June 30, 2006

Insurance and lack of coverage

I have been going round and round with the insurance company I chose during the open enrollment two years ago. I should have known after the way they never sent me insurance cards last year that they were a disaster waiting to happen, but I selected them anyway. I didn't feel I had much choice, since we still were not entirely sure about the Spousal Unit's disability and when it would kick in. We were strapped, and it was the most reasonable (make that least expensive) of the three offered plans.

Well, things have not gone smoothly. Here, just let me show you the latest correspondence I have written. It is to the Human Resources department here where I work, specifically to the benefits area.

Recently my husband was contacted by our physician and told that he was no longer a patient with them because of non-payment for services. Apparently Humana had not paid for any of his doctor visits for an extended period in spite of numerous resubmissions by the physician billing department.

When contacted by my husband, the Humana representative stated that it was because they were not our only insurance carrier and that they would not pay until the other carrier had paid their portion. Apparently they were under the mistaken impression that because my husband is on SSD and could qualify for Medicaid, that he had availed himself of Medicaid coverage. This is not the case and they were informed of that.

In spite of being informed that Humana is our only coverage, they have yet to act on this and the bills remain unpaid. These bills include not only the charges by the office of Dr. SP of AHN, but also for charges by the C Group and hospital charges for his stay at St Whosits for congestive heart failure a few months ago. He is unable to see his physicians, unable to get his necessary medications refilled, and the mental stress of this is now detrimentally affecting his health.

To compound this, for the last two years that I have been a participant in this particular benefit plan we have not received an insurance card and have had to print proof of coverage letters from the Humana site each time any of us have been seen by Dr. P or his associates. This year alone we have requested cards no less than three times, both on line and over the customer service line for Humana.

These bills need to be paid. The amounts due, as I understand, are not part of the patient responsibility but are covered charges. No amount of conversation with Humana has been productive to that end.

Thank you for your attention to this matter.

So, does any of you think I'll even get a response to this?

We'll see.

Posted by Mamamontezz at June 30, 2006 09:20 PM | TrackBack

Whenever this kind of crap happens (and it has happened to us as well, just not to THAT despicible level) I let the Frizzen Spouse handle it because my
response tends to lean towards: "Dear insurance goons: Pay my fucking bill or I will burn down your goddamn office. Thank you, -Grau"

Posted by: Graumagus at July 4, 2006 01:37 PM

That sucks, call the insurance comm. in your state and tell them, Cat

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