Having Health Insurance Is Hazardous To My Health!

As many of you know, we had a beautiful baby girl a month and a half ago.  As with any change, a new baby has meant that everything has changed.  While there are challenges, they’re all worth it for those beautiful moments that only a newborn can give you, a soft sigh, a little breath, or a touch of wonderfully soft skin.

One area that hasn’t been amazing has been the health insurance.  As with anything major, the cost of having a baby is pretty high.  There are insurance claims upon insurance claims.  The ironic part is that keeping on top of all the insurance claims have been a source of more stress than actually having a newborn!

Consider this:

Adding our baby was pretty simple.  HR walked me through the steps I would need to go through to add the baby to our insurance plan.  The plan wasn’t changing, since we were already on family coverage anyways, it was just adding her to the plan.

Simple enough, right?

It seemed so when she appeared on the website after I logged in a couple days after providing HR the information.

Smooth sailing, except that all of the claims associated with her delivery and hospital stay were…

Rejected.

Huh?

I talked to the insurance company and they said, “Well, it’s because you haven’t responded to the form we send out which makes sure that she isn’t covered by any other insurance plan.”  When I pointed out that I had just added her a couple of days ago and there was no possible way that I could have gotten that form and responded to it, the nice lady said “Oh, yeah, it probably hasn’t even gone out in the mail yet.”

Double huh?!?

At least she was nice about it.

She explained that the system that tracks the responses only provides a Yes/No as to whether this information has been provided.  If it’s no, the claim is rejected.  There’s no date stamp or any other flag that could at least give the customer a chance to receive the form and mail it back.

Luckily, the lady was super nice and she was actually able to enter my responses into the system on the phone, and submit the claims for re-processing.

Still, doesn’t that seem like a huge waste of everybody’s time over something so simple?

Here it seems that it’s a good thing that I have health insurance because I’m stressed but I’m stressed because I have health insurance!  Figure that one out!

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I’d Rather Be Safe Than Sorry

Last month was the four year anniversary of having closed and moved into our home.  It’s been great.

With that came the annual responsibility of paying our homeowners insurance premium (we don’t escrow).  We do our car and home insurance through Allstate, as having both with the same company saves us money on both policies.

I’ve gotten into a pretty good system where I have this payment set through my online access.  It deducts from my bank account and we’re good for another twelve months.

Not this year.

I went in a couple of days before the date of which the payment was due.  Having worked with this before with no problems, I figured I’ll keep my money as long as possible.  Logically, I know it’s only a couple of pennies in interest that we’re talking about, but still.

Except it wouldn’t let me in.

I had the username and password correct.  I keep this in a master list of access codes and the site even confirmed that I was entering it correctly, but it wouldn’t let me in due to some ‘Account Upgrades’ that were taking place in the back end.

Concerned, I called my agent’s office.  The nice lady on the phone (who I’ve dealt with many a time) assured me that I have until 10 days after the policy is due to pay it without penalty and that the account access would be restored by then.

What do you think I did?  Do you think I said ‘OK’ and hung up, taking my chances that I could pay past the due date.

Nope.

I cheerfully asked ‘Well, can you just process the payment for me?’

‘Sure’.  So I paid over the phone (oh, and with my 1% Citi card so I’ll get 1% of my policy amount back, woo hoo).  Ahead of time.

I guess I could trust the insurance company.  They’ve never given me reason not to.  They’ve always handled every claim I’ve processed quickly and without error.  They’ve always worked with me when I had any concerns on pricing.  They always handled everything on the up and up.  They’ve given me every reason to trust them.  I could have.

But I didn’t 🙂

Better safe than sorry, I say, and I certainly slept better that night having exercised those words of wisdom!

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One Work Benefit Is Still Awesome (For Now)

I’ve bemoaned several cost-cutting measures by my current employer that have had a negative impact on our finances. Specifically:

  • Suspension of employer matching to our 401(k)
  • No raises in 2009 or 2010
  • Up to 100% increases in premiums for health care in 2011

All in all, it’s been a pretty rough couple of years and definitely not what I had been projecting when you think of such things.  I think we sort of got used to the idea that we’d get a raise every year (or two years) and that health care costs, while increasing rapidly, wouldn’t effectively double.

Still, enough complaining.

One thing that I’ve realized is really good is our life insurance benefits.  Our employer ‘gives us’ life insurance at two times our salary for nothing.  Additionally, you can ‘purchase’ up to eight times more at a pretty reasonable price.  You can also add life insurance for your spouse and for children.

I did some comparison shopping a while back, and no insurance company that I contacted could even come close to what we pay annually out of my paycheck.  Not even the company that supplies our home and auto insurance policies could anywhere near, and they were the cheapest!

It’s important to be well protected, so I will definitely make sure this is always addressed.  I know that I’ll have to look at this if any of the following scenarios were to take place:

  • I no longer worked at my company
  • My company discontinued or reduced this benefit
  • My company raised the cost of this benefit

For now, it’s a pretty kick-butt benefit, one of the few remaining, so I’ll happily take it for now!

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Another Twitter Success Story

I freely admit that I don’t use Twitter to anywhere near the potential that it could be used for.  I have a hard enough time keeping things current on the blog that I don’t spend a lot of time outside of my blog and other blogs.

However, I thought I’d give Twitter a chance as I’d heard that it can be a pretty good method to get through to companies in times of frustration.

Verdict: Success!

OK, so I’ll give the story.

Earlier in the year, Baby Beagle needed some surgery.  It was nothing life threatening, but something that they told us that he would need pretty much right after he was born.  As such, I boosted our FSA savings for 2010 in anticipation of the surgery.

The surgery came and went and Baby Beagle came through with flying colors.  However, the insurance and hospital payments didn’t go so smoothly.

There ended up being four claims filed, which I’ve learned is pretty typical for procedures.  The surgeon and anesthesiologist each filed one, and there were two filed by the hospital.  Three of the four claims were approved and paid by the insurance company within a couple of days.  The fourth, however, was flagged for needing more information.

The strange part is that the one that was flagged was what I would consider the most ‘generic’ claim of the four.  It was the hospital claim that was basically covering the pre-op, the operating room, and the recovery room.  To me, when the insurance company approved the claims for the surgeon and staff, it seemed pretty much a given that there would be hospital usage charges, yet that’s the one that they held back.

I never got a bill, but for the next four months, the claim sat in limbo as the insurance company wouldn’t pay it, yet the hospital claimed they had sent the information.

Finally, on Monday, I’d had enough.  I posted a Tweet on Anthem Blue Cross’ page.  Within an hour, I had a response and began an e-mail dialogue.  My issue was esclated and voila!  Tuesday evening I received an e-mail noting that the information had indeed been received but was stuck in ‘backlog’.  They processed the claim and everything is now moving forward!

Now, I know what we have left to spend for medical related costs through the rest of the year, and I also have the peace of mind of knowing that there’s not a bill potentially hanging over our head.  While, I was 99% sure that we wouldn’t be on the hook for the claim amount, it was a pretty big amount and I didn’t like even thinking of the possibility.

Maybe there is something to this whole Twitter thing!

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