I switched medical plans in December. My paperwork was completely filled out and in on-time. Every "i" dotted and "t" crossed.
I received ID cards the end of December. With some doctor whose name I didn't recognize on them. (Yes, I verified that the doctor my son sees and the doctor I see are preferred providers under this plan.)
I call 12/29/03 at 7:45 a.m. "Your employer didn't forward all the information." What? It's a one-page form for crying out loud. Whatever. The rep agrees to change the names and get new cards out immediately.
1/9/04 at 8:55 pm: No new cards. Another interminable phone call. (Have I mentioned yet how crappy their phone system is? You have to input all your identifying information just to speak to a rep and THEN you have to do it all over again FOR the rep.) "We have sent the correct ID cards - they were mailed on 1/2/04." "Interesting," I respond. "They're not here." "It's the snow. No mail delivery," says the rep. Reply I, "I've received mail every day - I don't think it's that." "They're on their way," says she. End conversation.
1/13/04: No ID cards and increasingly irate providers. Call again (7 p.m.)and AGAIN input all information only to be told by rep I have to tell her all the info again. "No way," I say. "Just transfer me to your supervisor, please." She won't do it - she "can't" without the "information" and of course, she doesn't see any mention of said calls in their records, (have I ever mentioned that I have a pretty short fuse?)and tries to imply that somehow I am at fault. We get that little snafoo starightened out (she will have the correct person MANUALLY produce the ID cards and send them.) I request to be transferred to the supervisor t the conclusion of the conversation and she again REFUSES!
So, I told her I'd contact the Insurance Commissioner's Office if she'd rather. I somehow got my name transferred to a supervisor "call back within 24-hour" list. We ended with "I'd better receive that call and those cards. Savvy? And I will still make complaints to all the appropriate places. This is ridiculous."
Grrrrr.
HOW HARD CAN IT FRIGGIN' BE???????
Sigh.
So, any other horror stories about insurance companies? I'm battinga 1000 this year between my grandmother's auto insurance and medical insurance.
posted
hmm...times like this makes me glad I have simple college insurance....maybe you could bribe them with some soup and a game of spoons...if all else fails you can smack them over the head with the spoon too! :: Huggle ::
posted
Pacificare...grrr is right. I would like to take Vioxx (long-lasting anti-inflammatory) for my endometriosis, but Pacificare says that they'll only let me take it if Hydrocodone doesn't work. Narcotics?? Good grief, the pain isn't frequent enough that I want to even risk getting addicted to something like that. So I guess I'll be taking large doses of ibuprofen instead. Stupid insurance. My condolences to you, Shan. Bureaucracy is evil.
Posts: 3546 | Registered: Jul 2002
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posted
Actually, vioxx is best reserved for folks with the inability to tolerate regular antiinflammatory drugs due to heartburn or reflux. If you don't have stomach problems, you shouldn't need vioxx. It's not any stronger and may even be weaker than the older drugs. Lots of other antiinflammatories are cheaper and equally efficacious, and there are many that are long acting and taken once or twice a day. Check and see if there are ANY antiinflammatory drugs on your insurance formulary. Naprosyn, for example, works very well twice a day. Lots of other possibilities too.
Approving narcotics over antiinflammatories is just ridiculous, tho, and I've seen it several times before. The companies practically recommend certain narcotics, which I can only assume are cheaper. The insurance costs in the long run would, I assume, be a lot higher than just approving the antiinflammatory agents. Stupid.
Posts: 1990 | Registered: Feb 2001
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Our health insurance was recently up for renewal at work. Our current company was going to jack up the rates significantly (several hundred dollars a month), so my boss was shopping around (through our insurance broker). So, we each (there are 3 of us) filled out the generic questionaire (name?, age?, weight?, dying of cancer?, etc). Now, on these forms it always asks if you are taking medication (which I am). I marked yes, but I refuse to elaborate. I don't think it is the right of every insurance company that wants to submit a bid to know exactly what medications I take (I have no dire health conditions - that is the only yes on the entire page). So, we find a new health insurance company that will save a little over $100 each month (the company pays empolyee only insurance in total, I have no contribution). We fill out our final enrollment paperwork and submit it, on which I list the medications I currently take (one is a bcp taken regularly, another a headache medication taken approx. monthly - I end up needing a new bottle every 3-4 months, and a sleeping pill I need for a couple days every 3-4 months - I've yet to even use all of my first bottle). We find out this week that the insurance company came back and jacked up our rates supposedly because of my medication. WTF?! My boss is on Lipitor (not a cheap drug), yet my 3 somehow warrant an enormous price increase? The bcp costs the insurance co (after my co-pay) about $25/mo, the headache med about $15/bottle, the sleeping pill about $20/bottle. Any normal person, not on any regular meds, will end up costing their insurance co at least that much every year with anti-biotics, etc.
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I wasn't a big fan of PacifiCare. I don't recall them doing anything particularly bad, but they just rubbed me the wrong way. Plus they farm out their chiropractic care to this company called ASHP that made me fill out rather a lot of paperwork too often for my tastes. My company started offering Definity Healthcare this year so I switched over. So far it seems to be pretty good. We'll see how it goes.
Posts: 4534 | Registered: Jan 2003
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posted
I have my own GRRRRR. I was authorized for dental insurance as of 5/7/03. It is actually a really good dental plan. Delta Dental, which I've heard nothing but good about. I found a provider that I like at the end of last year. Well now Delta is claiming that I'm not in their system anywhere, and the acutal dentist is a little upset.
I just went up and talked to H.R. and to complicate matters they are switching from one delta dental plan to another delta dental plan (a better one actually!) as of 1/1/2004.
Problem is I called the Delta customer service number and they can't find me in the system still.
H.R is working on it but everything looks ok from there end...
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AJ - Your company's HR person (or perhaps AP person) should be able to prove to Delta Dental that you are, in fact, covered if they've made an error (you should show up somewhere on your company's paperwork). What about providing them with a copy of your card?
Posts: 5879 | Registered: Apr 2001
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posted
Well I've followed up on everything again. They were eventually able to find me in the system. It may have been one incompetent rep, that didn't take the time to accurately look me up.
But everything before 1/1/04 has to be submitted through the Illinois office while everything after has to be submitted to Pennsylvania. No wonder the poor dental office assistants were confused!
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