Never Give Up, Never Surrender!

It turns out I have quite a developed opinion regarding insurance. I think this is probably the case for most people who have encountered an expensive illness.

I thought I'd explain my philosophy so people might see why I'm so adamant about getting the in-network exception for the rest of my reconstruction reinstated.

There is only one number I care about in regards to my health insurance--the maximum out of pocket my family has to spend. It's a sure bet we'll meet it this year, as we have every year since I've gotten the bc diagnosis.

This amount is several thousand dollars--roughly the cost of a Hawaiian vacation for my husband and me.

We're happy to have coverage and happy to pay what we owe on time. But I will not pay one dime more.

In appealling this latest goofiness, I have heard too many times that I can just use our out of network benefits to finish up the work. This would trigger a whole new limit, and would mean we would pay 20% instead of 10% and there would be no caps for reasonable and customary charges--so basically, sky's the limit in addition to the in-network maximum that we will still meet.

There is no way I am going to have my family pay for two tropical vacations in one year that we will never take.

If there is not a local doctor who performs the service, our insurance allows for using a doctor who does the work and will cover that at the in-network benefit level even if they are not in-network.

Almost all plastic surgeons who do a lot of DIEPs don't contract with insurance companies as a general rule, and there is no local doctor who can do a DIEP, so getting an in-network exception is the way I have to go.

And I won't give up.