Can't believe insurance co can do this!!!

[Chicken Lil]

I am so ticked off right now I could just scream.

It seems that it is always a struggle to deal with health insurance companies, that somehow they love to take your payments than always try to wiggle out of paying when they should!

Okay I was a single parent for several years, and a job with health insurance is an absolute must for me and my girls. Anyway three years ago I met and married a wonderful man, who is a diesel mechanic. At the time his job had no health insurance, so I added him to my family policy. I already paid for a family policy, so my, and my companies cost stayed the same. My share of the $1100 a month is just $190. This was one of the big reasons I took this job, even though it paid considerable less than my last one.

Okay time passes, no objections etc. Than last April DH took a better paying job, and it does offer health insurance. However, for him alone it would cost $250 a month and the policy is really crummy. We decided to opt out, as why pay the extra money on something that won't do us any good.

Now come this Febuary, and my husband has an emergency apendectomy. Of course we called it in and did what my insurance said. So everything goes well, and he is recuperating well.

Guess what, now my insurance is contesting paying for this because my husband was ELEGIBLE for his own insurance through his employer. They also want to drop him from my policy!!

Nevermind that I will still have to have a family policy to cover me and my two girls. Never mind that it will cost us an extra $250 a month for crappy coverage!!

Anyhow I spoke with the Illinois Insurance Commisioner Office. What I found out is that my insurance co. will eventually be forced to pay for my husbands medical care, but I will have to file a complaint with the state, and it will probably take a while to resolve. In the meantime if I want to protect my credit rating, and avoid a long hassel with the providers we will need to come up with about 50K!!

FYI, those posters who claim to always pay cash and say everyone should just save up for what medical service they need, please don't try to tell me we should have a couple hundred thousand sitting in the bank to cover these things!

On top of that the Ins. Commision group said that yes, because of the type of company I work for, it is covered under some federal labor laws, and they can make my husband drop off my policy! Because of the high cost of healthcare they are seeing more and more families being forced to have multiple insurance policies in one family.

I'm not sure about the whole Universal Health care thing BUT I do think the feds need to start regulating the health insurance companies better, and closing up these kind of stupid loopholes. Plus health insurance laws need to be the same in every state. It is ridiculous that there are always so many different rules, depending on where you live and what kind of company you work for!

Forgive my rant, but I think I am going to EXPLODE!

 

[JennsPeeps]

I heard someone on NPR the other day who was in a precarious financial situation. The advice that was given by the financial experts was that they had a house & a car, which are the primary reasons people work to maintain good credit. The advice was that the caller should focus on paying every bill possible and worry less about the credit rating and more on getting stuff paid in a timely manner and surviving.

I suggest you call a financial planner and a lawyer about this situation. You can always refute the credit rating but getting funds back may prove impossible or too long & drawn out to be worthwhile mortgaging your future to do.

You're between a rock & a hard spot, but there is light at the end of the tunnel... somewhere. Seek and use good counsel.

 

[Ang]

Whew. What a mess, huh. Why do you need 50K up front? Can you set up a payment plan that you can manage while sorting out the mess. I am not sure what part of the state you are in. It may be more difficult to set up a payment plan with the hospitals/doctors in the Chicago/Rockford/Springfield areas but they should allow you to do that. No one has enough money set aside to pay for a surgery unless you are well off. Most people just make payments. And I would check with a lawyer that specializes in insurance, too. Good luck to you!

 

[Chicken Lil]

Hi Jens Peeps,

Actually the Insurance Commission office said we should not pay more than 10% of these bills, as recovery from the insurance company would be difficult. Meanwhile they will make sure the Insurance Co pays the part they are required to cover under my policy. It will just take a while.

I guess I shouldn't worry about the credit rating thing so much, as we pay everything else on time, I just hate dealing with all of this garbage. Especially since I will have to notify all of the different providers, since everyone who took care of him bills seperately.

Plus, I guess I'm really miffed at having to pay for another policy. Especially as my eldest DD will soon be 21, and I will help her with her insurance cost while she is still a full time student.

So soon we will have three different health insurance policies just to cover one family.

You know for three years he has been on my policy without a problem. He only had to see the doctor twice, once for strep, and once for a broken toe. They never said anything. Now that he has a big expense they are balking and want him off the policy. It just sucks!

 

[Chicken Lil]

Quote:
Actually I am about two hours straight south of Rockford, in Princeton. I will not need a lawyer, as the State Insurance Commisioners Department has lawyers and will be going after the insurance company to pay. It will just take a while for everything to process. We will start to make some payments, and see what happens.

 

[JennsPeeps]

My DBF is w/o health insurance right now and I'm terrified something wil happen to him. I feel your pain.

 

[VT Chick-lit]

Chicken Lil, follow what your Insurance Commisioner has suggested, even if it will take time to force them to pay. Additionally contact the providers of service for your husbands apendectomy and notify them that the insurance is balking and that your case is in the hands of the Insurance Commisioner for your state for litigation. Contact a lawyer, for a consultation regarding what you can do, in addition, to protect your credit rating and your assets. Some lawyers offer the first consultation for free. If you can not get the medical providers to work with you and temporarily wait for payment, get a payment plan for those who won't wait. Remember, they should only get paid after your necessities are paid.

My husband and I went thru this when he was hurt at work. There was no disputing the fact that he was hurt at work and that it was a workmans comp case. He was out of work for 8 months as he healed and went thru therapy. The workmans comp insurance jerked his medical providers around, paying nothing or only $5 or $10 a month to some providers until we would complain. We were getting nasty letters from some providers until we contacted the Insurance Comissioner and then notified the providers that it was being turned over to the Comissioner. Be aware that you will need to check your credit rateing from the three main credit agencies to verify that this does not apear there. If it does, contact the agency and place a memo regarding the circumstances on that file and also contact that provider, and see if they will remove the blot from your record, because of the pending insurance litigation with the State. About 5 years after my husbands accident, we were going for a morgage to build our house and found out that a medical provider was never paid by that workmans comp insurance ($250). We promptly paid the bill and put a note about the issue in our credit file. This was enough to get us our morgage. The sad thing about this story is that my husband worked for the State of Connecticut in their Department of Corrections and all this was thru the states workmans comp insurance.

 

[Chicken Lil]

VT Chick,

Thanks for the helpful information, I will definetly follow up with what you said.

Doesn't it just burn you the way you have to fight for the Insurance Co's to do the rihgt thing?

I see you are in Vermont. My DD will be moving to South Burlington in August. Cool place!

 

[VT Chick-lit]

Is DD going to school in Burlington. There are several colleges there. I live about 45 miles north of South Burlington. It is a lovely place for chickens!

 

[crzychicken]

You got to love those Insurace companies they want you to pay big $$ but when you need them for get it it's a fight for what you already paid for, miss 1 payment canceled I think they feel your time is worthless buy the time your done fighting you'll have hundreds of hours into it. Here in Mass they regulate the increase they can charge pre year well my payments doubled for the same Ins and my co pay for meds doubled I was paying 25$ NOW 50$ my uncl never paid into medical Insurance he's a head has had 2 heart surgerys and a few other thing he put the away in CDs for years he paid the docs cash they gave him a discount for paying the bill himself and they got paid without waiting for money or doing all sorts of Ins. paper work.He's now in his 80's he is still ahead and he is on medicare now and a supplment Ins. that he pays out of his Insurance fund he strated himself 68-years ago. We are run by Ins company's car home, healty, life, even store offer it on product's we buy our money is insured, almost evey thing has Insurace. I don't buy the cost we(Ins Co) pay out Please we are the one paying in more ways than one as people we need to wake up ! and take back our country.INSURANCE AND TAXES not much of our pay is left after that.