About six weeks ago, I lost one of my running shoes with one of my orthotics in it. When I finished college and started law school, I tried to continue running to decompress after a long day of what became useless classes. However, by December, I was having trouble walking. I went to a podiatrist who showed me that I had a neuroma, which basically meant that my nerves in my foot were much thicker than they should be. This was an injury I ran through in college with much pain, but it eventually caught up to me.
The doctor fitted me by using plaster casts for orthotics that cost over $500, which the receptionists assumed would not be covered by my health insurance since they were not mandatory. Luckily, the health insurance I had through Chicago-Kent paid for the device without me having to pay a cent. I wore them when I periodically ran and whenever I wore my running shoes. I had very few leg injuries that could have been caused by my lack of running. Nonetheless, I began running more often about a month ago and then lost the expensive pad. Ironically, it was the day I signed up for the Lakefront Marathon in Milwaukee that I realized the shoe had disappeared.
I called and made a new appointment for new orthotics so I can continue my marathon training. And again, they were not going to be covered by health insurance. About a week before they arrived, I got a bill from the doctor that asked me to remit $25 and that the expected $1230 that would be due afterwards would be expected from insurance. When I was at the appointment, I was quoted about $540 for the new pair of orthotics and did not like seeing this expensive bill sitting in the mail. I assumed that I would have to pay this when insurance turned me down again. In addition, I had called in between to inquire if insurance would be covering the bill. They told me no and I moved some money to pay the $540.
When I picked them up today, I was ready to pay the price but wanted to ask about the bill. I asked if insurance was covering this because of the bill I received. The receptionist said no. I charged the $560 that the orthotics cost and left. But I could not understand why if insurance covered the same orthotics that they would cost more than twice as much. I know this is something that goes on, but can anyone explain to me why? This cannot help any sort of health care reform if insurance companies get shafted to cover costs for people who don’t have them. If they cost $540, then the insurance company should be charged $540. All of this smoke and mirrors regarding prices doesn’t make anything easy for consumers, let alone people trying to fix a broken system.
This was a voluntary purchase of a device I need to run. I understand insurance not paying for it. But I would imagine they would be more willing to cover the cost of them if they only cost the company $540, instead of almost $1300. I don’t use my insurance often as I luckily am rather healthy. This situation just made me question how the medical industry works and wonders if the sick aren’t the only ones getting screwed by the system.
I haven’t heard one word of this in the health care debate and I like to believe that I am rather well-informed. If you have any knowledge why this happens, let me know or point me in the direction of information that would help me understand what is going on here.