My son was refered to a pediatric GI specialist in January. Before we went I called the PPO phone number on my insurance card to be sure he was in network. I was assured that he was. So I take my son for his consult and resulting upper endoscopy. I pay my copay and think I’m good to go. Yesterday I get my explaination of benefits letter. The first thing I notice is that it says my copay is the out of network amount not the in network amount. The second thing is that my copay wasn’t even applied to the bill. The final and my favorite thing is that after they copay they will pay 55% fo the balance. This is my favorite because they pay 80% for in network and 60% for out of network so where the hell did 55% come from?

I understand that times are tough and everyone is trying to make a buck but son of a bitch! Our premiums go up every year, our coverage goes down and other than check ups for the kids and the rare illness we don’t use our coverage. I have the pleasure of paying for everyone else’s chronic illnesses but when the occasion comes that we need to use our coverage they try to bend us over like a two dollar whore.

I’m sure if I added up all our premiums paid versus what they actually pay out I’m sure they come out way ahead. We are over a barrel because should the unfortunate illness or injury happen and we were uninsured we would be completely and utterly donkey fucked.