Monthly Archives: March 2011

Same Time Next Next Year

I just got a bill in the mail for $145 from our Pediatrician for my daughter’s last well visit. She turned 8 in January and we took her to the doctor as we always do for her annual checkup. I was wondering why the bill was so high I thought that they hadn’t applied our insurance or something. My husband had taken her to this visit and the office was just changing over their computer system so there was a lot of confusion when they checked in. I called the office and they said that my claim had been denied by our provider United Healthcare because our benefit had been exhausted. I called United Healthcare right away because I knew for a fact that this year’s visit was exactly one year from last year’s visit. After bypassing the robotic system — I despise talking to robots on the telephone, they need to hire some Cylons so I can’t tell that they’re robots — I had to go through several customer service humans to get my answer as to why my claim was denied. My company, the global one who shall not be named, has decided to only cover well visits every other year for children aged 7 and up. WTF?

Needless to say this news started my blood boiling. The next day I told my manager about it and he referred me to our HR representative. She sent me a copy of our Health Plan and I saw it there myself. I had never noticed this before. That shows you how carefully I reviewed all that stuff. I wonder if this is a policy that is often found in other healthcare plans or is this just my company’s, the global one who shall not be named, policy? How about you Internets, is this part of your employer’s benefits plan as well?

Frankly I think it is terrible. If you look at all the medical services that are not covered under the plan, i.e., plastic surgery, private duty nursing, hearing aid repairs, various infertility services, etc., you can logically see why they would not be covered. But a routine physical examination of an 8, 10, 12 . . . year old child is not covered? That makes absolutely no sense to me at all. This is preventative care for a child not some fancy elective medical service?!! Grrrrrrrrrrrr! My HR rep said that they do have an appeals process which I guess I could try to slough through but that is not the point. I believe that they should cover routine preventive care for everyone, every year no matter what age. Most adults don’t get to the doctor every year anyway. At a minimum they should cover yearly exams for kids to age 18! Meanwhile my company, the global one who shall not be named encourages everyone enrolled in their health insurance plans to fill out these healthcare assessments every year by giving you a $100 Visa® gift cards. You can also earn another $100 Visa® gift card by completing a Weight Watchers or defined exercise program. This is a terrific benefit and I happily received my $200 in essentially free money last year but if it is at the expense of paying for my child to see a doctor for a physical every year, I just don’t know.

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