My Health Insurance Company Is Trying To Kill Me
My Health Insurance Company Is Trying To Kill Me
"They are genius (and stealthy) in their tactics to exhaust me financially, emotionally and physically."
One such encounter went like this:
Me: “Hi. I’m calling about my daughter’s ambulance and hospital charges. I haven’t been able to reach my grievance coordinator about the appeal.”
Representative: “I can help you.”
**Me: **(Genuinely excited.) “Great!”
Representative: “Oh, I see your daughter turned 18. I can’t discuss her information with you.”
Me: “I sent a release of information form by mail, fax and email. I also faxed our conservatorship papers.”
Representative: “I’m sorry, it’s not on file. What office did you send it to?”
Me: (I give the information.)
Representative: “That’s the wrong fax number. Let me give you the correct one.”
Me: “I’m not inventing numbers out of the ether. This is the third new fax number I’ve been given. Are the address and email inaccurate too?”
Representative: “I’m sorry, but I can’t discuss your daughter’s claims with you without this information. Can you put her on the phone to give verbal consent?”
**Me: **“I can’t put her on the phone. She’s currently in a treatment center and has no access to a phone, which is why I have a conservatorship to help with her medical care.”
Representative: “I’m sorry, ma’am. There’s nothing I can do without the forms or her verbal consent.”
Me: “Who do you think pays the insurance premium and all her providers? I’m just trying to settle her claims, and I don’t know what we owe without access.”
Representative: “I can only answer general questions.”
Me: “OK. From the bills I’ve received, we’re being charged out-of-network fees for the ambulance, ER, ER doctor and hospital.”
Representative: “Was this out of state?”
**Me: **“Yes.”
Representative: “Hang on, I have to transfer you.”
I was on hold for another 15 minutes, and then got cut off. I called back, was transferred twice and then repeated a version of the above conversation before resuming — with a grievance coordinator!
Grievance coordinator: “The ambulance and ER facility were both out of state and out of network.”
Me: “A treatment center called for an ambulance. I wasn’t given a choice of who responded or where they took her.”
Grievance coordinator: “They used out-of-network providers.”
Me: “They dialed 911. No one stops to ask the closest ambulance what their network status is.”
Grievance coordinator: “They did transfer her to an in-network hospital, but the physicians were not participating providers.”
**Me: **“Under the No Surprises Act, insurance must cover all providers in the case of an emergency, whether they are in network or not — even if out of state.”
(There was a long silence.)
Me: “Are you still there?”
Grievance coordinator: “Yes, ma’am. Once you get the conservatorship papers to us, we can look at those claims. Is there anything else I can help you with?”
Me: “Apparently not.”
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When I started my first "real" job, where I got health insurance, it was an absolute nightmare trying to find a therapist through their network. I remember having to call them to figure out if they would cover visits to a specialist in trauma. Sat on hold for an hour and 45 minutes, just to get some random woman who would NOT give me any information until I told her "why" I needed to see a therapist.
After trying unsuccessfully to skip past the question, she kept asking, so I said fine, and trauma dumped all over her. I'll save you the details, but I could tell she was shaken once I finished. After all that bullshit, she still couldn't even tell me if the provider was covered or not, and instead sent me a 90 page non-searchable PDF listing a bunch of random therapists in random order located all over the state (which was negative help). I was so upset I just hung up on her.
Medicare for all. Health insurance is a scam that bankrupts Americans, puts barriers between you and care, and actively harms all of us collectively.
It is so fucking bullshit in every way. I cannot comprehend why someone would have a problem with single-payer, which is so much better by comparison than what we have to do now.
The only thing I can think is "but I might wind up with slightly less coverage than my work currently provides," which is also practically impossible for all but the very upper crust...