Saturday, October 27, 2007

A Different Problem With Health Insurance

Okay, so I know a name like "Working Stiff" conjures up images of someone hunched over a desk working into the wee hours of the morning, but I promise, even if my posts seem to come out of left field, they are employment-related in some way.

Almost six years ago, I decided to get Lasik surgery. After talking to people who've had Lasik, I chose a doctor who had performed the surgery for someone I know. This surgeon was (and is) highly regarded, with an excellent reputation. Although he felt my corneas were on the thinner side, he was confident that the surgery would be successful.

After I got the Lasik, everything was great! I could see! No more glasses! No more contact lenses! Things were going great!

And then it happened...

A year ago, I was diagnosed with ectasia. Ectasia occurs when someone with a pre-existing condition called keratoconus has Lasik surgery. Keratoconus (and ectasia) causes your corneal tissue to start thinning out. This causes the curve of your eye to change from a spherical shape to more of a beer belly, and causes an astigmatism.

What really stunk for me, was the fact that the symptoms of ectasia usually start to appear within a year or two of having the surgery. However, being the unique person that I am, I didn't get symptoms until several years after my surgery!

Right now, I have rigid gas permeable contact lenses that are specially fitted to the shape of my eye. This seems to be solving the physical aspects of my problem so far, but overall, this condition is costing me a fortune!

When I first moved up here, there was a Kaiser facility really close to me. So, I went with a $1500 deductible plan. My monthly premiums were lower, and I was in good health. After I was diagnosed with ectasia, I had to start seeing specialists. Instead of the normal $30 co-pay, I had to pay a $95 co-pay per office visit. It hurt financially, but I understood it was more specialized care.

Recently, I've been getting medical bills totaling several hundred dollars for doctors' visits that I had several months ago. After looking through my plan, I discovered that I am responsible for ALL SPECIALTY CARE COSTS up to $1500 (the level of my deductible). Plus, unless I get additional vision coverage, none of the health plans cover the costs of glasses or contact lenses. Because I need to get specially-fitted lenses, that alone costs several hundred dollars, which DOES NOT apply towards the deductible.

I contacted Kaiser to see whether I could switch to a co-pay plan. The monthly premiums would be higher, but doctors visits will only cost be about $50.00. A person in Member Services was very nice, but said I would have to re-apply as a perspective member. Now that I have a preexisting condition, THAT'S going to be tough!

My point is this - even if your employer takes care of your healthcare coverage, READ ALL YOUR OPTIONS CAREFULLY! Even if you're in excellent health, if you have a deductible plan and there is ANY inkling that a health problem could get serious, see what you can do about changing to a co-pay before it's too late! Otherwise, you will be working until you drop!