August 2, 2007

Insurance–the fun times!

Posted in The musings of Erin at 3:29 pm by Erin

I hate dealing with insurance companies.  I have reason to hate them.  When P was born, I immediately (OK, a few hours later) called the insurance company to find out about adding him onto my policy.  The woman said that I should go online and add him for the next semester’s policy and he’d be covered.  She implied that he was covered under my policy for the first 30 days, to the point where I flat-out asked if I needed to pay anything until the next semester and she said no.  P was back in the hospital frequently for bilirubin checks for the first week of his life, had home uv lights, and went to the pediatrician several times after he was born, so there were quite a few bills.  They started coming in right after the spring semester coverage started.  Imagine my surprise when the insurance company claimed that I hadn’t added him during the correct time and they wouldn’t cover anything after he left the hospital.  After many, many tears (keep in mind that within the previous three months, we’d bought a house and J had quit his job as a lawyer and started his own law firm, meaning the only real salary was mine–as a graduate student) and frustrating conversations with them, I ended one by blowing up and saying "My husband’s a lawyer and I’ll just let him deal with this!"  I was shocked when they immediately started covering the bills.  Seriously.  I hadn’t said it to scare them into it or anything.  I was just so frustrated that I wasn’t going to deal with it anymore on my own.

Oh, but there’s more!  During my pregnancy with P, my grad school switched insurance companies.  I was assured that the new company would continue to cover the pregnancy and birth, which they did.  However, my OB’s office bills pregnancies as a single global charge at the end of the pregnancy, covering all prenatal visits and monitoring, as well as the doctor’s fees during the birth.  The new insurance company refused to pay, (rightly) claiming that they weren’t my insurance company from April through mid-August and didn’t want to pay for charges stemming from that time.  The old insurance company said, "Sure we’ll pay for those months.  Have the office send us a date for each appointment and a charge, and we’ll pay our portion."  Seems easy, right?  All the OB’s office had to do was break down the pregnancy by date and specific charge for each date.  After TWO AND A HALF YEARS of dealing with the mess, and J doing some fancy lawyering tricks when they tried to put it on my credit report, it was finally taken care of.

(You may get the idea from this post that having a lawyer in the house is useful.  It is.)

To be fair, that one wasn’t the fault of either insurance company…my OB’s office couldn’t get their act together.  But I still spent an inordinate amount of time on the phone with them.

As a semester-to-semester contract employee of my college, I have no insurance coverage through the college over the summers when I’m not teaching.  I have access to it–we can sign up for COBRA benefits–but we would be paying the entire $850 a month for the cost of a family plan.  As I can sign up for it and have it retroactively cover us from the last date of coverage on, we decided not to sign up unless we needed it (i.e. someone broke a leg or something).  Reasoning: if we needed it, we could get it and pay the $1700 for the two months.  We had saved the money in the bank specifically for it, so that wasn’t the issue.  But if we didn’t need it, we could save the $1700.  Happily, we didn’t need it.  We are generally very healthy people, infertility excepted.

My fall semester insurance began again on August 1st, so I called today to get refills on my migraine medicine and my birth control pills.  I’ve been out of migraine meds for several weeks (only suffered through one, luckily) and my BCP run out this coming Saturday.  CVS called me a few minutes later to say that my insurance coverage had been terminated; did I still want the prescriptions?  I explained that yes, it was terminated but should have picked back up the day before.  I called the insurance company and discovered that HR at my college had never submitted the paperwork to get us going again.  I called HR, where I was given an apology and a promise to take care of it and call me as soon as it was done.  They called an hour later to let me know it was done.

5 hours later, I called CVS again.  Nope, still no insurance coverage.  So I called the insurance company again.  It can take 24-48 hours to get the coverage started again.  They helpfully said that I can get the prescriptions filled and submit a reimbursement form, if I’d like.

Migraine meds (for nine pills): $240+

Birth control pills (the three-month version): $140+

Total: almost $400

Do I want to pay that now and get reimbursed in 4-6 weeks?  I don’t think so.

I told J that if it’s not done before we leave for vacation with my family on Saturday, I’ll just skip a week of BCP and go back on them next weekend.  I added "But I could get pregnant, so we’ll have to abstain."

Then we had a hearty laugh.

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8 Comments »

  1. Tom said,

    Ugh, whenever it comes down to insurance, you might as well take the day off and prepare yourself to get everything situated. Stupid insurance companies.

  2. My Reality said,

    Insurance companies suck.

  3. Samantha said,

    I think most everything having to do with medical world sucks. The less interaction with it the better.

  4. lucky#2 said,

    I hate, hate, hate insurance with a passion; yet, without it, we would have our daughter. The double edged sword.

  5. Jesspond said,

    I’m an insurance AGENT and I’LL even say that insurance companies (mostly health insurance) suck.
    Hard.
    Hard sucking.

  6. Mel said,

    Seriously, I need to get one of those lawyer guys in my house 🙂 The non-profit life just isn’t getting us anywhere.
    You probably need more migraine meds now just for having to deal with that.
    I’m here with the margarita and a huge hug. I wish things moved faster with Ethiopia, but make this Channukkah the most kick-ass Channukkah ever.

  7. Jitters said,

    Argh.. Insurance sucks. They stopped paying for my infertility meds half way through treatment – no one knew the reason and apparently they should not have been paying for them at all according to a snotty phone rep.

  8. Blondie said,

    We have just joined a health insurance group and I am preparing myself for future unslaught of trouble…
    Good luck with it all.
    PS. I tagged you if you feel like joining in. See my blog for details.


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