HealthProblem

I am unfortunate enough to have Coventry Health Care as my provider. “Provider…” ha, that’s rich. All they provide me with is headaches and a monthly bill for healthcare that I can barely use.

I learned my lesson the hard way last year when I called to find out if a specific test was covered, told it was, but was NOT told that the cost of that test would not be paid for, but rather, would be applied to my deductible. Had I known that little nugget of information, I would have not had the test.

So now, I call to check on everything. That being said, before my daughter went back to college I wanted to get her eyes checked, so I called Coventry and asked. The man on the phone told me that my girls are covered through the age of 19, at which point I said, “Great! She turns 20 next week, so I can just get her in under the wire.” He laughed and agreed that it sounded like a good plan.

I had to jump through quite a few hoops to get her an appointment before her 20th birthday, but I got it done. I get her to the appointment and hand over my insurance card. A few moments later the receptionist calls me over to tell me that under my insurance, the eye appointment isn’t covered.

What?

I immediately get on the phone with Coventry, where they once again, cannot even find my insurance via my member ID. The woman on the phone informs me that under my plan, pediatric eye care ends at 16. I explain to her that I had called just the week before and was told that she was covered through her 20th birthday. She says, “Sorry! That’s wrong.”

So I have to go in and cancel the appointment. I felt like such an asshole, but there was no way I was going to chance having to be responsible for the cost of this eye exam. After apologizing profusely for wasting their time, my daughter and I left the doctor’s office and headed back to my work.

I was pissed. I had just blown my lunch hour and wasted my daughter’s afternoon. I called hubby who was equally pissed – he had to take time out of his day to drop my daughter off at my work so we could make this appointment. He said, “I’m calling Coventry.”

To which I replied, “Don’t waste your time. I can’t get the appointment back, and they’re not going to do anything anyway. They are the Healthcare System….they make it their business NOT to care.”

But he called anyway, demanding that they pay for my daughter’s eye exam, because they had told us we were covered.  He kept upgrading to supervisors and managers until he finally got a woman who was willing to pull the tape of my initial phone call too see if this guy had misinformed me. She assured us that someone would call us back within 48 hours.

That was August 18th.

My husband, refusing to give up this fight, called several more times, wasting countless hours, and each time a Coventry employee assured him that a manager would be back in touch with him. Guess how many managers called back? Zero!

It all came to a headthis past Friday afternoon. Without taking up too much more of your time, I will tell you the two lies Coventry told us.

LIE 1: Had we just gone ahead with the appointment, Coventry would have paid for it in the long-run. I will wait for you to stop laughing before I continue.

I have a feeling someone finally did listen to that tape and heard the guy tell me she was covered up to the last day of her 19th year. That is the only reason why this person would be saying this, other than they really wanted to get us the hell off the phone. This is like 4:30 on a Friday afternoon, and my husband and I are RUINING the start of their weekend.

There is no way in hell I would EVER had continued on with the appointment. I know how these asshole companies run – I learned that last year. I’m still paying off a $550 cardiology bill for services they said were “covered.”

I argued this point saying that I had called Coventry while AT the doctor’s office, and was told that she wasn’t covered, so why would I be so stupid as to go ahead with the appointment? And this is where lie #2 came in, just minutes after we were told that she would have been covered,

LIE 2: Because I made that phone call asking if she was covered from the doctors office, I was no longer misinformed about my coverage, thus freeing Coventry of any wrong doing. Because in their eyes, during the second conversation I had with a Coventry employee, I was told correct information. Therefore I was aware of their policy and have no platform on which to complain.

Except I was already AT the doctor, and I had lost hours of my time because someone on your end is a fucking idiot and told me I had until the day before her 20th birthday to get her eyes checked. In other words, because I did my due-diligence TWICE, Coventry was free and clear of any wrong doing.

Yeah, I hate Coventry. And before any of you get on an Obamacare soap box, know this. I LIKE that I can get relatively affordable health care. I pay $365 per month, which absolutely kills us financially. It leaves us with little to no money for anything fun at the end of the month. But if it weren’t for the President’s plan, I’d never be able to afford anything, because it would most likely be $700 or $800 per month for the same shitty coverage.

At least with this coverage if I get hit by a bus, I may not lose my house. I will close with this…If you have a job with an even marginal health care plan, be very, very thankful.

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