Thursday, February 28, 2008

health insurance rant

I get pretty good health insurance from my employer, so I can't complain too much. We had no copay or deductibles when I started, but things have changed and that's the state of things these days; I don't expect too much, and am grateful for what I have.

Until they started trying to overcharge me for deductibles. I noticed late last year I was getting billed for deductibles that just didn't seem right. My supposed family deductible for the year was $200, and I found out I had been charged nearly twice that.

I put a call into Customer Disservice about two months ago, and the rep said she would look into it. I was sent an undecipherable log of claims and payments, which never once mentioned what my yearly deductible was.

Today I tried the messaging approach. I'm much better in email than I am on the phone. The first message I sent basically stated that, according to all the records I had access to online, I had been overcharged by nearly 100% for deductibles in 2007. The reply I received was:

"Your deductible for the year 2007 was $560.00. We sent you documents that showed you had not met that deductible."

Okay, I was starting to get irritated. The documents NEVER ONCE stated what my yearly deductible was! To cover my ass, I retrieved all the info I could online, which showed that no family member had received care at a clinic above cost level 2 in 2007, and that our family deductible was indeed $200, it said so right there on the Web site. Then I sent another message stating the facts.

I got a message later, saying they had "requested a resume" and if something was in error, I would be notified. I think in insurance language this means "unless you keep after us, this is not an issue."

And I know the argument they are trying to get by with. I had a stepson covered in 2006 at a clinic at a different level. They are trying to say that if he was covered even for a brief part of 2007, we would have to pay the higher deductible. But my policy clearly states that "the amount of the deductible will be determined by the highest cost level in which a family member incurs expenses"...Ahem...He did not incur expenses in 2007. Ever.

$200 is a lot of money to me and my family. I will certainly keep up with this, and I am getting annoyed at are what the insurance company's obvious efforts to tell me that I am wrong, they are right.


elise said...

I can sympathize since I recently got a doctors bill for my daughter's visit to the emergency room on July 4th 2004! While trying to straighten it out I was sent to a collection agency! It was a real nightmare! To make a long story short I didn't have to pay it only because the doctor was a participating doctor with my insurance. (contractually obligated to submit in a timely manner) If he wasn't, I would have had to pay a bill that was sent 3.5 years after the fact! Some of the phone calls I had to make were frustrating - especially to the collection agency!

Good luck!

elise said...

p.s. I wouldn't have mind paying my portion of the bill but since it was so late there was no chance that my insurance would cover any of it.

John Karavas said...

As an insurance agent who has to work w/ employees each year to help them arrive at a monthly health insurance cost contribution, I can assure you that a $200, $400 or $600 family deductilbe would be a "God Send" to many of them since they are selecting $2,000 to $5,000 family deductibles to keep their weekly cost down. I guess it is the old feeling bad about "having no shoes until you meet the man who has no feet" thing.

Deb said...

Elise- That would have been frustrating indeed! Glad you got things straightened out, but sorry you had to deal with a collection agency.

John- A $5000 deductible? Wow. I don't think we would have met that even this year, with higher than usual claims. Yes, I really have nothing to complain about. Actually, it irritates me to listen to my coworkers complain about our health plan, because it is pretty good.