Tuesday, July 29, 2008

This is an Example Why Medical Insurance is a Mess - Too Funny

I think this is too funny! Let me re-phrase that, if everything is done as should be, it's too funny!

Ok, I'll get to the story! I have been a stay-at-home wife and mom for 14 years now. Let me say this again


Did you understand that? Good. Well, you've got one up on our medical insurance company.

Remember when I used our wonderful medical insurance to see a primary care doctor (for the first time in three years)because I had poison ivy soooo bad. And it's not like I ran there right away, I waited until the poison ivy was on my throat and I could tell a difference in my breathing - like, you know, my throat could swell shut, and I could cease to exist!?!

Anyway, I received a bill from said primary care doctor for $90.00. HUH??? Ninety $$$, in addition to the $20 copay I already paid?!? Here's where the funny part comes in. Several days before receiving the bill, I got a letter from said insurance company saying they had denied my claim because further investigation into this claim led them to believe that it was a workmans' comp claim, yada, yada, yada.

I had to appeal this decision in writing with the insurance company. I tried to explain that while yes, I was working (pulling weeds out of my flower bed), I am not compensated or even appreciated by anyone and that I am not covered under workman's comp or anything else for that matter, except insurance, you know, in case I would get sick or something, like poison ivy.

This was a pretty standard billing. I guess now we know why medical expenses are so high!

*I got an explanation of benefits from our medical insurance today, 8/18/08. The claim has finally been settled and paid.

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