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November 14, 2008, 02:03 PM ET

If the Disease Doesn't Kill You the Fine Print Will

In preparation for cataract surgery on my left eye (the predicted consequence of retina surgery—which was successful!—that I had last March), I’ve just finished sorting through various medical records and insurance requirements in order to figure out how much this surgery is going to cost me. I had my folders laid out in front of me, I was online studying my insurance records and my insurance plan, and I was on the phone, at various points, with representatives from my health-insurance company and my “Flex Plan.” Quick, up-front advice: Before choosing an “out-of-network” option with health insurance, make sure you like paperwork.

Almost everybody claims not to like paperwork. I’m different. I love it. To me, the sense of accomplishment that results when one sorts through a mess of papers and then organizes that mess into neat little piles satisfies a profound, human need. (The preceding couple of sentences are lies, but I thought I’d try them out to see what lying in print looks like.)

I could have used a smart accountant to help me today. Instead, I was on my own, studying my flex-plan charges (I’ve now maxed out for the year with that) and my allowable insurance deductibles for in-network versus out-of-network charges (I have a plan that permits me to go out of network, which I am doing for this surgery). The little chart on the Web page of the insurance company organized everything into three columns. Column 1: “Initial Amount” (the amount of money I started with, differing according to in-network or out-of-network physicians); column 2: the “Applied Amount” (what the insurance company applied to my in-or-out of network deductibles); column 3: “Remaining Amount” (what the insurance company says I still have left before I have hit my maximum out-of-pocket costs for the year.

(I assume that anyone who tried to read the preceding paragraph is asleep by now, since I barely stayed awake while writing it.)

I actually like my insurance company. Really, I do. I’m now telling the truth. They have a nice, neat, friendly Web site, and their brochures (the ones that enticed me to sign up with them in the first place) picture people of many races looking mighty healthy while they yuk it up together.

After many phone calls with a lot of very friendly people who, judging from their accents, I surmised live somewhere in the South, and a lot of sorting through papers and staring at crisp charts on the insurance Web site, I finally decided I needed to make one final phone call, rephrasing my question.

“How much, exactly, is this operation going to cost me?” I asked. The person at the other end of the phone laid the answer on variables she couldn’t assess, telling me to figure out my deductible and my out-of-pocket maximum. (Duh. The problem lay in figuring out my deductible and my out-of-pocket maximum. Don’t these people get it?)

I hung up, twiddled my thumbs for a moment, and then, on a hunch, redialed. I tried the same question again with a different rep. This time a snappy youngish voice admitted that understanding these plans could be complicated (she was flattering me, but I loved it). The call lasted under a minute and I had my answer.

The irony is that in having to have surgery for a cataract, I’m currently living with an eyeball that can barely see. But while settling the issues surrounding the surgery that will make that eyeball able to see again, I’ve had to peer at the teeniest, tiniest print, both on and off the computer, mightily striving to decipher whether that blurry, blotchy thing I see is a 6 or an 8.

Modern life no longer punishes its victims by drawing and quartering them in the main plaza. Instead, it puts them at their kitchen tables, trying to make sense of health insurance plans.

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