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The Joys of Being ‘Covered’ by Insurance

My daughter broke her arm. We only had to pay $100 for the emergency room visit (they asked about our insurance before they asked about her condition). The doctor that tended to her in the emergency room was not an approved doctor by my insurance company so I had to find a doctor that was on the approved list.

After contacting an orthopedic doctor that my insurance company recommended, I had to contact my daughter’s primary care physician to get ‘approval’ to see the orthopedic doctor to care for my daughter’s broken arm. I had to prove that it was necessary for my daughter to see an orthopedic physician.

After explaining that we were in the emergency room for a fractured arm (back in the old days, it was called a broken arm) that was reset and put in a cast, I was ‘approved’.

Off to the orthopedic doctor’s office to the tune of $25 for the visit, which required additional X-Rays because they couldn’t access the x-rays that were taken in the emergency room (another $25 co-pay for the x-rays).

Each subsequent visit to the orthopedic doctor (weekly) required additional x-rays for which $25 co-pay was expected.

One month into her treatment, it was decided that she should undergo physical therapy, 3 times a week for 3 to 4 weeks to the tune of $25 co-pay per visit. By the way, the insurance company informed us that for as long as my daughter remains insured with them she only gets 90 physical therapy treatments for a broken right arm for the rest of her life. If she wants coverage for another broken arm, she will have to break her left arm. That’s good to know, isn’t it?

Let me see where was I, oh yeah. I was about to tally the savings because we have insurance.

Savings for Having Insurance

Emergency room: $100
Orthopedic Dr: $25
X-Rays $25/ visit = $100
Physical Therapy: $300
Approx Annual Insurance Premium: $6,000

We paid $6,000 out of pocket so that we can get away with a $525 broken arm. The sad part of all of this is that as a family, we generally spend more time in the Chiropractor’s office than we do in a medical doctor’s office. Our chiropractic visits are not covered. We’ve paid about as much in chiropractic visits as we have paid in insurance premiums.

Personally, I’d rather turn my insurance premiums over to my chiropractor, but my daughter’s broken arm made me realize that we pay $6,000 a year so we can get off easy for the occasional broken arm.

I’m trying not to sound too sarcastic, but just imagine how much we would have paid if we didn’t have insurance…

Gone are the days of the $5 co-pay!

About the author: Felicia A. Williams is a former insurance broker who is now a freelance writer.

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