Paying A Deductible You Don't Have

For those of you who haven’t been here for the hundred or so times I’ve mentioned it, I worked in insurance for around 5 years. Technically more than that. I did benefits. My company handled (outsourced) benefits for very large companies. AT&T, IBM, HP, GSK, Starbucks (every now and then), the list goes on. Working for companies like that you had to be on your A-game. Insurance, health reimbursement accounts, blah blah blah. – Long story short, we handled it. We were in charge of the wellbeing of these people.

I didn’t love the selling, but I did love the depth of it all. I genuinely enjoyed recommending plans. I enjoyed comparing various plan benefits, estimated out of pocket, deductibles, prescription costs, ect. It was even more interesting because it was Medicare. Highly regulated. Extra complicated. I could tear a plan apart and put it back together in 60 seconds flat if need be. I was pretty good at my job.

Paying A Deductible You Don't Have

The point of me saying all of that is to say this: I know benefits. I review benefits for fun. Everyday it was my job to stress to clients how important it was to not only know, but understand their benefits. I wasn’t just selling insurance. It was my job to educate my clients on how their Medicare and supplemental insurance works. Until they had an understanding of what they had and how it (all) worked together, I wasn’t able to enroll them into in a plan.

Knowing Your Medical Benefits

Last year I was scheduled for a sigmoidoscopy. Something that may sound intimidating to most, but for me it’ s pretty routine and regular. Normally a few days prior the (doctor’s) office runs my insurance and everything is prepped. They’ll call me with a time and confirmation. This particular time it was a little different.

I don’t remember the entire call, but at the end the rep asked me how I would like to pay. This was extremely odd to me because since being diagnosed with Ulcerative Colitis and working in corporate America, I’ve always chosen the most comprehensive plan my employer had available. I asked her a few questions for clarification. – That’s when she informed me I would have to pay *blank* amount because of my deductible.

Side Note: This is why it’s so important to advocate for yourself. It can be difficult and intimidating at first, but you must do what’s best for YOURSELF first.

After she told me how much my payment was I explained my (health insurance) plan doesn’t have a deductible and typically no out of pocket for procedures like this. She advised she’d give me a call back. – About 30 minutes later I get a call stating I was in-fact correct, my plan has no deductible and no out of pocket. This obviously did not come as a surprise to me, but I know it could have easily been a mistake that could cost someone else a pretty penny.

It’s so important to know your benefits and your rights. Especially as someone living with a chronic condition. We have much more at stake than your average “healthy” person.

 

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