Bike versus car: bills, bills, bills

Whenever most Europeans hear the words "America" and "health care" in one sentence, they'll most likely add "trouble" in their heads. Funnily enough, although we spend a lot of time talking about health care, no one in my circle of friends and family has experienced those three things simultaneously. In fact, most of us are happily (if not expensively) insured, and in those few cases where people aren't, one usually doesn't hear a whole lot about it.

Now that didn't mean that when I lost my bike v. car battle, I didn't worry just a little. After all, although Tricare has been incredibly fair and helpful over the years, this was America, and who knows what kind of fine print Tricare had hidden away somewhere that would preclude health care for people dumb enough to ride their bikes on Georgia roads. And even though husband-dear told me that I would be fine, and Tricare would cover the ambulance ride, the care I got in the ER, and pretty much everything else, I wasn't so sure. I asked around about other people's experiences, and heard all sorts of horror stories. From insurance companies refusing to pay because the expenses were the result of an accident, leaving the person to battle with the other party's auto insurance, to insurance companies promising they would pay, not following through and not telling their customer about this, leaving them to deal with charming collection agencies, to auto insurance companies refusing to reimburse the victim's health insurance, which led to all levels of bureaucratic hell.

But after having followed the required "call your PCM within 24 hours after having received emergency care", I decided there was little I could do about anything, and let it go. No, really, I did. I was too busy pondering the future of my tri-career to worry about pesky little things such as medical bills. I know, I know, thousands of people go bankrupt over medical expenses every year, and I'm more concerned about whether or not I'll be able to beat my 6:26 half-iron record next year.

Anyway, until the EMS bill came in, that is. A grand total of $500 for a ten-minute ride. Since I was expecting an amount closer to a thousand, the amount itself didn't do much for me (except lead to a whole lot of speculation about why Georgia ambulance rides are so cheap). The fact that I was receiving a bill in the first place was, however, a lot more alarming. Although I don't know about other, possibly fancier, health insurance companies, I do know that when you're with Tricare, you don't usually see a bill. Unless someone screwed up, in which case you're in for a lot of lengthy and potentially blood-pressure increasing phone calls. And that was the last thing I was looking forward to. Since the bill had the ominous "You are responsible for making sure your insurance company pays this bill, and will be responsible for any late payments" warning on it, you can imagine that I had immediately determined that Tricare would forget to pay, and I would end up owing the EMS company thousands and thousands of dollars in fees and interest, and would end up going bankrupt.

What can I say? I have a very creative mind.

Anyway, the bill came in on Thursday night, and that week was a particularly busy one for me. So busy, in fact, that I forgot to call the EMS company or Tricare, and when I remembered the bill on Sunday night, I was so worn out, the prospect of bankruptcy and financial ruin just didn't do it for me anymore. Of course, how these things work is that the Tricare notification of payment came in the next day. They had in fact, in a burst of efficiency, paid all of my bills: the EMS, the ER, the pharmacy, everything. It was awesome.

But not as awesome as seeing what Tricare actually paid. For those of you not familiar with Tricare, it's basically a government-run program (which makes the notion of military members opposing universal government-regulated health care a contradiction to say the least, but I digress), which means that if you go to an off-base facility where the patients will be charged, they like to control what something costs. Although they cover almost everything (well, except IVF...yeah, I know, very ironic), that doesn't mean they'll pay full price for it. Your doctor may charge you $100 for a test, but if Tricare will not pay more than $50 for that test (they like to call this the "approved amount"), then that is what the doctor will get. And to prevent doctors from rolling the remaining amount over onto the patient, Tricare also lets the doctor know what they're allowed to charge the patient. So even though I thought that the $500 for my ambulance ride was reasonable, Tricare apparently didn't think so. The amount they paid? $114. Yes, that would be a little over a hundred dollars. Call me strange, but I almost feel bad for the EMS company. With all the military folk and their dependents around here, there's no way they're even close to breaking even with amounts like that.

After about five minutes, however, that sense of guilt disappeared, as I realized that my bills had been paid, and the fight about who would pay for what was off my plate. People have been telling me I should call the driver's auto insurance company and demand a settlement for pain and suffering, but you know what, I'm not going to. Personally, I'm just happy to know that all this has been taken care of. And for all those times during baby-gate that I cussed out Tricare for not paying a single dime? I'm sorry about that Yeah, nope, still not cool with that. Sorry.