“Fucking HMO bastard pieces of shit!”—Helen Hunt in As Good As it Gets

Our heroine here is my grown-up daughter Ariel. She left regular employment a bit over a

After all the work to get it, the puppies ate my insurance card.

After all the work to get it, the puppies ate my insurance card.

year ago and is currently living with me attending grad school.

Like the responsible young woman she is—over 26—she started making her COBRA insurance payments when she left her job. Unlucky to have several ongoing issues, she managed the hassles of trying to find an in-network doctor for that, or getting a referral from her primary care physician for the other. She made a special trip to her primary care doctor in northern California, got a referral to an ENT for her ever-annoying tonsils, only to discover that the referral was no good in Manhattan Beach. She’d changed her address with one set of insurance people, but not with another set of insurance people.

Things went downhill from there.

Then when Ariel tried to get a new primary care physician here, in order to get a referral to an ENT, they told her she was cancelled.

WHAT?

“Apparently my premium was increased six months ago,” she said, “They say they sent me a letter at the first of the year, but I never received it. I kept making my payments but they weren’t enough…and so now I’m just cancelled!”

“That’s crazy,” I said, “Can they just do that?”

“I filed an appeal,” she said. “That will take three weeks.” She showed me her payment photocoupons she’d been using to make her payments right along.

Now, if I had a business and a customer was paying the wrong amount, I’d send that person a notice pointing that out. No, actually I’d pick up the phone and give that person a call. The magazine subscription people hound you for YEARS if you let anything lapse.

Three weeks later–actually five weeks later–they told Ariel her appeal was denied. Tough luck.

I’ll spare you some of the gory details. Ariel’s many attempts to buy insurance. How she accidently ended up on MediCal, but Covered California wouldn’t let her pay for real insurance, her many phone calls with an hour on hold each time.

You hear insurance horror stories, like the guy in Michael Moore’s documentary Sicko, who has to choose which of his two severed fingers to have sewn back on…because his insurance will pay to replace one finger, not two.

You hear those stories, but they are hard to believe, impossible to believe. In fact you don’t really believe them.

Until it happens to you.

It was the same with Ariel. I know she’s responsible. I know she pays her bills. I know she follows up.

But a little part of me—“more than a little part,” she told me later– thought that maybe she had just overlooked that letter about the rate increase. Threw it in the trash with the other junk mail.

photoI thought that.

Until it happened to me.

Divorce is a “qualifying event” in insurance lingo, which meant I’d be moving to my own COBRA policy. “How does that work?” “Who do I pay?” “When does this happen?” I asked LOTS of questions.

“You’ll get a letter explaining it all,” said the friendly HR woman, “in the meantime, just use your current insurance card.”

I followed up a couple of times. And the response was always, “You’ll get a letter….”

Finally it was time to get my vaccinations for Sri Lanka, which reminded me to follow up AGAIN with an email.

This time she called me back right away.

“The premiums were overdue, so I organized the company to pay it. You should send me a check to reimburse the company and I’ll get you everything else you need, including a copy of the letter.”

She did indeed send a copy of the letter. The letter I never got.

Just like Ariel never got hers.

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About Karen Ray

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