor's there, in their facility, and we might only be half way along in the process instead of at the end, but there is one main advantage to have gone with the Shriner's instead, and it all come down to the money involved, on our part that is.
Our travel time, and lost wages of course were not covered by insurance, neither were the necessary meals and stops for drinks, and the like. We also discovered, after the fact, that we could have "tried" to re-coup some of the travel costs, and the like on our taxes, "if" we could prove that the Doctor visits were the only reason we traveled two hours each way, which we couldn't have 100%. When you go that far from home, and there are stores you do not see near home, and family and friends that you do not see any other time, you make the most of your time.
Now, as I look back at the deductibles, co-pays, amounts not covered for some unexplained reasons, I second guess myself. I even did that today, when I reviewed the statement from only the hospital from Robyn's most recent surgery in December. Which by the way the total amount came to almost $14,000, of which $36.00 was deducted for the insurance's adjustment, then their "allowed" amount was shown as $9,600, then another $30.00 was taken off as another adjusted amount, of which the insurance paid exactly $4,739.10. Leaving me with the balance amount due of $4,800.07. I had to call them and make payment arrangements, obviously! I am going to be making what amounts to a vehicle payment each month, for the next 18 months.
If, we had waited and gone with Shriners, we would have still had to cover fuel costs, and for meals, and lodging, and for other incidentals, we would have lost wages too, plus we would not be finished with the process, and instead probably wading somewhere right in the middle of it with much more pain and suffering to go, but I would not be looking at another large payment each month coming out of already strapped budget.
Asking if I would do it the same all over again, more than likely, because there is nothing better than a happy and content child running, jumping and playing without pain and difficulties, but I would have probably done a little more research into better insurance.
We have told my daughter's Doctor the following more than once, "She loves you, she just doesn't know it yet!" And maybe one day I will feel the same way about our insurance company!

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