Uh... lemme go get my supervisor...
Here's an ongoing battle I've been having with my health insurance carrier, chock full of indifference and ineptitude. I live in Massachusetts, work in Connecticut. And you can probably already tell where this is going.

I'm supposed to be covered for visits to my doctor, also in Connecticut, because he's in the Primary Care Provider Plan Region covered under my employer's group policy. But it never quite works out that way. Every time I see my doctor (and it's a good thing I'm not chronically sick, for I don't need to see him often), the claim is rejected. Reason: doctor INELIGIBLE. Insurance company's Robot B-9 chokes on the zip codes. And it always comes around to why do I need to see a doctor in another state?

Most folk learn in the elementary grades that New England is where the teeny tiny states are. Geographically, San Bernardino County in California is larger than the Bay State, and runs on about the same budget. My father used to commute a greater distance from our home in suburban Chicago to his job in the city than I do here. But if I lived in San Bernardino, I could concievably choose a doctor in San Jose, hundreds of miles away, and be covered. My doctor, two towns away from me in Enfield, is INELIGIBLE.

And, of course, the customer service people at the insurance company think I'm a roaring idiot. I call, wait through the cycles of death holds and your call is more valuable to us than rubies messages and transfers to people with IQ's progressively warmer than room temperature, so I can get the claim authorized. It literally takes hours of my time to accomplish this.

They've paid the claims, reluctantly, sending me admonishing letters every time stating this is a ONE TIME EXCEPTION and perhaps I need to understand my plan better. Here's a handy guide.

Okay fine. I go to my company's HR officer and ask her to confirm these people are on crack. There's about a dozen people where I work who live up here. Don't they require medical attention occasionally?

"Well, our plan for Massachusetts is with a different carrier, and if you wanted to see a doctor in Massachusetts, you'd have to be on that plan."

Okay, it's all the same to me. Sign me up.

"You'll have to wait for the open enrollment period in October to switch plans, and your eligibility would begin next January. I can help you choose another doctor in Connecticut if you'd like."

Dur.

Did you understand the initial problem here? I explained it in pleasantly modulated tones with easily comprehended words. No CT doctors for me. Fools won't pay 'em.

"You would have been eligible to switch plans within 30 days of moving out of state if you'd applied for the coverage."

Ohhhh-kayyy. How did that slip through the cracks? I filed a change of address with you the moment I moved, and, funnily enough, tax withholding for two states started with my very next paycheck. Right on the ball with THAT, weren't you?

So I'll have to wait until January to contract SARS. Meanwhile, big dumb Connecticut-coverin' insurance company will happily continue to collect my premiums for worthless coverage.

My call may be worth more than rubies to them, but my money will do in a pinch. Things like this make me wish I really were stupid, because people seem geared up to better accommodate stupidity. 9:51:49 AM    comment []trackback []