As all Kossacks are aware, healthcare in the United States is a mess. Insurance premiums are skyrocketing and out-of-pocket costs are mounting at an alarming rate. The legalese and confusing language would flumox even the most educated person. Nyceve has written many diaries over the years documenting this with facts and heart-breaking personal stories.
Today, I dealt with the blatant lies and shiftiness from my insurance company. To wit, my husband has fairly decent insurance benefits, but lousy hourly pay. We have 3 kids, and need health/dental insurance. My husband has a group plan through work, and we contribute more than our fair share to have them. Needless to say, a large portion of my husband's paycheck is deducted to pay for said benefits.
Long story short, at hubby's last dental check-up, our dentist said he needed an inlay on a molar. The cavity was too big for a filling. Unfortunately, our dental policy requires pre-approval for said procedure. In the meanwhile the tooth is dangerously close to breaking/cracking, and would need a root-canal and crown if that happens. The inlay is 800.00, of which our insurance covers half. Needless to say, Shenandoah sent a letter disputing the dentist, and wanted more info. It wasn't enough that our dentist office sent in x-rays and every requirement for the pre-authorization. I spent 2 hours on the phone today practically begging them to approve the claim. No dice. The representative lied repeatedly with delay tactics and gave me the run around. The Shenandoah rep kept insisting our dentist hadn't sent the needed info. Mind you, I had already spoken with our dentist office, and they were baffled at the hoops we have to jump through for a needed procedure. I was almost in tears after dealing with this.
The last call I placed to Shenandoah today was the final straw. I spoke with the same rep. and called her on the b.s. She hemmed and hawed when she knew the run around was not working with me. I called her on the lies and dishonesty. Yes, I threatened a lawsuit. In the end, I sent a fax, e-mail, and written letter detailing my experience with them, and demanded an immediate response.
I would also like to add that we are on a fixed income. In noway, shape or form can we afford to pay this. We have no safety net. We will have to get a personal loan from our Credit Union to pay our portion. After this ordeal, I felt sick to my stomach, and guilty. I was thinking, "at least we have insurance." Someone without insurance would suffer until the tooth became impacted, and had to be pulled, or worse.