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annabel
Joined: 12 Jun 2006
Location: Daegu
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 Posted: Thu Apr 05, 2007 12:49 am Post subject: Korean insurance- what exactly does it cover? |
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My boyfriend has been having persistent headaches and numbness on the left side of his head and body, so we went to the hospital today to get it checked out. They said it's probably a migraine variant but wanted to take an MRI to rule out anything more serious, so we were about to do it when we found out it would cost W540,000! We were told that our health insurance (I think it's the 50/50 one most foreigners get) would only cover it if there ends up being anything wrong. If the MRI is clear then the insurance won't cover it. We would have to pay up front first and be reimbursed later if eligible for it.
Does this sound right? What is our health insurance supposed to cover anyway if it doesn't cover diagnostic tests? And whenever we go to the hospital here, are we always paying the full price up front and are expected to apply for reimbursement later? If that's the case I need to get my money back for a few hospital visits I've made in the past!
Thanks to anyone who can shed some light on this, we're really stressed out right now.... |
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maeil
Joined: 09 Jan 2006
Location: Haebangchon
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| Posted: Thu Apr 05, 2007 12:54 am Post subject: |
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| I remember a few weeks back (2 weeks?) reading a post about how doctors often try to push unnecessary expensive tests like MRI's. I don't honestly know anything about the procedure, about whether it's really necessary in this case etc, but I would be suspicious of paying so much up front. Can you go somewhere else to get a second opinion? |
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annabel
Joined: 12 Jun 2006
Location: Daegu
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| Posted: Thu Apr 05, 2007 4:10 am Post subject: |
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| This was his second opinion, the first was in Canada. He's been having the problem for a couple years now on and off, so he'd really like to have the MRI for his own peace of mind (mine too!). I'm thinking of suggesting he go to one more hospital here and see what happens... but I just can't believe the insurance wouldn't cover something like that. And I don't understand how the insurance actually works... what good is it if it doesn't cover stuff like this? We're paying W90,000 a month out of our paychecks to pay for medical insurance and right when we need it the most it doesn't do us any good... and what about the reimbursement part? Are we always supposed to get reimbursed- for the appointments/prescriptions too- and I just didn't know it before? Or does the hospital/clinic automatically deduct the insurance amount when they charge us at the reception desk? |
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bixlerscott
Joined: 27 Sep 2006
Location: Near Wonju, South Korea
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| Posted: Thu Apr 05, 2007 4:56 am Post subject: |
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| Run like the wind. Just say, NO, and walk out and seek second opinion. |
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chronicpride
Joined: 16 Jan 2003
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| Posted: Thu Apr 05, 2007 5:56 am Post subject: |
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| annabel wrote: |
| This was his second opinion, the first was in Canada. He's been having the problem for a couple years now on and off, so he'd really like to have the MRI for his own peace of mind (mine too!). I'm thinking of suggesting he go to one more hospital here and see what happens... but I just can't believe the insurance wouldn't cover something like that. And I don't understand how the insurance actually works... what good is it if it doesn't cover stuff like this? We're paying W90,000 a month out of our paychecks to pay for medical insurance and right when we need it the most it doesn't do us any good... and what about the reimbursement part? Are we always supposed to get reimbursed- for the appointments/prescriptions too- and I just didn't know it before? Or does the hospital/clinic automatically deduct the insurance amount when they charge us at the reception desk? |
That 540K is accurate. I was quoted that, and my neurologist was my friend of a friend who is a doctor in the same hospital, so I know it was on the level. I had a slew of similar health issues last fall and almost had an MRI. The doctors were actually advising against it in my case, as they felt that MRIs are a last resort test.
This may or may not apply to your BF, but how does he handle stress? All of my similar symptoms came on during a really stressful period. Headaches, sporadic muscle aches, numbness and tingling in limbs, etc...You say that he had similar episodes back in the West, which sounds like the symptoms are sporadic and possibly could be coming on from stress or even accumulated stress that has built up. As for me, I didn't feel particularly stressed out at that time, but acknowledge in hindsight that there was a lot of gradual stress build-up that began to manifest in some physical symptoms.
If you want to avoid the cost of an MRI, but want to do a much cheaper preliminary test that could determine if an MRI is definitely warranted, then ask the neurologist about taking an EPT (Evoked potential test). The test measures the patient's response to different stimulation, like light in your eyes, sound in your ears, etc...
If the test is negative, than it'll likely mean that it's stress-related or a disc problem in his neck or back or something. |
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annabel
Joined: 12 Jun 2006
Location: Daegu
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| Posted: Sun Apr 08, 2007 1:11 am Post subject: |
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Thanks everyone for your replies!
My BF actually had wanted the MRI because he was really worried and he knew it would be a definitive test... especially since he hit his head pretty hard soon before the symptoms first started a couple years ago. Having the Korean doctors suggest getting one just reinforced his own idea, he was going to ask for one anyways if they didn't suggest it first.
I was just amazed that our health insurance doesn't cover things like that-or anything I've had done myself in the past, for that matter it seems... I did find out that the money we pay every month for health insurance gives us the same insurance that all Koreans have. But I still don't know what that means or covers. If I find out I'll post it.
Anyhow, after being quoted the W540,000 for the MRI my BF decided to wait first and talk to his manager about it, and maybe try another hospital. The manager was exceptionally kind and helped us out, found us a clinic in Daegu that actually specializes in doing MRIs and so was much cheaper (about half price), drove us there, waited with us for hours, translated everything, drove us back to our house, and somehow got the price down even further for us- it's only going to end up costing us W150,000! We work for a university that usually leaves us take care of ourselves so the help was unexpected, but thank god for it 'cause we were getting really stressed out!
The MRI was clear and only showed some kind of sinusitis that he can get taken care of at any ENT clinic. They thought the numbness and headache problems were a result of his slightly high blood pressure and, yes, built up stress (not mental but physical and environmental stress)... and the temperature changes/yellow dust isn't helping anyone either...
Just thought I'd post the rest of what happened in case it can help someone else out sometime. |
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