Outrageous Insurance Nonsense

Usually when there's a health insurance problem, I get very agitated, get on the phone, and get angrier and angrier until I find out it is all my fault.

This last time was different. Instead of calling immediately  this time I made a spreadsheet consolidating numbers from the insurance website, the health debit card website, and the prescription drug order website. It showed the MS drug vendor submitted enormous numbers to the insurance company -- $25,000+ for the first order and $7,500 + for the second -- and the debit card acknowledged them but never billed them, and the insurance company acknowledged them by upping my out-of-pocket maximum to that $7,500 number. I sat on that spreadsheet for a week.

Then at the beginning of the next week, I thought, why are they billing me those huge numbers in the first place? The process should be: drug vendor talks to insurance, they decide what to bill me, then they send that number to the health debit card. That's how it was last year, when I had the old insurance plan.

LAST year. OLD insurance plan.

Took me NINE DAYS to remember I changed to a different plan with the same insurance company. "Has your insurance changed?" No, same company. But also, why yes, new plan. I had obediently told everyone in January except for the pricey drug vendors.

I called and was very nice when I explained it all and yes indeed, that was what happened. 

"This may take a week to get resolved."

Yes. Fine, fine, fine, fine.

 

Comments

[KC]

Uuuugh. We're having Insurance Nonsense where an orthopedic clinic is trying to charge a fee for visiting the (freestanding) ortho clinic as though it were a temporary stay at a hospital, when it was just One Visit To A Specialist (who didn't actually do much), which should just be the copay...

We did decode the insurance bill that was charging my spouse a small bill for "surgery" (???) at an urgent care facility where he most definitely did *not* have surgery. The actual reason for that specific charge? They gave him a finger splint he could use if he wanted to. Surgery, a finger splint you can use, same difference, right?

[theQueen]

KC - And then just yesterday I got an email saying i have exceed the amount the financial aid people will give, which is odd given that I specifically asked both times not to get the aid, and called them in the start of the year to cancel it.

[KC]

...???

It is a mess.