The Insurance Run Around

Yesterday Hazeline was 10 months and 9 days old.  Yesterday was also the day that I received a notice in the mail that her newborn hospital care was not covered by our insurance.  How can that be?  Those bills have been paid…twice.  Even if they hadn’t been covered, where do they get the nerve to send me a denial 10 months after the fact?  Especially, after I’ve received letters from not one, but two, insurance companies that these bills have been paid.

Perhaps I should back up a little.  When Greenleigh was born, it was explained to me that she would automatically be covered under my health insurance for 30 days and then it would be up to me to add her to the policy.  I did that and kept her on the policy for about 6 months until Erajh got a better deal through his employer, at which point we switched her over to his policy.  Everything was remarkably easy.  No glitches, no hiccups.

With Hazeline?  Not so much.  It’s pretty much been a disaster.

When Hazeline was born I figured she would be covered under my insurance for 30 days, so I never bothered to contact Erajh’s insurance until she was 20-25 days old.  By that point, surprisingly, the pediatrician’s office had already billed for her newborn care and been paid by my insurance.  Perfect!

Except it wasn’t.  That was actually where the problem started.

Erajh’s insurance policy covered Hazeline retro-actively, which created a problem of who was going to pay for her care immediately after her birth- my insurance or his.  After all, mine had already paid.  Several hundred phone calls later, it was determined that Erajh’s insurance would cover it and the pediatrician’s office was sending back the money they had received from my insurance carrier.  Apparently, EOBs (Explanation of Benefits) must be sent in triplicate or quadruplicate because I got a ton of them, but they all said that Hazeline’s newborn care was covered by Erajh’s insurance.  All was right with the world.

In November, we had the opportunity to move the entire family back to my insurance because Erajh’s rates went way up.  The switch was made, almost seamlessly.  A snag here and there – i.e. my insurance doesn’t cover the after hours fee at our pediatrician’s office – but for the most part we went on with life as normal.

Until yesterday when I was notified that neither of our insurance companies will be covering Hazeline’s newborn care.

So let me get this straight.  In a society where so many go without health insurance because they can’t get it or can’t afford it, we are, in essence, over-insured.  And yet, our claims that should absolutely be covered because they were within the first 30 days of life, are being denied…by both companies.  How do they get away with this?

Oh no, my friends, someone will pay.  I will make sure of it.  And it won’t be me.