Jeff and I pay for our own healthcare coverage, and while that could be an entirely different post in and of itself, I think anyone who has ever dealt with an insurance company will appreciate this little anecdote.
We tacked on dental insurance when we decided to go with Company A because my husband's family has teeth that break in half while eating mashed potatoes. Seriously, Jeff broke a tooth eating scrambled eggs. I hope our children inherit teeth genes from me.
Now, once we were enrolled we were supposed to get a detailed booklet of our coverage, telling us what was and wasn't included. I did look at the before I applied, but I'd never be able to remember all of that. We never got that booklet so I called them and they directed me to the online member site. It did have a detailed description of our medical benefits. And right under that, where you clicked "Dental" it had descriptions of that coverage as well.
Or so I thought.
So two months later when Jeff needs a crown, I check to see if that is covered. Yes. The dentist calls Company A to check and see if it is covered. Yes.
We get the dental work done. It takes three trips.
On the second trip, the dentist tells us that Company A denied our claim.
Obviously, this sets me off a little bit so I call and very, very calmly ask them why it was not covered.
Turns out, the dentist benefits on my member site? The one that they told me was my specific plan? Turns out that's just a suggested plan. Because that makes sense. And the fact that they approved the work before we started it? Oh, yeah. Oops, someone must have missed that we weren't really covered for that. I'm sorry, how is that my mistake?
So I call Company A and ask the lady who answers what is going on and if she can tell me how I can know what we are covered for.
"Oh, it's only listed in your coverage booklet."
Right. I called and asked for that and you sent me to my member site.
"Oh yes, well we wouldn't send you the coverage booklet until after you'd already filed a claim."
WHAT? What kind of business practice is that? Are you seriously sitting here telling me that you do not send me a detailed description of my coverage until AFTER you've approved and then denied a claim that we sent in? And also after telling me that the information on my member site was a description of my coverage when indeed, it is not? WHAT?
At this point I had to hang up and call back. It wasn't that lady's fault that I was so angry. I don't even know how many people I talked to, each one telling me that they couldn't help me. I don't know how many people I was transferred to, how many supervisors I asked for.
I can tell you that I'm currently in the market for a new health insurance company.
