Friday, August 21, 2009

Health Care Stories: Melbourne, FL

Ian wants you to hear him out on his comparison between US and Costa Rican care.

Recently, I underwent a full hearing test. If you've never been through a comprehensive hearing examination, it's about an hour or so of sitting in a soundproof room wearing headphones and reacting to a variety of sounds and challenges, as directed by a technician who is sitting outside the room, talking into a microphone that feeds directly into your headphones.

My particular examination had five components -- five different types of tests that were run. I had to indicate when I heard specific pitches, repeat words that were spoken over white noise, and so on. I completed the test, took care of the $30 co-pay, then went home.

A few weeks later, I got a call from the doctor's office. Blue Cross/Blue Shield was only paying for one of the five tests, since my plan only covers a single hearing test a year, leaving me on the hook for a couple hundred dollars.

Needless to say, this resulted in a typically frustrating back-and-forth dance between BC/BS and the doctor's office. The people in charge of billing at the doctor's office said that this is how they always file these tests -- as a single claim with five specific line items -- and haven't run into this issue before. Blue Cross/Blue Shield insisted that the claim they received counted as five hearing tests, and they would only pay for one (the cheapest one, natch).

After fifteen minutes of getting nowhere with "David" on the BC/BS side, I took the matter up with the Insurance Commissioner here in Florida. A couple of web forms later, my claim was filed. Three weeks later, I got a form letter stating that the case had been decided in my favor.

So far, this is an open-and-shut case of general insurance company corner-cutting. Fortunately, at least in Florida, the process for dealing with this is straightforward and can be done from the convenience of your own desk.

A week later I traveled to Costa Rica (my native land) to visit family and vacation in general. Wanting a second opinion, I scheduled another hearing examination. Costa Rica has had nationalized medicine since forever, but since I'm not paying into the system, I was responsible for any and all costs.

The process was identical to the one in the US -- the soundproof room, the headphones, the technician on the other side speaking into a microphone (in Spanish in this case). And like in the US, when I was done, I had to pay $30. That was the full price of the examination -- not the co-pay. A quick look at airfares yields the fact that it would have cost about the same for me to fly to Costa Rica and have my exam done there as it would to get the same test done in the US without insurance.

I'm not sure what this means in the bigger picture, other than something doesn't add up somewhere.

Melbourne, Florida

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jadedj said...

Yes indeed. And there is more to this...for me though. I too have a hearing loss, in the high frequency area. I can hear, but if there is extraneous noise, I can't distinguish certain words, particularly when spoken by females. I never can hear beepers, or timers. Never. This can be corrected with hearing the tune of about $6,000. I too have BCBS, but no insurance company in this country will pay for hearing aids. However, if I were on Medicaid, you know, the SOCIALIST medical plan in America. The hearing aids would cost zilch.

So, I can not understand why some people would not scream and holler about military budgets, and yet yell socialism every time we try to get a national health plan through congress. Ridiculous

Ariela said...

Thank you for the reality check. I bitch and moan about our health care system (Costa Rica's) so often, that I forget how good we really have it. Love you.

Utah Savage said...

I sent my healthcare story. I hope you got it. If not let me know and I'll send it again. said...


Glad to hear of your success. Wish I could move to Costa Rica. As it stands, exiled in Orlando while family lives in Indian Harbour Beach est of Melbourne.