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Posts Tagged ‘Insurance’
Wednesday, September 16th, 2009
Over the past few Fridays I’ve been making appointments with a variety of my doctors. I’ve seen an optometrist, a dentist, and my general care practitioner. Also, I’ve been back and forth to the pharmacist a few times to get some prescriptions that I need. This Friday I’m going to see a nutritionist, too. But I have to tell you, while I’m going to visit these various care providers, I’ve noticed that my insurance pretty much sucks in all respects.
Below is the bulk of a text of an e-mail that I sent to one of the leaders at my job. The purpose was to explain all of the problems that I’m having with the insurance – frankly, some of this stuff is insane…
Prescriptions: The most aggravating issue that I have is the prescription coverage. My doctor prescribed a certain drug for a condition that I have, but he gave me free samples to use first. Once the free samples were completed, I tried to get the prescription filled and the pharmacy told me that the insurance company didn’t cover the medicine (first they said I wasn’t in their system – a recurring theme as you’ll see). Instead, I have to take two generics – the free samples that my doctor gave me were working very well, too. I don’t mind taking the generics, but now I’m inconvenienced with taking two pills instead of one.
Additionally, I tried to fill the generic prescriptions and one was approved with no problem while the insurance company wouldn’t immediately approve the second one. They wanted additional information from my doctor, which the pharmacy requested. The Pharmacist said that the process should take no longer than 2 – 3 business days, so given the upcoming holiday, I might not be able to get my medication until after Labor Day. [Note: I wrote this e-mail on Wednesday, September 2nd]
Gym Reimbursement: The insurance company has a Healthy Lifestyles program that I am enrolled in. This program offers $150 for reimbursement of gym membership expenses if you go the gym 120 times in a given year. When I switched to my new gym in March I asked if it was covered in the program and they said yes. On a following call with the insurance company, they told me that the visits to this gym would only count if they were made in between certain times of the day (basically when we’re at work). That effectively kills my ability to claim this reimbursement and it makes their program useless.
Request for Information: In one of these calls to the insurance company, I asked them for a package of information that detailed all of my benefits because I, unfortunately, lost the package that the secretary gave me when I was hired (I lost it in the move to Tinton Falls). They sent me a package for those members who are 65+ years old living in Somerset County. I called them back and told them that they must have the wrong guy and that I was 28 and living in Monmouth County while being employed in Mercer County. They apologized and sent out a new package…the same package as the first time. So I threw out both packages since I’m not a senior citizen living in Somerset County and gave up trying to ask them for a listing of my benefits.
Delta Dental: When I went to the dentist two weeks ago, I had to wait an hour before I could be seen by the doctor because the assistant was told by Delta Dental that I wasn’t in the system. Apparently, she called a few days prior to my visit and I wasn’t in the system then, either. I gave her our office contact information, but I was in the dentist’s office at 8am for an 8:15am appointment so there wasn’t anyone in our office who could help that early on a Friday morning. After waiting on hold and going back and forth with the insurance company, I was magically found in Delta Dental’s system and able to see the dentist at 9am.
Optometrist: The insurance company subcontracts their vision coverage to a vision company. I went to the eye doctor about four weeks ago and it took them over an hour to figure out how to bill me AFTER I had seen the doctor. They were on the phone with the insurance company who took no ownership over their contract with the vision company and said that I wasn’t even in their system (they eventually found me). So the eye doctor’s office called the vision company, who said to contact the insurance company. This went back and forth until someone finally got on the phone and figured out what to do and how to bill me.
Pearle Vision: When I was getting my glasses at Pearle Vision, the person helping me pulled up our company’s specific plan with the vision company and it cited that we had a really great plan that covered some parts of the equipment (great discount on lenses). Then when he called the insurance company to get some confirmation number, they wouldn’t speak to him and put him through to the vision company, who bounced him back to the insurance company, who ultimately said that we had no equipment coverage. The folks at Pearle Vision were baffled since their information (which had been updated about two weeks earlier) clearly showed all of the equipment coverage that we should be getting on our plan.
This is where my e-mail ends. However, there is an addition to this mess…
Nutritionist: It turns out that my nutritionist visit (which is essentially preventive care – the stuff that everyone in America should be engaged in) is not covered either. You see, my nutritionist is not registered as a medical care provider and thus can only enter a certain billing code to the insurance company. Well, my plan doesn’t accept that billing code – they only accept nutritionists that bill as medical offices. So I have to pay for this visit out of my pocket.
Here’s my question – if I’m paying for health insurance and I have all of these needs that aren’t being met by the insurance company…why am I paying for health insurance again?
Posted in United States Politics | 4 Comments »
Thursday, September 10th, 2009
It’s barely past noon and today has been filled with nothing but bullshit. First, I went over to the college where I teach to figure out why my magnetic parking pass wasn’t working for the faculty parking lot. Turns out that the dope who gave me the parking pass and my parking sticker a few weeks ago gave me all of the wrong information. Wonderful. This was a real pain in the ass last night as I tried to get into the faculty lot and the damn thing wouldn’t open up!
The folks over at the parking office were wonderful, though, and they gave me the proper information. As it turns out, I’m not allowed to park in the faculty lot since I’m an adjunct professor. I’m okay with that – whatever works. But they made me take off the “Faculty” sticker on my car and replace it with an “Employee” sticker since that was the only one that they had in the office. In other words, I can park on less places on campus now because of the office didn’t have the right sticker. How do you not have the right f’ing sticker?!
Whatever.
After I was on campus I went to the post office because I had about 8 textbooks that needed to be returned to the publisher. You see, when professors get free copies of books (called “desk” or “examination” copies), they can do a few things. First, they can review the text book and choose to use it for their course which is what the publishers are hoping to accomplish by sending a free copy of the textbook in the first place. Second, they can review the textbook and opt not to use it for their course. At this point, they have two more choices. If they don’t want to use the textbook, then they can either a) keep it on a bookshelf in their office or b) return the textbook to the publisher.
Since returning textbooks to the publisher helps to lower the overall cost of the texts for students around the nation, I opt to return the texts. The publisher, to their credit, lets the professor print a “postage due” label so we don’t have to pay a ridiculous amount to ship the books back. However, when I went to the post office, I had to pay $6 for a box to send the damn books back in! Ridiculous! I know it’s only $6, but come on!
On my way back home I stopped at Wegmans to pick-up a prescription. I actually have no complaints about this stop since it was quick and easy. However, the fact that I had to wait a week for my insurance company to approve the prescription is pathetic…and that annoys me.
All of that aggravation aside, I should note that last night was the first night of the course that I teach and it was awesome. For the first time I was able to use this little Kensington clicker device that my Mom got me for Christmas last year. It lets me flip through the PowerPoint presentation from anywhere in the classroom. Plus it has a red laser pointer thing so I could point out certain parts of pictures from the back of the classroom. It was great!
Also, tonight is the first night of a class that I am taking at the college. As an adjunct I’m able to take one class per semester for every class that I am teaching that semester. Since I’m teaching one class, I can take one class. It’s a good deal. I’m taking this course because it’ll put me halfway to receiving a certificate in Public Relations, which can only help bolster my resume.
Let’s hope the rest of today isn’t as aggravating as the first half has been!
Posted in Computers, Internet, & Technology, Idiots, Morons, & Fools | No Comments »
Thursday, August 27th, 2009
Going back and re-reading some of my posts over the last few weeks makes it pretty apparent that I’m finally taking a long-overdue interest in my health. Between the optometrist visit, the dentist visit (including follow-ups), and the doctor visits, I’m trying to get myself in the best shape possible. Part of this is because I haven’t been to these various doctors in so long, but I’m really going to these places because I have health benefits and I feel that I should use them…before the government finds a way to mess up healthcare.
Speaking of healthcare, one of the subscribers to this blog (by the way, have you subscribed to the blog yet? If not, go to the top of this page and subscribe there!) sent in his proposal to reform healthcare. It’s interesting, to say the least. Frankly, I think there is merit in the proposal, which is copied below from a recent op-ed:
A proposal to reform medical care and save the federal and state governments and the American taxpayer billions over the long run.
Federal and state governments would pay all costs of a medical school education for students who otherwise would not be able to afford a medical school education. No student would be excluded, provided that upon completing medical school, the doctor would be obligated to provide a percentage of their time and practice for treating low-income patients deemed eligible by federal and/or state governments.
The doctor would be obligated to treat a small percentage of eligible low-income people for free (office visits only). The percentage and number of years of obligation to do so would be decided by peer review. The less money provided to the students for their medical education, the smaller the percentage of their obligation for treating the eligible poor.
Participating doctors would not bill Medicare, Medicaid, insurance companies for the treatment of the eligible poor, thus saving federal and state governments billions of dollars in the long term.
The cost of the free medical school education provided by federal and state governments would be offset by the savings achieved by not having doctors bill Medicare, Medicaid and the insurance companies. Students in any stage of medical school would immediately be eligible to participate.
Doctors would have the option to treat eligible patients in their office, at hospitals or clinics. Clinic space could be provided for out of office visits.
The same premise can be applied for health providers and caregivers willing to participate under the same above rules and obligations. The federal/state governments would defray all cost to all eligible health providers and caregivers to open up their medical practice/office. Doctors, labs, chiropractors, and therapists would be eligible under my proposed program.
The potential saving to the federal/state governments from non billing by participating caregivers would be enormous.
Regarding unnecessary diagnostic tests that are ordered by doctors out of fear of medical malpractice, a meeting of the minds could be convened among federal and state policy leaders, bar association representatives, medical insurers, and health providers, to come to an agreement of understanding as to limiting diagnostic tests deemed unnecessary.
Joseph P. Martino
Millburn, New Jersey
What do you think?
Posted in Random Entries, United States Politics | 1 Comment »
Wednesday, May 20th, 2009
Yesterday I received an e-mail telling me about the Palisades Car Insurance search for the nicest drives in New Jersey. I thought that I would share the information with you all since there is an opportunity to win free gas in the promotion. Read on…
Palisades Car Insurance is starting their search for the nicest drives in New Jersey. We are asking New Jersey-ians to submit their nicest drives in text, photo, or video so that everyone can enjoy the best NJ has to offer. The best part is that everyone submitting a nice drive will be entered to win one of twenty-five $50 gas cards!
Submissions will last until June 22. At the end of June, Palisades will share its top 10 drives (as selected by an expert panel of Palisades Crashbusters ® – people who drive over 300,000 miles a year) on its website.
For submissions please visit Palisades.com/nicedrives and fill out the form.
Why the nicest drives? Well, Palisades is the nice New Jersey car insurance company. So nice, that its service is ranked as one of the highest in the state — better than Allstate, GEICO, State Farm, Progressive, and others. (Source: Palisades was ranked far superior to many national insurance brands – including Progressive, GEICO and State Farm – on how well its policies and practices supported quality and speed of repairs, as well as the overall customer experience according to a recent independent survey of NJ body shops conducted by USA/Direct, Inc.)
There you have it – looks like some of you could have the opportunity to win a free gas card. Not a bad deal for entering some information on a website.
Posted in Random Entries | No Comments »
Thursday, March 25th, 2004
Is there anything worse right now in the United States than the job market?
Well, I should probably clarify that statement – the worst part about the job market is the fact that the only jobs that are available are jobs at McDonald’s and Wal-Mart. However, for college graduates – there’s nothing out there. Yeah, you might be able to get a job at an entry-level position for a major financial or insurance firm, but when you get that job, you might as well kiss happiness goodbye.
Every single person who I know that graduated from college with me last year is as equally appalled at the job market as I am. And it’s not a matter of them not being able to find one as so much as it is the fact that the ones that are available offer no upward mobility and shit pay.
What is the answer to this? I sure as hell don’t know – if I did, I definitely wouldn’t be going to an “interview” at Borders bookstore today for a part-time job…
Posted in Money, Jobs, & Finances, Random Entries, United States Politics | No Comments »
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