Yesterday Annie had her two year well-baby (well-toddler?) visit with Dr. Looove. We’ve been preparing Annie for the last week for her visit by talking about the super awesome fun princess doctor who was going to tickle her and give her a princess shot! YAY. Annie was super-into it. She even practiced being the doctor.
It had been a while since Dr. Looove had seen Annie, and she couldn’t get over all her curls. I was like, “You should try detangling them, you’ll get over ’em real fast.” Annie did the typical little kid thing and clammed-up when Dr. Looove was in the room. No saying her name or counting or any of that. I should have shown Dr. Looove some videos. Anyway, everything checked out great, and all the measurements I took a few weeks ago were accurate. I think that basically makes me a doctor.
And then. Dr. Looove started talking about the vaccination Annie was due to have, and she looked down at Annie’s chart and said, “Uh oh. You have Blue Shield insurance?”
I haven’t said anything on here because I didn’t want to start BABY WATCH 2012!!! but I found a new insurer in Blue Shield – and they offer maternity. They accepted me and we started on the new plan December 15. And it turns out, on January 1st, Blue Shield and UCLA Medical Group parted ways. They have yet to come to an agreement on a new contract which means…it was basically like having NO insurance at Dr. Looove’s office. Do you know how much a vaccination and well-baby visit costs? I do, I do! Almost seven hundred dollars – THAT IS THE CASH DISCOUNT.
So that kind of put a damper on things.
Dr. Looove seems to think that UCLA and Blue Shield will work this contract malarkey out. Blue Shield let contracts with UCLA expire in 2006 for two months and in 2008 for four months. I really hope they come to an agreement soon, because literally all of my doctors are through UCLA. OB/GYN/Perinatology, Hematology, General Practitioner, Psychiatrist, Therapists, need I go on? The thought of finding new doctors and then filling them in on all of my medical and emotional history is exhausting. Do not want.
The timing is super hilarious. If I’d known UCLA and Blue Shield were going to part ways fifteen days after I became a new customer, I would have stayed on my former, less-expensive insurance plan. Dear Lords and Ladies of UCLA and Blue Shield: Please fix this. Kthanx.
So, does their “parting ways” basically mean you don’t have insurance? Because that? Would s-u-c-k.
And Heather? I’ve been on Baby Watch since *2010*. Ha! (;
No – I have insurance, but as it stands now if I want to use it, I have to go outside of the UCLA Health system.
Oh, no!! Hope they stop the nonsense soon!!
Just wondering why they (the office) didn’t catch this when you went in the office BEFORE seeing the doctor? Happened to me once with a dentist that didn’t take my insurance..and I let them do a root canal!
We were taken back as soon as we got there, so there wasn’t time before we saw the doc. One of the receptionists told me that they called to see if there were any out-of-network options. They love us there and I know they did all they could.
Heather, I just wanted to let you know a similar thing happened here in Michigan with Blue Cross Blue Shield. They “parted ways” with Beaumont Hospitals, one of the largest hospital systems in the area. They eventually worked it out, and all is well now. I think it was just both sides way of playing hard ball. Hopefully Dr. Looooove is correct, and yours too will work out. Good luck! C’mon baby!
My bigger question is why would a doctor visit and a vaccination cost $700? The visit was what? 20 minutes? Doctors aren’t gods…their time is not worth thousands per hour, no matter what anyone thinks. And most vaccinations have been around long enough that their cost shouldn’t be that high.
You probably know this, but the system is broken.
I am so sorry you had to experience that. We have been there also. What we didn’t know at the time, was that you can get vaccinations through your local health department and they are way less expensive. We had to do this for our first daughter. We continued to see our regular doctor and pay the full price but had all the vaccinations done through the health department and it cost us $10 a trip. I was a little nervous about having them done by the health department, but they had a great nurse and we were in and out so fast. I do hope your insurance and doctors can work out a new plan because I personally know how frustrating it is to have to deal with this. Best of luck!!
This happened to us last year when I was 7 month.Our Blue Cross Blue Sheild was not going to be accepted at the hospital we were to deliver at.They worked it out…I’m sure yours will too!
Meant to write…7 months pregnant!
Holy cow! I have a friend that moved to Canada with the State Dept. She took her kid to a Canadian Doctor (so not covered by her health insurance) for a sick visit. I cost her $40. Can you believe how cheap that was? Can you imagine what a foreigner would pay in the States for a sick visit with no insurance? Ridiculous!
OMG that sucks. I’m sorry. Hope they work it out.
Check with your insurance company to see if they will reimburse you what you paid out. I work for a hospital and there are a few companies in the area that provide insurance to their employees that is non-par with our hospital. The patient pays up front then sends a receipt to their insurance company for reimbursement. I hope they’ll be able to do that for you.
The front office staff should have informed you of that when you checked in since I’m sure you had to give them a new card seeing as it’s a new policy. At least then you would have had the option to reschedule or work something out.
We were taken back as soon as we got there, so there wasn’t time before we saw the doc. One of the receptionists told me that they called to see if there were any out-of-network options. They did give me a bunch of copies of everything and said that it should all count toward my deductible.
Okay – NO DISRESPECT but this whole insurance thing/pay for your own medical cost is what F-R-E-A-K-S me out about the states! I don’t know HOW you do it…the whole pay for your own medical care?! Honestly – if someone doesn’t have insurance & is struggling to pay their normal bills how can you possibily afford to pay a MASSIVE medical bill? Seriously, what happens in those cases? I feel sick for you guys! I know if that were mean in Heather’s shoes, there would be NO way I could afford to get my child the shots she needed.
Last month one of Canadian Skiers fell & hit her head on a hill in Park City Utah. Despite the efforts of all involved, Sarah Burke unfortunately passed away 9 days later. The day after her passing another blow came to her grieving family. Her hospital bill for just those 9 days was going to be OVER $200,000 & this would have to be paid for out of pocket!!! Talk about being overwhelmed!!! Thankfully a site was set up for donations & soon over $300,000 was raised. Thank God for that b/c honestly, I don’t know how this family could possibily pay such a large amount of money.
I can honestly say, if it wasn’t for how overwhelming & confusing I find your insurances seem & how much your medical costs, I would move my family to California in an instant to get my body into the warmth!!
Good luck Heather!! This is EXACTLY what you need right now!!! Uuugghh – I’m sorry – this sucks!!!
Thinking of you!!!
This won’t solve everything, but you should be able to get the vaccines she needs at your local health department for free or at least at a steep discount. They are super expensive at the doctor’s office without insurance (I speak from experience).
Well, the good thing is that we can find another doctor for any future vaccinations, assuming this isn’t ever worked out. She won’t need any more vaccinations until she’s four (other than a flu shot, which we can get for like $20 at the local CVS).
We were between insurances one month (job switch) and here in VA the state offers a discount (really almost free) on vaccines for the uninsured so our doctor just “signed us up” under that program (no paperwork for us — yea!). Not sure what the CA rules are, but worth looking into for your last visit. It ended us being cheaper to pay the visit out of pocket than pay Cobra for the month…
You’re right, Piperkc. That program is called Virginia Vaccines For Children (or VVFC). It’s wonderful for patient’s such as yourself.
She makes such a sweet doctor!
Good luck with the insurance thing… I am contemplating changing jobs, and this is one of my biggest worries (possible new job = different provider, might have to change all/most of our current crop of doctors. ACK!)
Sorry about the insurance. Hope they fix it very soon!
If your office didn’t notify you when you checked in, I bet they will work with you over the costs.
Definitely send in the bill details and see if you can get at least a partial reimbursement for your out of pockets costs.
As for the low cost / no cost vaccinations – most states are no longer allowing insured persons to take advantage of this – so check that first. In my home state if they find out you have insurance you can be charged with fraud…
Yes – one of the receptionists suggested that, and also said at the very least the visit should count toward our yearly deductible.
Ugh. I work for UCLA (transplant coordinator) and it is a big PITA. I’m hopeful they’ll work it out and you can stick with all your drs at UCLA.
ME TOO. UGH I can only imagine what a pain that is for you – especially dealing with continuity of care and all of that!
Meagan Brockington says:
I am sure your doctor’s office will work with you. Our doctor told me I could bring my newborn by to check her weight anytime. Well, when I called to schedule a time the receptionist said I had to bring her in for a visit. When I went in for the visit I told the doctor what happened and he said he would waive the fees for the visit since I really didn’t need to see a doctor and just wanted her weighed. I would call them and at least ask. All they can say is no.
I hope they work it out soon too – going to new doctors and having to explain everything is the worst! I think that Dr. Annie could convince them to play nice. Take care .
This happened to us in Northern California with Stanford and Anthem Blue Cross. I didn’t get my mammogram on time because of that. Although, Stanford took the high road and agreed to give everyone the contract prices while the negotiations were going on. After 4 months, they came to an agreement and it was retroactive. Hopefully the same will happen for you.
Seven Hundred Dollars for one well visit???!!!!!
Man alive, you pay for your wonderful weather in other ways don’t you?!
Our well visit with a vaccine or two is only about $200 and that is cash.
Oh I just cringe when I read articles like these. $700 for shots in the US for a 2 year old? Then my mind goes to I wonder how many children have to miss out on good health because it is way too expensive for some households to afford America’s rediculous health insurance rates and system! It is times like these I am very glad I live in BC and do not have to search or pay for a health insurance plan (not a necessity), and all of our son’s shots are and have been free. Canada believes every of it’s citizens should have the right to good health and we do at no cost! And I have to tell you if our system was any thing like yours our family would have a very difficult time with the insurance rates per our family, per our household, per month. We would miss out for sure!!
Wow. I don’t do well baby check ups, and I’m also in Canada, so I don’t have to worry about things like this. But that seems crazy for a few minutes of a doctor’s time. I remember when I got my new family doctor she was telling me how much she gets paid per patient visit–something like $60 for a 10 minute visit. No wonder our doctors move south.
In my line of work, I just heard about a new product for consumers. It’s called Kare360 and is from a company called The Karis Group. They are patient advocates. Their main business is with large companies, say your big employer provides you health insurance and this little service as a bonus. They’re just now moving into offering the product to individual consumers. As a customer, you get someone sort of like a case manager who will do almost anything for you related to your healthcare short of diagnosing you– even menial tasks like sorting your medical bills, etc., but most importantly they pick up the phone and negotiate with doctors/hospitals to get discounts on your medical bills and tango with your insurance company (like say your doctor claims he’s in-network but your insurance company says he’s not), as well as see if you qualify for any state/federal programs/charities/etc. Most often they’re able to negotiate cash patients’ bills down to insurance patients’ discounted prices and can usually find other discounts as well (they say they get discounts on 3 out of 4 bills and save on average 30-50%). It’s like $13 for an individual and $25 a month for a family. Sorry for the hard sell!!! I’m not sure if it fits your situation but I wanted to tell you about it! I JUST heard about them and am trying to get my mom signed up. She has MS and all the healthcare industry issues that go with it.
Really? They couldn’t have told you that ahead of time? The whole insurance nightmare is why I will probably allow myself to be shackled to this job/company the rest of my life. At leat I know what to expect. So sorry you are going through this. And just…OMFG.
Anthem Blue Cross (Express Scripts) just parted ways with Walgreens as well. Not as big a deal as what you’re going through with DR.’s and hospitals, etc….But I’m super lazy and I sure miss the drive-thru at Walgreens!
Literal weeks before insurance was extended to children up through the age of 26, my brother went to the ER for an eye problem. (Word of warning: do not wear your contacts for a.) weeks longer than you’re supposed to, and b.) to bed every night for two weeks). The bill was thousands of dollars. I don’t remember the exact amount, but it was mind-boggling for the services he’d received. Luckily, that hospital took a certain number of indigent cases every year, and accepted my brother as one because he was unemployed and could prove the lack of income. (Never mind the fact he lived with my parents…) Otherwise, I don’t know what he might have done.
It’s so sad to me that decent health care in this country is nearly unaffordable without insurance. And people think the current system is fully functional! Boggles the mind, it really does.
Well crap!! That stinks. I will keep my fingers crossed that they work out their disagreement sooner rather than later.
I too was wondering like another reader mentioned above, why this wasn’t brought to your attention before you saw the doctor? Seems like the front desk would have asked you at check in if there have been any inurance changes and could have let you know before the doctor did. Sorry you had to spend so much, that seems really high for a checkup and a few vaccinations that most health clinics admisnister for free. The cost of medical care if mind blowing.
Lynda M O says:
What can possibly cost $700 in a half hour visit with one shot ?~! That’s just insane… No wonder the divide between the insured and the uninsured is so wide. And the politicians wonder why there’s so much talk of a leveling of the ground over which we all must walk.
My insurance company and the Maternal Fetal Medicine group who I love, love, love and saw me though my twin pregnancy are no longer cooperating. It’s been going on for months, with no end in sight. It’s a nightmare. I paid for my First Trimester Screen out of pocket, and then drove to a very shady area in a different town to a hospital that does accept my insurance for the 20 week scan. I don’t know what I’m going to do once I hit 30 weeks and I’m supposed to have weekly Non-Stress Tests. Wishing you good luck with insurance and baby-making.
Holey Moley! $700? That is just wrong!! I often wonder what people with no medical insurance do when they need to see a doctor. It’s a sad situation that needs to be remedied. Imagine how many people don’t get the care they need because they can’t afford it. I’m sure your insurance will kick in before long, Heather.
I don’t have insurance and I HAVE to see a pain management doctor for chronic, debilitating headaches every two months and I am in so much debt because of it…The visits cost $150 and my “cash discount” is $80, which has been going on for about 8 months when I lost my insurance for turning 20 years old. As part of my contract I have to get random UAs. (Urine analysis) Those also cost me money. If the appointment goes on longer than 15 minutes, they charge me for two appointments, which all I am in there for is a prescription. I have to check my bill every month because a few times, they have double charged me because I cannot afford to pay them for the appointment up front. I love my doctor and his staff, they have allowed me to be a functional human being, and I am so grateful to have the option of seeing him and having access to a doctor. I have a patient assistance card from Johnson and Johnson for my preventative medication (Topamax) which is $780/month and the company gives it to me for free, and my county has a prescription discount card which discounts my pain medication down to $38.37 down from $380.00. I am so thankful.
What I am NOT thankful for, though is I am in debt to the tune of $7,000 at the last time I checked because I had procedures done to try and stop the headaches. When I had this done I did have insurance.
Heather, $700 for ONE vaccine, that’s how much my mom’s medication costs that’s 80 times more potent than morphine, so I hope Annie now has super powers. But in all seriousness, that is outrageous. I hope your insurance company will sort it out, and reimburse you.
Having worked for doctors before, I know that office staff cannot possibly keep up with changes in the MANY insurance plans that each of their patients have. While I totally empathize with this situation (we have a private plan that doesn’t cover vaxes, so that’s out of pocket for us!), it is ultimately the patient’s responsibility to be aware of the coverage & changes under their own plan. If there is a procedure or something requiring prior authorization going to be done, then staff will be calling to check coverage but other than that, it is up to each of us!
I truly hope this can be sorted out for you- not just regarding today, but so that you won’t have to switch doctors in the future.
survival and needs says:
Seems like the front desk would have asked you at check in if there have been any inurance changes and could have let you know before the doctor did.
We were taken back as soon as we got there, so there wasn’t time before we saw the doc. One of the receptionists told me that they called to see if there were any out-of-network options. They did give me a bunch of copies of everything and said that it should all count toward my deductible. Small victories, I guess.
Imagine if there was one insurance company and all the doctors were on it and you were always insured as long as you were alive. And it was free. It’s a crazy utopia called the rest of the developed world!!!
This insurance crap is ridiculously disgusting!
Allison Y. says:
Had to pay for my twins 5 year old well visit with about 5 vaccines each. Totaled $700 for both of them. UG.
Insurance crap is ridiculously disgusting!
Buying the t-shirt on this one. Katie’s reconstructive surgeon doesn’t accept our new insurance. The thought of having to find another one makes me ill. Fortunately, her neurosurgeon is covered and suggested that we just see him until either a) reconstructive guy changes his mind or b) we reach the point where a next step has to be taken.
And, of course, new insurance is fighting with Walgreens, so seven years worth of records, yeah, get to start all over with a new pharmacy. Finding a competent pharmacist is almost as hard as finding a good doctor. Argh!!!
YES! When we moved I was soooo sad to leave our pharmacist! I feel your pain.
Elizabeth :: Bébé Suisse says:
The American health care system is absolutely ridiculous. This is just one example. I don’t understand how fixing it is such a political issue – simplified plans and covered access to the doctors of one’s choice should be basic components of any system.
Elizabeth :: Bébé Suisse says:
One more thing – after moving to Switzerland, I was very impressed with the health care situation, especially in contrast to the American one. It’s not a public system like in England, for example, but for reasonable cost one can purchase very good basic coverage, at a range of prices for a range of different levels of deductibles each year, above which one pays 10% of the costs. All the companies offer the same basic coverage, and there are complementary plans available for those who want more coverage (for alternative medicine, osteopathy, etc.). The cost is the same for everybody (in each age group – child, adult, senior), no matter the person’s health history or perceived risk.
Oh – and everything pregnancy-related is entirely covered! A little incentive to women to reproduce in a country with a low birth-rate.
It really doesn’t have to be so difficult, USA.
Wow…I cannot believe one visit was $700. No wonder the insurance company doesn’t want to work with them!
I just pitched a fit because I have to pay nearly 20% more on my self=employed health insurance. To the the tune of 637/month up from 484. We get all preventable care covered. But can I just say “HFS, Batman!!! ” In NC, the vaccines for children are considered preventative, so free. And even then, the physical is not that damn high. Seems like highway robbery, plain and simple.
But can I at least offer you this: You do know that you can deduct medical expenses and once they exceed 7% of your income. And you can go back and amend any returns too, if you did not claim that…Just a thought. PS, I know a great CPA…
The thing that’s so craaaazy is how much an office visit can vary. At my old doctor, a check up was like, $100-200. At my new doctor, a check up (that granted, included bloodwork) cost $900! We have a VERY high deductible ($7k!) plan at the moment, which makes me think I have to find a new doctor. Again.
alternatives to waiting it out:
local care clinic like Walgreens or an urgen care center
negotiate your vaccine prices direct (what do you think insurance does)
if it’s a brand vaccine, see if the pharma company can pay or discount you via coupon