Tuesday, July 15, 2008

Going for Broke

So it’s now been 10 months (give or take a couple of days) since the car crash. I still limp, and it’s quite possible I always will. All of the time and money put into physical therapy couldn’t bring me back to normal, but my doctor had told me as much from the very beginning. He said that I had sustained a “career ending injury.” Bummer.

But here’s the good news. The surgery and follow-up treatment (not to mention pre-surgery treatment) of my foot was enough to put me well over my “maximum out-of-pocket” (hereafter “max OOP”) insurance expenses for the year. In other words, I got jacked up enough that my insurance was eventually covering my expenses 100%. Of course, I had to reach my deductible and pay 20% of much that came after that, but eventually they were contractually obligated to take financial pity on me.

I’m bringing this up now because, a few months after my last physical therapy session, I have learned that a decent-sized reimbursement check is on its way back to me from the physical therapists. The physical therapists had made me pay my 20% up front, and it was only when I got my report from my insurance company that I realized my insurance should have been (and indeed was) covering the therapy at 100%. So, the 20% I had paid was unnecessary. Of course, the slowness with which these things get processed did not allow me to prevent shelling out the money in the first place, as I was unaware that I had met my max OOP.

Melanie and I consider ourselves quite fortunate. July and August are always a bit more financially straining, due to the fact that the previous year’s school loans have been depleted and nothing more is coming in until September-ish. It doesn’t help when you have unexpected medical bills as we did, all of which resulted from a car crash that happened on the same day we found out we were going to have another baby (which in turn brings more expenses). It also doesn’t help that we have to move to Tallahassee in a few weeks. Fortunately, because I am set up on school insurance, my insurance “year” goes from August to July, so my September 2007 surgery and my January 2008 (and beyond) physical therapy both worked toward the same deductible, OOP, etc. If we had been on traditional insurance, I probably would have had to meet my deductible again just a couple of months after meeting it in the first place. The only downside to our insurance is that Melanie and I have separate max OOP’s, so even though I reached the cap, Melanie did not. Otherwise, I guess we would have had a free baby! Shucks.

Lesson of the day – when you get injured, try to make it expensive. Try to sustain maximal harm, and try to do it as early in the year as possible (based on when your insurance considers the year to begin). You then needn’t worry about any more injuries occurring during the year, because if they do, you’ll be fixed up for free. And who doesn’t like to get things for free?


  1. You crack me up. Thanks for the advice, I will definitely take it to heart. And your maximum oops? That's hillarious... if I didn't question if that's what the insurance company calls it too... aren't they the silly SOBs? Or was it your own acronym?
    Anyway, it is sad you've sustained a career ending injury. I guess it's good you didn't become a football player eh?

  2. Hey Buddy! I miss you and hope all is going well. Keep my in mind if there is anything I can do for you. Not that there is but, just so you know you're in my 5!

  3. oh Ben, only you can take such a lighthearted approach to such oppressing concerns. God bless you!