Liar Liar Pants on Fire
So I need to rant for a minute before I finish packing for our trip.
What gives insurance companies the right to lie about coverage and not be held responsible. Before everything with Wesley, my experience with insurance companies consisted of paying co-payments when I went for regular doctors appointments. Since Wesley was born, we've had 3 different insurance companies. Kaiser covered pretty much everything but both United and Tricare have been trouble. First, United Healthcare pre-approved Wesley's medical supplies and when it came time for billing, they claimed it wasn't a "covered benefit." So now we've received medical supplies (at extremely inflated prices) that we have to pay for because apparently insurance companies don't have to live up to their word. Second, Tricare assured me that one of Wesley's prescriptions would be covered. They said they could put in an "override" because of the way the medication has to be made in infant form. So today when I showed up at the pharmacy to get a refill before leaving for GA, they claimed that his prescription includes a "non covered ingredient," so they won't pay for any of it. After speaking to a supervisor, I find out that they don't have the ability to do "overrides" and I will have to have Wesley's doctor submit an appeal (which can take up to 90 days to be processed once it has been submitted) to try and get the prescription covered. I just don't understand how the insurance companies have zero accountability for what they tell you will be covered. Thankfully the pharmacist felt bad for me and gave me the prescription for $60 instead of the $260 it costs out of pocket. Praise God for working through a very kind pharmacist to help us be able to get Wesley's prescription.
Ok, now I really have to pack for our trip. I can't wait to see Colby!!
What gives insurance companies the right to lie about coverage and not be held responsible. Before everything with Wesley, my experience with insurance companies consisted of paying co-payments when I went for regular doctors appointments. Since Wesley was born, we've had 3 different insurance companies. Kaiser covered pretty much everything but both United and Tricare have been trouble. First, United Healthcare pre-approved Wesley's medical supplies and when it came time for billing, they claimed it wasn't a "covered benefit." So now we've received medical supplies (at extremely inflated prices) that we have to pay for because apparently insurance companies don't have to live up to their word. Second, Tricare assured me that one of Wesley's prescriptions would be covered. They said they could put in an "override" because of the way the medication has to be made in infant form. So today when I showed up at the pharmacy to get a refill before leaving for GA, they claimed that his prescription includes a "non covered ingredient," so they won't pay for any of it. After speaking to a supervisor, I find out that they don't have the ability to do "overrides" and I will have to have Wesley's doctor submit an appeal (which can take up to 90 days to be processed once it has been submitted) to try and get the prescription covered. I just don't understand how the insurance companies have zero accountability for what they tell you will be covered. Thankfully the pharmacist felt bad for me and gave me the prescription for $60 instead of the $260 it costs out of pocket. Praise God for working through a very kind pharmacist to help us be able to get Wesley's prescription.
Ok, now I really have to pack for our trip. I can't wait to see Colby!!
I bet you need to see Colby, now. I think honesty and accountability is something we as consumers should demand. Not just from insurance, but from anyone with whom we do business.
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