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Let's talk Insurance
I hate our insurance company (United Health Care)-- or as I like to call them, United Lack of Health Care. I speak to them at least twice a week to argue a claim, fix a mistake, beg for coverage, etc., etc.
My question is... is my insurance company particularly bad or is this just routine for everyone now?
Who is your health insurance provider and are you happy with them?
This discussion has been closed.
Re: Let's talk Insurance
We have cigna and it is horrible! I also have to call a couple times a month. They say that for 2010 after preterm labor admission, daily ultrasounds/NST, fetal ECHOs twice weekly, a C-section, 2 NICU stays, and cardiology 2 day stay, and open heart surgery for one of the twins, we did not meet our out of pocket maximum ($5000.) It is ridiculous! They keep processing claims wrong.
This year, I am staying on top of every single claim. For example, the synagis was supposed to go the deductible, but they only applied it to one baby's deductible. For the other baby, they paid 80%. Each individual has their own deductible! I feel like idiots work there! I have to call and have them reprocess it, but I am not sure I have the strength. I may just take the cheaper price. Of course, I already paid because the insurance pharmacy would not send it out without my credit card number. Now they processed it differently, so I have to call and track down $600. this is just one example, but they are so stupid, it frustrates me sometimes!
We have Aetna and they've been pretty decent so far. Our coverage is good (which we definitely need with our IF stuff) and the only thing they don't really seem to have together is midwife care. We got a bill after DD was born simply b/c I had midwives and didn't get a referral. They told me I needed a referral this time around, too, but after I looked into it, I let them know I didn't need a referral and they were like "yeah, we know". So they need to make that directive a bit more clear. Other than that they've been good.
As of Jan 1, we have Express Scripts for our rx benefits and we haven't had to use them much, so I can't really speak to them yet. Though they're willing to cover Makena for me, so they get an A++ there. They will also continue to cover our IF meds if we decide to go for round 3.
I have BCBS of Ilinois. For the most part they've been okay. The only thing I didn't like about them was my son was born in NICU from thte end of 2009 into 2010. We had to pay out a 2000 dedectuble for both years even though it was just for 1 hospital stay. That was a bit annoying.
We also had a problem that someone entered us in a HMO instead of a PPO plan. I abrupted before that info was corrected. It wouldn't have been as big of a deal if we lived in Illinois, but we live in Colorado so everything under the HMO plan for us was out of network and not covered. That took FOREVER to fix since I had to go bill by bill with them. And there were A LOT of bills. But they covered DS's Elecare at 80% which was a BIG help and saved us almost 600 a month.
I work in the industry and I can say honestly, they all suck as far as customer service goes. However, policy wise, how much they suck depends on your employer that you get coverage thru. The employer negotiates coverage & rates.
At one time I had BCBS and so did my mother. Since she works at Walmart she also had to have Medicaid as a secondary. Though I had the "same" coverage, my company supported the plan further and my expenses were much more affordable.
1998 Ovarian Cancer Survivor. 7 Miscarriages: 6w, 13w2d, 4w2d, 7w4d (DD's twin), 5w. Failed Tubal after c/s (!!): 5w2d, 6w4d
I am a little late weighing in but felt compelled to as insurance has been a huge thorn in my side lately. We have Anthem. Over the course of this, I've called for specific information, done exactly what they've said, only to not have things covered as I was told. I call back, that person tells me I did something wrong, etc... I am to the point where I don't trust anything any one of them tells me. We went through a huge pre-certification ordeal with synagis which eventually was certified, only to have the actual claims later come through as denied. It is incredibly frustrating and a huge source of time consumption for me. I really wish that dealing with the insurance company wasn't necessary, but the only other option is to pay all of their "denials" out of pocket, which just isn't feasible. Grrrr... Thanks for listening to my rant.