If I had a gasket...Virginia in the underwriting department just blew it!
If I was pregnant...I would be in the hospital in pre-term labor!
If you could see my face...you'd be very, very scared!
I feel like my eyes grew springs and popped out of the socket!
I sympathize with my children because, right now, I would like to (for just this once) throw myself on the floor and scream at the top of my lungs!
Get it. I'm mad.
So why doesn't Virginia get it. I have been dealing with her for 3 months and I have, as our mother's would say: HAD IT UP TO HERE!
So let's go back and catch you all up on what led to this explosion. Chad started his own business in December thus putting us on our own for insurance. No big deal right.
Wrong. Chad has high cholesterol so individual insurance doesn't weight out in our favor. So we started going the business route. Only, it's now a new year. Last years taxes have to be done. Only...we got really tweaked this year but I'll spare you the details. So we needed a second opinion and an extension. So that's that.
Then we find out Costco has pretty decent insurance now. So we started the process. Then we find out there is no maternity coverage for me...so I have to drop out of what seems to be this never ending race to get insurance...all while praying along the way that no one gets hurt and my health holds up better than last year. So Chad and the kids are still on board. I start applying for individual insurance by myself since I am in great health. Despite last years freaky rashes (doctor's diagnosed as an allergic reaction) and my lump in my breast (scar tissue from nursing).
So, we wait. And wait. And wait.
"A few more days"..."we're very busy"..."something isn't filled out right" (but on our copy here at home is! urgh...and we faxed it so how was it any different!)..."we're very busy"...then "we just got your medical info from your doctor"..."we're busy"..."underwriting is reviewing your medical information" and the comment we were sick of hearing..."CALL BACK IN A FEW DAYS!" Seriously, I am going to rip someones head off!
So we go to the river. Come home and we have our letters. HALELUJAH!
Wrong, again. They raised Chad's premium for his high cholesterol...started the insurance without approving the new premium. But, oh well, at this point they are covered at that's what matters.
Then, drum roll please...my envelope. D-E-N-I-E-D! What? You've got to be kidding me. Denied. I'm healthy. And the reason..."Upon review of medical records." Did they misunderstand things? Thinking what happened last year was serious. Scary, yes. But, all checked out fine.
So for 2 1/2 weeks I have been trying to find out exactly why! I leave message after message. No call. Finally about a week later. A call...but of course I was at work with a message "call us back." So message. message....what someone answers. Fabulous. When I asked why I was denied I got this in return..."Oh we can't give that information over the phone, you'll have to email us."
So I email them. Followed with 3 follow up emails within 1 1/2 weeks...and no, not one response.
So I call the main underwriting department again. What is going on? They then tell me..."we can't disclose that information to you buy phone or email. You have to give us written consent to give it to your doctors who can give it to you." They say the reason...HIPAA. Really, because HIPAA is to protect ME! Only I should be able to get that information. So I say, "So you are telling me, I write you a letter...allowing you to send a letter with the reasons for denial to my doctor they in turn give to me." Since when are doctors in the middle of me finding out why I'm denied for insurance!
So I fax them the letter this morning. Conveniently, they didn't receive it. So we send it again. They get it this time now that I'm annoying and they say, "Ok, we will forward this on to the appropriate department and it will take at least a few days for processing." WHAT? Why couldn't I email it directly to that department! Can I have their phone number? But they tell me they don't have a number for that department. So, I throw a fit...and insist her supervisor calls me immediately (but she's not in, of course). I hang up...and there you have it...I've somehow BLOWN A GASKET I didn't know I had.
And I'm back at square one. No insurance. Wanting to get pregnant. And now needing to take my husband and my kids off their insurance because business insurance won't accept me alone! There goes my other gasket!
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6 comments:
Hang in there- insurance is a beast. If it is easy for you to get pregnant, maternity insurance might be a good route. We have a great guy that sells it here in UT, but I think he can get you covered in another state (did it for our friends in CO). Until then, down with the red tape!
We also have non-business insurance and it has a $5000 maternity deductible, so for our next baby we will be getting maternity insurance through Aflac. It's actually just a regular hospital indemnity policy, but you can get 4-5 policies starting at the same time for a total of about $100 a month and get paid about $5k when you stay in the hospital for delivery, more if you have a C-section.
oh my gosh, I am so sorry for the nightmare! When I worked in a medical office in Provo after BYU I dealt with insurance companies a lot...they are so useless...they cover nothing and charge a ton! I swear, there is no winning. And by the way, you know I totally would have yelled at that lady on the phone too...and demanded the supervisor...and upon them telling me she wasn't in, I would have called them liars and yelled at them for not having better hired help...but that's just me..the evil me! Love ya!
I FEEL YOUR PAIN!
Danny has been self employed our whole married life and the insurance thing has been a nightmare.
For the first time ever, we are without insurance cuz they kept raising the premium AND cuz we weren't quite prepared how expensive it would be to have Tyson when we raised our deductible to $2,500. It ended up costing more like $5,000 cuz he was born in March and we had to start our deductible at the beginning of the year all over.
I really feel your pain.
Have you tried Healthy Families for the kids? It's affordable health care for kids but you have to make under a certain income. I'm actually going to look into that. I think for once we qualify.
I've had the best luck in customer service at Blue Cross although they were the ones that kept raising their premium. I also have the number for this company that does insurance for small businesses. It's great insurance, the premium is based individually so with my big family it's hard to make that cost effective.
But we are in the process of finding insurance ourselves and Danny has high cholestoral so I'll let you know what I find out.
I hear you! I hate insurance too. I can't get covered either because I used fertility pills. PILLS! How stupid is that. I asked them to just not cover anything fertility and they said, "that's illegal". So...it's illegal to remove the fertility clause, but legal to deny me (otherwise perfectly healthy). What a joke! Here in Virginia they also have a way of getting around the pre-existing clause and will make you wait at least 6 months before getting pregnant even if you already had insurance (not a concern for me, but my sister is pretty angry about it). Our health insurance system is such a joke.
Good luck to you. I think the maternity coverage that Ashley and Steph talked about may be the best option. I feel your pain!
Good Grief!
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