I would totally vote yes for socialized medicine right now

We have health insurance through the Post Office where Paul works. For the most part the coverage is great, the cost of prescriptions is OK and the copay's don't break the bank...until now.

Apparently as far as the day to day healthcare needs go we are covered but not so much when it comes to a catastrophic event (their terms not mine). Since Bailey is being seen for outpatient care at the Sister Kenny Institute and they call themselves a hospital we have to pay the copay associated with a hospital visit. It is $75 per visit. Well if you look at her twice a week visits this would be $150 a week. A high number but one that could be handled with some fancy calculator dancing and penny pinching. Well, think again. The phrase "per visit" pertains not to each time we physically visit the hospital. It refers to each therapist she sees. So, given her current schedule of going to SKI twice a week and seeing 3 separate therapists each time they calculate these as 6 visits per week. Now, let's do that math again...

Six visits each week, each with a $75 copay. That's $450 per week for her therapy. Ouch.

I will give you a minute to digest that before I continue...

So, now we understand the cost, let's look at the actual coverage. Our policy covers 50 visits per year. Apparently this is pretty standard for any health insurance policy and not really surprising to the people at the clinic but to us it was rather shocking. We were told that Bailey would likely have outpatient therapy for a year or more. So if she is scheduled for six visits a week and is limited to 50 visits per calendar year we are really only getting coverage for about 9.5 weeks a year. Excuse my language but - WTF??

I have spent many hours on the phone with both the insurance company and the rehab facility and really haven't gotten any solid answers. The benefits books reads like the three disciplines are combined into one visit if they are done in the same day so that would mean she could go for 25 weeks but why then are they telling me that I have to pay a copay for each of the 3 disciplines? The folks at Blue Cross are telling me that it is counted different for billing purposes but for coverage purposes they are combined. How does this make any sense?

I have been referred to Social Security Disability to see if she would qualify for any assistance but everything I am ready seems like she isn't.

Any suggestions would be welcome!

Thanks for listening to my rant.