Effing Health Insurance

Tonight, as Manager Dad went through an unpleasant cleansing ritual in preparation for a medical test (I will spare us all a retelling of the details) I decided to show some solidary to his discomfort by spending the evening reviewing our medical policy coverage.

After several hours, two broken pencils, and a splitting headache, the only thing I know for sure is that as mad as I thought our tax situation made me, it pales in comparison to the utter, impotent, quasi-homicidal rage that I feel toward Aetna U.S. Healthcare.

Eff.

Yes, I know – you’re thinking, ‘But you’re so lucky! More than 43 million Americans don’t have health insurance at all, so suck it up, you damn ingrate!’

But we still PAY for it, and I can't think of any other product you pay so much for, yet understand so little about. Insurance companies are the most inscrutible, incomprehensible lot around, and they seem to go out of their way to make sure that people don't have the slightest idea of what they're paying for. I have a Master's degree and an MBA (Ok, so the Masters is in advertising, so maybe that one doesn't count), and I STILL can't figure out exactly what my company’s health plan covers.

Those of you who have met me know that I am proudly anal-retentive. I have pre-printed grocery lists that are organized by store, by aisle, hanging on our fridge; items must be circled immediately when we run out or they are not purchased. I have Quicken, a top-of-the-line HP financial calculator, and a custom-built spreadsheet that tracks every cent that has ever come in or out of our family budget. I can tell you things like the out of pocket cost for my epidural (worth every penny) or how much we spent on Aunt Mary's 2002 Christmas present (too much, since she hated it anyway).

I spent hours with a magnifying glass, the benefits manuals, the aetna & merck-medco websites, and a variety of free web-based analyzers. I built a spreadsheet that I THOUGHT accounted for all costs, copays, and prescription fees. The spreadsheet was so detailed, so complicated, so hyper-linked, so formula-and-function-laden, it would make a University of Chicago economist weep in sheer, helpless awe, assuming (s)he could stand to look directly at it for more than thirty seconds before it seared his/her corneas.

Unfortunately, as my inappropriately hot high school math teacher once explained to me, it’s the inputs that matter.

I believe his exact words were “Shit in, shit out”.

So because of all of the shit that I THOUGHT I understood, I switched my family from Manager Dad’s health insurance to mine, mainly because I liked more of the doctors in my network. We pay slightly less per paycheck for my coverage. (Good). But I lost a $500 annual credit from my company that I was getting for NOT taking their health coverage. (Tolerable, because it was a wash when you factored in the lower premium costs).

Where the feathers really start to fly is that after I signed us up, they dropped my chosen method for the prevention of future Manager Kids from the approved medications list. (Bad). So now instead of paying a $10 copay, I pay $50 out of pocket per month. (Very bad). And while they cover Manager Dad’s extremely expensive, no-generic-substitute daily maintenance medication, I somehow didn’t realize that they only cover 20% of said medication’s cost, whereas they had covered 80% under our old policy. (Disaster).

And finally, I somehow managed to miss this little tidbit – that every family member has to meet a $300 deductible before I see one bloody dime from Aetna.

So the end result is we’ll pay thousands more out of pocket than if we’d just stayed with our old policy.

Manager Dad, a kind, patient man who is not type A like me (which is probably the reason our marriage has survived thus far), keeps telling me not to beat myself up for additional health care costs. But I am furious with myself, especially at the thought of the time I wasted trying to get us what I thought was a better deal. I will never get that chunk of my life back - I could have done something MEANINGFUL during the 36 hours between the receipt of our benefits manuals and the end of our open enrollment period besides develop a lasting eye-twitch and a dependency on legal stimulants.

A pox on those effers at Atena and their ‘manuals’. A double pox on my company’s HR staff and their lousy ‘benefit’. A triple-dog-dare, pre-existing condition, unqualified expense, non-HCRA reimbursable pox on them all.

Eff.