Don't Give Up! A Health Insurance Tale

By Catherine Zoerb, published Jan 21, 2008
Published Content: 13  Total Views: 2,951  Favorited By: 4 CPs
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I needed to get a vaccination. I was on the fence about getting it, but decided that if it was paid for, I'd go for it.
I was not sure if my insurance would cover this vaccination, so I gave them a call. They said that they did cover it, but only until the age of 26. The vaccination is three shots over a 6 month period. Since I was 26 at the time and would soon be 27, I asked them if the vaccination was grandfathered, or covered as long as I *started* it when I was 26. The person who I spoke to said as long as I started it at the age of 26, the series should be covered. Great! I went and started it, the first bill was paid, and I went on my merry way.

Shortly after the second shot, I received a $150 bill in the mail and a notice that it was not covered. I called my insurance company, assuming that there was some administrative mistake. I got the second shot when I was 27, but they had assured me it was covered as long as I started when I was 26. The person I spoke to this time said that they do not do that, but she and her supervisor would listen to the call (as all calls are recorded) and get back to me. If the rep had misinformed me, they would cover it.

Since I called specifically to ask that very question, and I am a clear communicator, I thought that would be the end of it.

Wrong. They called me a few days later and said that I had asked about it, but the rep had told me it was not covered.

Now really, when I ask something about money, I am very clear and specific. I knew that she had told me it was covered, unless I had terribly misinterpreted what she had said. I wanted to be sure that I had not misinterpreted what she has said, so I asked for a transcript of the conversation.

I was told to request it in writing and given a name and an address. I promptly send out a request and waited.

And waited.
....and waited.

I finally got a phone call from somebody who said that I needed to request a transcript via a specific form, but the person who was in charge of those forms was on vacation, and they'd get back to me when they could. I called and asked if they could just, you know, send me a form so the person could have it when they came back. They sent the form.

Did You Know?
Spending this time on the phone saved me $300
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