about a dream: health insurance

Wednesday, January 7, 2009

health insurance

i've kept you all at least somewhat updated on my (often unsuccessful) quest to get the family health insurance for $1,000 a month or less. i was really excited to learn in august that the girls could get child health plus for $40 per month each. full coverage, no copays or coinsurance. hooray!

i submitted all of the paperwork in august. it was rejected 5 weeks later because the girls already had insurance. ok, apparently i needed to send a letter to the current insurance telling them to cancel the policy as of the day the new plan (child health plus) would hopefully become effective. then hope and pray all went according to plan and the girls didn't go a month or 2 with no insurance at all.

well, a few more bumps and phone calls on my part (and a lot of pushing. i can be pushy with these insurance people, it's a fine art), and the girls get coverage. we didn't actually get cards in the mail or notification that the girls were actually approved until mid-december, but the policy was active as of november 1.

ok, so the cards come, and the girls' primary care physicians are NOT dr. russo. i know this is a problem, because the new plan is an HMO, and seeing a dr who is not their PCP won't be covered. we had 3 or so visits to dr. russo between nov.1 and when i got the cards, so i wanted these covered (3 visits would run $500-$600). i call on thursday, december 18, and first they tell me that they can't make the PCP change retroactive to the 1st of nov. the lady tells me i didn't specify a PCP on the application. i tell her i'm pretty sure i did, and so she pulls up my application. sure enough, i did specify dr. russo. she tells me that they couldn't find her PCP #, and that they should have called or mailed me a letter telling me they were assigning a dr. since it was their mistake to not contact me, the change became retroactive.

well, when we got home from maine, there was a letter in the mail from BC/BS, informing me that they were going to assign the girls a PCP. the letter was dated nov. 19, but the postmark was december 18. that's right, they mailed a back-dated letter on the day i called them!

ultimately, this is meaningless, because all of the changes were made and bills paid in full. but the proof that they would lie like this makes me very unhappy. i'm tempted to write and let them know i'm on to their little scam, but as that would take time and not accomplish anything, i wont. however, i must say that i'm rather an expert at dealing with health insurance companies, and if anyone ever needs help getting bills paid (or rules bent), let me know.

hopefully this is the end of health insurance drama, but i highly doubt it.

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