Same Stink, Different Deductible


Oh, the insurance woes. Does it ever cease?

I believe I mentioned earlier this month how over the moon I was that we had met our deductible (thank you, Spanky, and your nasty little appendix). I figured it would be October before we met the $5500 deductible, and so the insurance plan wasn't working out so well for us. Then Spanky had surgery, and things got a lot better a lot quicker. Because once you meet your deductible, everything in network is covered 100%.

NOT SO MUCH.

A couple of weeks ago I went to fill 2 prescriptions. I needed them both desperately; there was no waiting around. It was okay; my deductible is met, so I didn't have to pay anything. Or so I thought.

When I drove around to the window, my friendly pharmacist said, "That'll be $284.98 please." I said, "Um, I've already met my deductible!" And frankly, I was a bit smug when I said it.

At that point, said pharmacist, who happened to be the same guy who at the end of last year couldn't tell me how much prescriptions cost until he charged me for them (isn't it beside the point then?), informed me that the pharmacy has no way of knowing if I've met my deductible. Basically, girlfriend, you're outta luck.

So I paid. And I cursed.

Come to find out, the wonderful insurance company lets us pay for the prescriptions, even after we've met our deductible, and then they reimburse us. And they reserve the right to take up to 30 days to do this.

Somehow that doesn't feel like "after you meet your deductible, you don't have to pay for anything out of pocket." I don't have $900 of fluff in my checking account...ever! ($900 is the monthly cost of prescriptions in our house.) Now I realize that they're reimbursing me, but a month is a long time, and I'm not quite sure they understand the meaning of "out of pocket."

I know people have it worse than me. I know people who do. I'm just tired of getting screwed by the insurance companies who look for ways out of their obligations. And on top of that, they keep raising their rates. I'm just thankful I got out of that business and got a real job.