You don't ask, you don't get

I didn't label this a "Random Thought" because it does pertain somewhat to motherhood...at least becoming a mom has caused me to learn more about the health care industry than I ever knew before, and the more I learn the more I shake my head. Of course I'm no expert in this field, preferring instead to watch the weather outside, but when you receive a bill for some medical related expense just about every day in the mail (or so it seems), you're kinda forced to sit up and take notice about why your cash flow suddenly dries up....

Backing up a little bit, when we were in Virginia, my husband worked for a large company with pretty good health insurance options. Our premium per month was reasonable but not cheap, and I had great maternity coverage when I was pregnant with Jack. In fact I think from start to finish, including all the office visits, test, ultrasounds, hospital delivery with epidural, and post-natal checkups, we paid somewhere between $2oo to $300 all thanks to our insurance, even though in some sense we were paying for more of those costs through our premium every month (of which Bob's company paid a pretty good slice).

So fast forward to this baby, and things aren't so rosy for our pocketbook this time around. Bob works for a very small company now that does not offer health insurance. They do help with a Flexible Spending Account and a certain amount per month to help us cover the cost of our own individual insurance plan, but we don't have nearly the coverage with this plan that we did with the prior insurance plan. In fact we have NO maternity coverage at all, and cannot even use maternity expenses to meet our deductible. Bob said apparently most individual insurance plans in TX don't offer maternity coverage...I guess no one figured people in Texas might want to have children without having to shell out thousands to do so?

The one good thing (and in another way not so good) is that since we don't have coverage for all of these maternity bills, we can ask for a cash discount. As our realtor reminded us when we bought our house, "You don't ask, you don't get!" I can't tell you how much we've saved by doing this. For example...if we had maternity coverage, my last ultrasound would have been billed to our insurance company for $500. We were told this was amount we owed out of pocket. Since we asked for the discount, instead of paying $500, it ended up being somewhere closer to $200! Same thing with some of the standard testing I had done at the beginning of my pregnancy...we got 50% knocked off the bill because we were paying in cash.

So the "in another way not so good part" comes in when we started thinking about the discrepancy between what we've paid in cash and what would have been billed to an insurance company. In the case of the ultrasound, about $300! Either way, there was no difference in the level of service performed whether we paid for cash or had insurance, so why is the price jacked up over 100%? If the price for us was around $200, which was probably a better reflection of the true cost of the service anyway, why isn't that the price billed to the insurance company? No wonder insurance premiums are so high! Yeesh!!!

I'd like to say I'll step down off my soapboax now, but since this problem doesn't appear likely to go away anytime soon, I might be up here awhile...