I've got fairly decent health insurance. But it seems like medical insurance companies always find some way to "scrooge" you.
Example 1: Company switched carriers, was promised that we would get identical coverage as previous plan. Months later after plan is in effect, start getting bills for hundreds of dollars for services that were previously covered. Ultimate conclusion: insurance company isn't going to honor their promise because the plan wasn't written the way they promised, and it was signed by the company. Of course, as an employee, I only know what my HR department tells me and shows me (and that can be a lot to read and try to double check!), and they don't seem to have any liability either.
Example 2: Start receiving bills for thousands of dollars after deductible has been met. After a lot of research into why, it turns out some providers are really slow getting their claims in after we prepaid them, and they owe us a lot of money. In the mean time, we get letters threatening collections that we must pay with money we don't have as the other provider is slow in getting it back to us.
Example 3: Health providers in generally requiring you to prepay up front, even when you are covered. I know someone who claims that he never has to do this and I shouldn't either, but I haven't found any provider (aside from ER or hospital stays) that doesn't require the money up front. We have literally had to rely on loans from friends that months later we haven't been able to pay back yet because the system is so slow to get everything pushed through.
Example 4: Have a recommended procedure done after a discussion with the doctor, only to find out months later that insurance won't pay a large part of the bill because the way the procedure is customarily coded doesn't match with your expectations and conversation with the doctor. And of course the billing office refuses to budge because they are already paid and have no skin in the game.
And of course in all these cases, it seems like the medical insurance companies and billing offices have almost IRS-like powers - they arbitrarily decide what you are going to pay, and you pretty much have no recourse. (And even if you did have legal recourse, with what money would you pursue it?)
This makes it very difficult to responsibly budget - even if you keep your budget, and save, one large unexpected bill, or the need to prepay something that insurance supposedly will cover, and you are very much in the red. Isn't a budget about deciding home much one will spend for each category, allocating funds to those categories, and then sticking to that? Obviously there are certain expectations with regards to health insurance - namely, that I will pay my premiums every month, and certain things will be covered. And then I won't have to worry about what I might or might not have to spend to stay in good health, because I have done the responsible thing and bought insurance. But the billing and service is so disconnected there appears to be no guarantee that this is ever the case!
This isn't a one-off question. This is regarding a problem that seems to recur time and after time, year after year, and which therefore must be planned for and if possible controlled. I have a hard time believing it is just perpetual bad luck!
How can one deal with this sort of issue? There are various approaches that seem somewhat shady or wrong to me (for instance, don't pay them and send your spouse to collections while maintaining your own good credit score), and others that are hardly acceptable (ruin your own credit rating or bankruptcy, which does nothing to solve the problem in the future, as some medical problems don't just go away, ever). Moving to another country that has single payer coverage is tempting, but impractical. Aside from continually alternating between feeling like I am drowning, and waiting for the next tidal wave to hit, how can I deal with medical billing issues that wreck the budget?
