by Lucinda Davis

Created on: January 16, 2009

Nobody should have to worry about taking their sick child, parent or loved one to the hospital, but we do. I'm one of the "lucky" ones who has health insurance on myself provided by my job. My child is not covered and if he breaks a leg or gets a fever that could possibly be meningitis then I run the risk of paying that premium for taking him through those hospital doors.

I'll tell you about the "lucky" ones first. Those who HAVE. Most of those who have health insurance also have deductibles, copays and co-insurance. When I was younger I would not have understood all of that. I thought if you had health insurance you were all set. So you go to the hospital with your health insurance because of an emergency and hand them that all powerful card thinking you are covered. You can hear the angels sing as you hand them the card. About a month later you get what is called an "explanation of benefits". Many people get them and see "this is not a bill" or "you may or may not owe this balance" and think their bill is paid which leads to other issues. I'm here to tell you to read that paper and please be organized. You need to keep all medical bills, explanation of benefits, and other pertinent information in a file where you can easily find it even four or five years later. You'll thank me later. So, you read your explanation of benefits or (EOB) and find that the visit to the hospital was $4000 and the insurance applied $1000 to your deductible, they paid the "reasonable and customary fee" (whatever that is) we'll say $2000 and they had a "contractual write off" of $500. Which would leave you paying the $1000 deductible plus $500 copay. Then you get another EOB a few days later only to find out you have to pay the physician you saw a separate amount, the lab another amount and the radiologist another amount because they all are different medical providers. Then there are so many types of insurance policies the insurance could outright refuse to pay, or say that it's not a covered benefit, or say that it was a pre-existing condition. Insurance companies have all kinds of excuses for not paying. There's the untimely filing excuse, which means it didn't get billed to them quickly enough and it's too easy for them to "lose" paperwork. Insurance companies are in it to make money just remember that, they wouldn't be in business otherwise.

Now for those who HAVE NOT, lucky me I fall into both categories. Your child doesn't feel well, do you put off taking him/her to the doctor

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