General Category > Insurance

An Insurance Funny

(1/4) > >>

Soundy:
... or would be if I didn't feel like crying

still fighting insurance about assorted issues...and still say BCBS of Tennessee S sucks...

well I have been discussing BAHA with them and they say they will pay for any leftover portion of
bills after I pay out my $2400 family out of pocket /deductable , but still not for the hardaware...just
the doctor and surgery...
but when I ran it by them they will pay 80% of cost of TV ears... as we all know hearing TV is more
important than hearing the truck fixing to run over you in a parking lot...I have a November appointment
with audiologist so will take it up again with him...

Then was discussing balance retraining with them after a nurse hired by BCBS called for what she called a
Family Checkup... mostly just making sure all birthdays and allergy and info like that was right and cross checking
ongoing issues.... she suggested the retraining therapy ... told her the cost was to high and the drive to long
and benefit gained would be lost... she gets a claims person on with us in a three way call and I was told that
after my out of pocket was met they would pick up %75 and my cost per visit would only
be around $125 ... I about half jokingly said they needed to pay for a Wii Fit and I could work from home ...
she ran it and they will pay on the fit and possibly some on the Wii system itself ... the girls are getting a Wii for
Christmas... last year they got up to around $600 here if you could find one ... I had picked up one for our
Fall Festival Raffle prize last week and was given a discount coupon of $75 and used it to get another for the
girls...she said to send a copy of the receipt and to get the Fit and send that receipt too and I will get a
little back...around 20% ...

All that is fine and dandy but hey are still not paying for my treatment and want a full MRI series and a complete
cardiac workup on me (due to heart  issues I had after taking Zomig ) ...the heart thing resolved and showed no
sign of damage to heart... I have to pay for both the cardiac work up (last one was around $5000) and the MRIs of
head  have been from $2000 -$4000 depending on where I have had them ...

I told the claims lady that all this insurance crap was going to drive me insane ...

now here is the funny part...


in a mono tone voice she replied ...
Are you aware that you have mental health coverage under your new policy?

Do you laugh ,cry or go running off down the road nekkid and screaming ??? so far I have chose laughing so as
not to cry and running down the road nekkid would probably upset my kids

leapyrtwins:
Soundy -

I'm so sorry to hear that you are still dealing with this crap  :(

The insurance person's comment is a scream  :D

I'm glad you decided to laugh rather than cry - it would have been my pick also  ;D

Hang in there and let's hope things get better.  Insurance companies - UGH!!!

Jan

Jim Scott:
Soundy:

My wife was a claims supervisor in a nationally-known insurance company.  She knows how the 'system' works and how to get results.  Still, she gets fed up dealing with Blue Cross, even though she is usually successful.  Example:  I turned 65 in February.  I'm covered under her medical policy (she's on long-term disability leave).  She called her company and asked three (3) different people if I would still be covered under BC if I opted out of Medicare.  They all answered in the affirmative, and she pressed the point with each one.  Surprise!  When I had my last MRI, they didn't pay because they 'assumed' I was covered by Medicare!  After about 8 phone calls to the company, she finally got a claims manager that admitted their mistake (my wife knows enough to ask for names of anyone she talks to on this kind of issue) and was actually contrite.  She said she would pay the MRI claim (and others that followed) and personally follow any claims under my name to be sure this didn't happen again.  The only 'catch': I had to agree to apply for Medicare in January.  Until then, any medical bills submitted under my name will be paid - with the usual deductibles. 

Think about that.  My wife (the primary policyholder) asked 3 different people at various levels in the company if I would still be covered under the BC policy after I turned 65 and did not take Medicare coverage.  All said 'yes'.  All 3 were completely wrong.  Their mistake (or ignorance) could have cost us hundreds and hundreds of dollars.  Fortunately, my wife was able to find a responsible claims manager to rectify this situation.    Still, it was frustrating.

I guess most of us posting in this particular forum have a story, but yours is the 'best'.  You express impending insanity due to the hassles the insurance company puts you through and the brain-dead representative asks if you're aware that you have mental health coverage on your new policy.  A classic that probably won't be topped for some time.  You should submit it to Reader's Digest or some other publication that accepts (and pays for) reader jokes and stories.  I'm positive they would publish it.  Just a thought.

Here's hoping you have better luck in the future when dealing with BCBS of Tennessee.

Jim

andrea in slc:
Oh good heavens, I'm still laughing after reading this last night AND showing it to my husband! You're right, laughing is all you can do unless you want to become hysterical or truely insane.

I'm so so sorry they are still giving you fits with this. It makes absolutely no sense to pay for part of a Wii, and something for you to hear the TV with, but not the other things. Wait, makes sense (as in logical) and insurance copanies would be polar opposites of eachother!

I really hope they will pick up more of the expenses for you! Good luck! And thank you so much for the laugh. I agree, submit this!

Andrea

wendysig:
Soundy
Sorry the insurance company is such a pain in the !**!  Hang in  there maybe they will relent and pay for more of the costs.  If they do drive you crazy at least your therapy would be covered -- thanks for the laugh ;D

Wendy

Navigation

[0] Message Index

[#] Next page