I received one of those “not-a-bill” insurance statements the other day. They are supposed to be informative but are madly confusing. When they are five pages long, they are scary.

The last thing medical statements should do is make people feel sick. But that’s exactly how I felt as I anxiously pawed through the sheets, looking for the elusive bottom line: What was I going to owe for the blood tests, the routine visits, the diagnostic procedures?

It was not a bill today, but there would be a bill tomorrow. I wanted the bad news as soon as possible.

There are many boxes on a not-a-bill, and some of them contain codes that are meaningless to the layperson. I suppose they come in handy if you have to call and complain about a charge. Come to think of it, I did once get a bill lowered because it had been coded wrong.

I suppose some of the other information is helpful too, but it all seems to swim before my eyes. Where was I on Oct. 4? I had a five-page not-a-bill. I have been a busy patient.

Sometimes the provider of the medical service is someone recognizable. Sometimes it’s a puzzle that I don’t want to have to figure out. I only care about the results of a scan, not that some doctor in Lewiston analyzed it.


And, of course, how much it’s going to cost.

I’m lucky, for an American. I have decent health insurance. I appear to be — after five pages worth of medical pokes and prods — in good health. I know that even my autumnal wild ride through “Medicine Town” is not going to break the bank.

Still. I hate having to feverishly search through a not-a-bill to learn what I’m responsible for. There must be a better way.

I suppose I should blame myself for the over-the-top not-a-bill. I was between health care providers after my doctor retired a few years ago, so I let things slip. Finally, I pulled myself together, found a new primary care provider and had a physical. This, as it will, resulted in a flurry of routine blood tests and diagnostic scans.

Meanwhile, I asked for a couple of referrals. Once I had entered Medicine Town (where all streets lead to a different specialist), I figured I might as well  make the most of it. One of these referrals was to an allergist. I’d suddenly developed allergies to sesame and tree nuts five years ago. Exposure to them had resulted in anaphylactic shock, which is even more frightening than a five-page not-a-bill.

Sesame is a sneaky allergen. It’s not legally required to be listed on labels, and sometimes hides under different names. I am always vigilant, but it was surprising that some sesame hadn’t snuck in somewhere in the last few years. I wanted to be tested again.


My dental hygienist had also retired, and it took me a couple of years to get going again with a new one. And my advanced age means annual eye exams. There’s not a lot wrong with my eyes, but I still had to have a three-part exam that extended over two months. My impression was that part of this exam was needed to qualify me for continued treatment for dry eye syndrome, because obviously a doctor’s word is not enough.

I don’t regret the allergy test. It showed that I am no longer allergic to sesame. That’s a big relief. I am allergic to dust mites, grass and weed pollen and mold, which are hard to avoid, as well as almonds, which I love but can live without.

It’s just hard for me to wrap my head around the price tag. The information provided by this test is potentially lifesaving for me. Suppose I didn’t have health insurance? Or I just had a plan with a large deductible?

I feel guilty complaining too much because I know I’m lucky. Even with good insurance, a major illness can devastate families’ finances, and their emotional well-being along with it. That’s really the elephant in the room, the thing I fear more than the five-page not-a-bill. It’s that in all those tests there could be evidence that I’m seriously ill.

Is it weird that I know I could handle any illness, but I would totally freak out at the thought of going bankrupt?

My scrutiny of the not-a-bill assured me that day had not arrived yet. Indeed, when the actual bill arrived two days later, it clearly stated I owed something like $200. Most of it was for the allergy test.


I think that I may have a couple more charges coming my way, though I can’t be sure because I threw away the not-a-bill in frustration. But for now, I am trying to stay out of Medicine Town.

Visits there are not good for my blood pressure.


Liz Soares welcomes email at [email protected].

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