Thursday, May 26, 2011

good news and bad news(s)

The good news is that our pediatricians price estimate was off and the doc bands only cost $3800.00, not $4500.00.

The bad news is that doc bands cost 3800 dollars!!! And, that I got a call yesterday from the insurance lady and she said the two who did the evaluation and pictures of Garrett (who can almost always tell how long a baby will need), think that he will in fact need 2 bands. And, she talked to our insurance company. I won't bore you with everything she said, but she went over some numbers, total costs, max they cover IF we get approved, percentage they cover of that max, and a deductible that we pay. Bottom line, we're looking at a total cost of $7600.00 and IF we get approved for the MAXIMUM our insurance will cover, they will pay AT THE MOST, $700. Seven. Hundred. Dollars. (Not $700 of each band, $700 total. I asked.) After doing a little quick math, I think that leaves Paul and I with a MINIMUM out of pocket of $6900. Holy Shit. I try not to swear cause my mom, my aunt(s), a couple friends moms, and maybe a couple younger cousins read this. But shit is my favorite word. And yesterday I deserved a good, Holy Shit. And, because this treatment is elective, we pay the whole amount in full, and then when/if the insurance company decided to, they send us a teeny, tiny check directly.

I think the lady who called probably thought I was crazy and emotional, but I had been working on labeling my old blog posts, and the one I was on when she called was THIS one, the one about my uncle dying. And today is the 2 year anniversary of his death.

Thankfully, God put a lot of things on my heart and mind last night that reminded me of how blessed we really are. I guess I needed some perspective, and I got it.

From the moment I found out I was pregnant with Garrett, I always knew I'd do whatever it took to provide my kids with whatever they need. Garrett needs a doc band (or two), and now Paul and I are learning how to sacrifice and make things work so that we can do just that.

We wont starve and we wont be homeless, so I'm pretty sure we'll survive this. Not sure how at this moment, and if today someone came up to me and asked if I wanted seven thousand dollars I probably wouldn't say no. But we'll figure it out.


J,B and K said...

So, you probably know that my Kenlee needed a helmet, and the cost was $3800. We were going to have to pay 3300 of that, but since ours was considered an orthotic, and Obama changed it so that there is no longer an allowed limit on orthotics, we got money back a couple months ago. We ended up paying more like $900 instead. I don't know if yours has to be written as an elective or if it can be considered an orthotic...but maybe that would help!? I hope so. All being said, our little Kenlee has a perfectly round noggin now, so it is worth it. Good luck!!

Adrian said... you have a Shriners or children's hospital close by? I should know more since I work at Primary's, (unfortunately I don't know much about the billing end of it) but I know that these non profit facilities sometimes work with you better than other clinics/hospitals. Just a thought.

Heidi said...

I'm so sorry, Andrea. I hope that your friends' advice above helps you and you don't have to pay quite so much.

Melanie said...

Bummer - I knew most insurances didn't cover the cost, but I didn't know they were so pricey! If it makes you feel any better, I think those babies with helmets are super cute!