Insurance and patient care – VENT

Me doing the “no thank you arms crossed” emoji. 🙅🏻‍♀️

Hi! I try really hard to stay positive but I’ve been pondering this since my husband was injured in November, he cut his finger badly working on our house. We had a trip to the ER, and concurrently, 2 surgeries and LOTS of doctor’s visits. Thankfully he’s doing better and we’re VERY grateful to his doctor down in Solvang – for taking good care of him. We have insurance, albeit with a high deductible, as we are both self-employed. We pay a fortune for it and this is really the first time we’ve met our deductible in our whole married life – 21 years. Our mailbox has been bombarded with bills, explanation of benefits, statements, etc. The total bill for his care is easily $30,000. How much did we pay? About 5k. How much did insurance pay? About $300. Sounds like a good deal right? No! That means the doctor’s office wrote off the remaining $25,000. Do I feel the doctors, the emergency room, the nurses deserved to be paid? YES! But the point is, why is so much written off?? Is medical care being overpriced so doctors can eek the most from insurance companies, to whom we’ve paid over $150,000 (AT LEAST!) in our married life – and never once filed a claim that actually met our deductible until now?

You might ask, you had children right? Welp, for our first – we were lucky enough that my husband was an employee for a large company, and we had a plan that covered a hospital birth. For our second, I actually looked into home birth because our cost for the hospital was gonna be $15,000. I ended up having a home birth with an amazing midwife for $3,000 and it was the best experience of my life…but still.

My point in bringing it up for my business is this: accepting insurance compromises patient care. I get asked every day if I take insurance, I don’t mind the question and I know it is imperative in the system we are in. BUT, if I did take insurance, I would have to mark up my prices, many of my frames are from Europe and aren’t inexpensive to get here. I try my hardest to offer the HIGHEST quality, the best service, a piece of my heart really – at the best value, to make sure I have the time to listen to your concerns, to make sure we find the best frames for your face, offer the best quality lenses and follow up to make sure all is well. If I took insurance, do you know what I’d have to do? Spend hours on the phone every week to find out benefits, argue with them about denials, send you bills for what they didn’t cover. I’ve been an optician for 24 years. I’ve taken insurance through the doctors I’ve worked for the whole time. In opening my business, I knew I wanted to do it differently.

If I felt insurance was truly fair and had your best health and vision in mind, would I take it? Yes! But do they? NO! They are a for-profit company and have actually bought out frame companies, doctors, lens companies, so they can get you in the cheapest quality products and make the most money.

Would I rather spend time with you? Helping you be the most comfortable, look your best, see your best, learning about you as a human – than on the phone with insurance companies? HECK YES! I love helping you. It truly is my passion.

Do I think there are people out there that care and try to offer the best care WITH insurance? YES, my husband received excellent care, but I personally know how challenging this is. Doctors need to see as many people as possible in the shortest amount of time. And as I get busier in my shop and have to prioritize my time, my priority is YOU and offering the best products, the highest care at the best value.

I will fill out your claims to submit for out of network benefits happily, I’ve gotten quite fast at it and want you to get as much money as you can for the insurance you are paying for.

Steps off soap box. Thanks for reading. I really do care about you and your insurance! But wanted to explain a bit more.

In other news, the Atascadero Chamber is offering a Shop Local incentive through the month of March. For each $100 spent locally, you can pick a $20 gift card to a local business and spread the love even further! Click this link to find out more.

Local artist Michelle L. Watson helped me with my window display, we joined the downtown community in displaying over 4000 hearts in camaraderie and gratitude for our community! Check ours out in the window on Traffic Way by Central Coast Distillery. Heart Eyes – all the way!