I have health insurance through my employer. It is Blue Cross PPO and my co-pay for each doctor’s visit is $40. I chose to have this plan mainly so that I can have the neurologist I’ve had since I was 17- that’s when I was unexpectedly diagnosed with epilepsy. The 12 years I have knowingly lived with epilepsy have been arduous, but it is finally managed with medication and for the most part, I feel good.
Every time I go to the pharmacy to pick up my month’s supply of 60 pills, I am charged about $300 because my insurance doesn’t want me to have brand name pills. However, my neurologist tells me that the generic version of my medication is entirely different and I’m inclined to believe my neurologist over Blue Cross.
About 3 weeks ago, as I was walking to work, my legs suddenly stiffened and I was unable to move. Terrified I was having some sort of seizure, or worse, I made an appointment to see my neurologist. Puzzled, he told me it was not a seizure, but couldn’t diagnose the problem with my legs. He did muscle and reflex tests which all came back normal. He then tested my blood for everything one can think of- again, all normal. Next, my neurologist decided to order an MRI. He threw out words like tumor, just to prepare me. As I waited for the MRI to be scheduled, my legs worsened. I fell one morning on the way to work and broke my wrist. The second of 3 falls in 9 days. And another side effect of my epilepsy medication- osteopenia- didn’t help the fall.
Finally came the 3 hour long MRI of my brain, neck, chest and entire spinal cord. And guess what that test showed? I’m as beautiful on the inside as I am on the outside, as my mother likes to now tell everyone. My neurologist was pleased with the results, I was very frustrated. He is now sending me to a peripheral nerve specialist who might be better at diagnosing me. I should have an appointment in 2-3 weeks.
Yesterday, I received the bill for the x-ray of my wrist (the first one) for $85 and found out the MRI cost $11,800, of which I personally will have to pay $3,000. I realize that the PPO is not my only option, but it has been the best option for me for many years. Now, it may not be what’s right or realistic anymore.
Although I couldn’t be more pleased with the passage of health care reform and I’m blessed to have always grown up with a sense of awareness to be my own advocate, (it has clearly helped me in life and in my career) I shudder to know that if this is an option for me, what on earth do people living in poverty do? Or people who don’t have access to resources, let alone a job? Even with health reform, things need to continue to improve for us all.