Insurance Shminsurance

I think I would have better luck if I simply put all the money I pay towards premiums into a sock and then paid cash for Doctor visits and services.

After Susannah was born I called our insurance company and spoke with a customer service rep. (hereby called "lady #1"). I told her I'd just had a baby and needed to add her to my policy. I didn't know what all I needed to do so I asked the lady "What do I need to do to have her covered?" The lady said "send a fax requesting Susannah to be added to your policy." So I did.

After her next Dr. visit I received one of those nice "explanation of benefits" informing me that her well visit isn't covered under my policy. What!??! I called the Dr's office and they said that all her "sick" visits (weight checks) had been covered but her well visit had not. Weird. I don't like the sound of this. Not to mention that at her 8 week visit she'll get some shots and that Dr. visit will cost me $500-some if insurance won't cover it. YIKES!!

I call the insurance office. I speak with a different lady (now called "lady #2") and ask her what in the world is going on because I had added Susannah to my policy just like the lady said I needed to. Lo and behold, Susannah was added only as a "dependant." And as a dependant only sick visits are covered. Well visits and vaccines are not. As a dependant it costs me a whoppin' amount each month. To have her well visits covered I need to spend another $40 a month and add the Well Child Rider. I'm afraid I, uh, might've sounded a bit very upset on the phone when I learned all this. Lady #1 NEVER mentioned the Well Child Rider. I said as much to lady #2 and asked if there was any way it could be back-added to cover her visit. Nope. Not a chance. I have to pay for that visit out of my pocket. But she was very helpful (at least acted like it) and told me what I needed to do to add the Well Child Rider. I also talked to her in more detail about 2 claims that had been denied (for Susannah's newborn stuff at the hospital). She said she was going to call that Dr's office and get it straightened out for me. And she was going to call me back "next week" - which is now LAST WEEK.

Yesterday, having given her ALL WEEK to call me back like she said she would, I called and asked to speak to lady #2. I got her voicemail. I left her a nice (really, I was polite) message asking her to call me back to let me know what's going on with the 2 claims. Have I heard from her yet? Nope. Not a chance.

Today, having given her a nice grace period of 24 hours, I called again. Uh-oh, I got lady #1. The lady that didn't tell me about the Well Child Rider. I bit my tongue, as much as I wanted to let her know I didn't appreciate her costing me a Dr's visit of money. I was calm, cool and collected, and asked about the Well Child Rider. It had not been added to my policy. She didn't even see the fax I sent in the system anywhere. The fax # I'd sent it to was one of their fax numbers. So we agreed that I would re-fax the request, attention to lady #1 this time. Then I asked her about the 2 denied claims that lady #2 was supposed to call me about. She said the system showed the lady is "working on it" and "is going to call you about it."

I'm waiting by the phone waiting for it to ring any second. NOT.

So I faxed the original fax AGAIN, with a note on it that it was the second time I was faxing it, so on and so forth. Lady #1 said she was going to call me back if she didn't get it. The phone hasn't rung yet. I'm going to give her a day or two to get THAT straightened out and I'm going to call again. The squeaky wheel gets the grease, and this wheel's squeak is going to get a whole lot louder if I don't get some serious grease here soon.

This has been a recording. Thank you. Goodnight.