Monday, November 27, 2006

Ah, Good ole' Health Insurance

I'm feeling pretty damned good these days. Energetic, not sick and not at all pregnant. Bad sign? Good sign? Lucky sign? I tend to question these things too much, I think.
My insurance seems to be rectified for now. Health insurance in this country is awful... for many reasons. My latest rant - computerized systems. Please tell me WHY my health insurance provider took 13 days to send my new card (the head quarters is approximately 3.5 miles from my home). But this is my rant.
Then tell me why it took an additional 11 days to then send me a letter that says I have 5 business days to declare all my "pre-existing conditions - excluding pregnancy". For all other ailments, I'll have a "6 month waiting period."
What? What? WHAT?
I had this insurance with my previous employer and I even paid cobra up until the new employer's health care kicked in. Before THAT, I had this health care provider under Rob's name. Before THAT, I had this health care provider under my name. And before THAT,... we were in NC with a sister insurance provider who transferred all my info... so I'd have no waiting periods. I've been covered for over 3 years +.
So when I get home after work on Friday to a letter like this (and I'm hormonal as hell), I loose it. Yes, yes, yes - it does say something about "excluding pregnancy" but contained within all that jargon, ... it really does not make you feel positive that pregnancy IS covered.
And besides, I haven't been to the doctor yet. According to MY calculations, we conceived in the last days of October. That's when I was under Cobra. Would this qualify as a pre-existing condition? Would it not be covered since it was under another policy? Ack! I go freaking nuts (yes, I am truly sorry Rob).
So, after my full blown melt-down Friday night... I called at 8AM this morning. Turns out I got the calmest man ever - he sounded like Denzel Washington. Thank God, too,... I man who didn't have his wits about him would have been slaughtered in my war path this morning. But his calm ultimately calmed me and we got to the bottom of it.
Turns out that this health insurance company - like many - uses computers. And somehow, despite the millions of dollars they rape from my paycheck, they still manage to not know how to use the said computers. They not only cover 10% of my needs at any given time (for a variety of pre-determined reasonings) but they also maintain 5% of my records. Its really silly considering they can pull up my file in a nano second and tell me WHY a particular procedure is not covered. But, damned if they can't find my paper trail of all the bills I've paid (let's see, 3 years would be about $14,400 in monthly bills - give or take. No kidding, we pay about $375 - $450 a month, do the math). They have a list of itemized reasons why something isn't covered or how much I still owe my doctor from a visit 3 months ago... but these guys can't see that on October 31 I had the same insurance through another company and switched on November 1. And the truly scary part, I told him my social security number, which, is also my policy number, and he found it no problem. What the fuck number was the guy using when he sent me that letter on Friday?

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