Remember that one time when I hurt my foot?
Well, here's the rest of the story. A few days after that first post, I got a letter in the mail from my former insurance company. It was dated May 12 and said that my coverage would be terminated on June 1. I couldn't believe it, so I called them up to verify. "Hi, I've changed jobs, and I know my coverage is ending, can you tell me when my coverage ends?"
Them: Blah, blah, blah. [translation, June 1]
Me: So I'm covered through May 31?
Them: Yes.
So I hung up the phone and made an appointment with the foot doctor. The doctor said, "No broken bones, take it easy, have a nice day."
I paid my copay and was happy to receive the explanation of benefits indicating that the insurance company had paid the claim.
Last month I got a new explanation of benefits. It said they had paid the claim in error and were getting a refund from the doctor because I wasn't covered by them at the time of the appointment.
I made a few calls and apparently between the insurance company and my former employer, they retroactively decided that my coverage ended April 30. It didn't seem to matter that I had in my hand a letter saying I had coverage through May 31 or that I'd called to verify, or that I'd never been notified of any change to the information in the letter.
So now I owe the foot doctor. And I'm irritated because what the insurance company paid and then took back was less than 1/3 of what they are now charging me. I asked about a discount. "Hey, I'll pay the whole thing off right now, if you'll knock of 20%" No deal. She very cheerfully explained that they are happy to take payments from those people who have no insurance, but she wouldn't budge on the bill. They'd rather have $20 per month spread out over most of a year than give a discount.
And it really, really bugs me because the only reason I went to the doctor in the first place (or didn't wait until my coverage from the new job kicked in) was because I was told in multiple forms that I was still covered.
5 comments:
Argh! If you decided to take the insurance company to court you'd probably win. But it'd cost you more to do that than just pay the bill. Argh! Argh! Argh! What a hassle!
I am sorry you have to deal with that. That is ridiculous!
How can they do that? 1. Back-off your coverage date, or 2. Take back the payment? If you show the doctors office the letter, can you convince them that they shouldn't have refunded the money back to the ins. co? This makes no sense to me. I can't believe they are trying to make you responsible for the bill--an even larger bill. Can you file some kind of protest with the ins. co? I wonder if there is anyone you can go to for mediation. I am sorry for your headache--so aggravating!
You might look into Small Claims Court ... you might pay a nominal fee to have them served, but in some states they restrict representation by counsel.
You may not need to actually take them to court. First - when you call to complain after you get frustrated with the first line make sure you talk your way up the chain. Point out both that it wasn't right of them to change coverage without notice, but that you're willing to take them to small claims court over it. This may soften their pointy little hearts by itself - what they'd pay out to cover the claim will be far less than they'll spend preparing for and attending the case.
Unless they sent you something contradicting the initial letter and verbal confirmation or called to tell you, you've likely got a good case. Depending on state law you may be able to recover filing fees as well.
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