In which I rant about insurance again

I have had it. Seriously, I’ve just had it. Yesterday was the final straw.

I’ve mentioned the troubles with my insurance company before. In the (not even full) year we’ve been with them they have lost faxes, called my husband a liar, lied about sending paperwork to the appropriate sectors to get claims fixed and so on. That is just the issues we’ve had on the phone with them. They also don’t cover shit.

They don’t cover the any of the cost of Chris’ Concerta, which is why he had to switch to Ritalin. And the insurance, as it turns out, doesn’t cover much of that one either. So he opted to stop taking it all together. And if you’re married to someone with adult-ADHD, you know how difficult it can be…I mean, you can only take being cut off mid-sentence to talk about something else so many times!

That’s a whole ‘nother story however. A story for when I’m about to divorce him.

So they don’t cover the medications we need to control his ADHD, okay. But they also don’t cover birth control for me so we don’t have another baby right now. And I don’t mean they don’t cover the Mirena, which is what I wanted, they don’t cover any birth control at all. And then? When I do end up pregnant, they only cover up to $1600 a year of any sort of office visits. Which we found out tonight.

We also found out that they do in fact cover the babies immunizations, which I thought they didn’t because I’m paying for them. Oh, they only cover the doest $150 of immunizations a year. Did you know that the  cost for the first year of immunizations is at least $620.

Luckily for us, he was born mid-year, so only the ones we’re paying for already, oh and the ones he got down two weeks ago. And then the ones he’ll have in January. Sweet! After February we can get a small break on the one shot they’ll cover! And Caitlin doesn’t need anymore until March either! Awesome.

The greatest part about this shit insurance is how much we’re paying a month for it. Close to $500-if not more. I did the math. If there are no pregnancies or serious injuries that involve hospitalization, it’s cheaper for us to be self-pay patients. Only Caitlin and Kinley take regular visits and I have occasional visits regarding my back. Since we wouldn’t be paying for both the insurance and many of the appointments, we’d be saving.

Last month, I went to a new gynecologist about some pain I’ve been experiencing. Before I even made the appointment, I called the insurance company to make sure it would be covered. I didn’t need the stress of this not being covered added onto the already insurmountable stress of it going on in the first place. The woman from the insurance company LOOKED AT OUR ACCOUNT, looked at my name and told me “yes, it will be cover. Don’t worry.”

I went, I got checked out, and was put on a prescription that is supposed to help (it’s not) and told to come back in January. With everything going on with my grandparents, I hadn’t made the appointment yet, and opted to make it in January so I know a clear cut date that’s okay. They called a few days later saying that they didn’t find anything abnormal, and that was that.

Yesterday, I received a letter from the office. My heart dropped into my stomach. During my appointment, the nurse had told me if they found something serious, a letter would be sent. They called me and said everything was fine, so why a letter now??

I opened it…it was a bill. The appointment that I called to make sure would be covered? Well, it wasn’t covered. Frig.

So, I called them to figure out what the ominous message “According to your insurance policy, this service is not covered by your policy” meant. Oh goodie! Their phones were shut off for an hour for training purposes. How perfect.

When I finally did get a hold of them, that’s when I found out that they only cover $1600, which considering I’ve been pregnant almost the entire time, I’m out of appointment until February. So much for the follow-up in January. And so much for getting my back and neck checked out too.

So, from now until February, I can’t be seen by a doctor unless I’m admitted into the hospital if I don’t want to pay for it in full. That doesn’t sound awesome to me at all.

By the time I was off the phone with them and telling Chris about it, I was in full breakdown mode. Just sobbing and crying. I’m seriously at my wits end with this insurance company and I can’t take having to deal with this for how much longer (at least 8-ish months depending on whether he gets moved to another contract, gets put on full time at his employer, or finds a new job).

I just do not understand how this freaking insurance company is beneficial to employers at all. I don’t united how they expect us to pay out the ass for “premium” service and get nothing.

So we need help. We need to find a decent ppo with individual plans that doesn’t cost an arm and a leg. For my sanity. Because seriously, SRC, an Aenta company, you suck ass. I hate you and the horse you road in on.

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