Now - just worried
In the mail yesterday, I received another envelope from our health insurance claim department, this time for DD3. Her visit to the doctor was for a Sports Physical. This is where I am almost holding my breath.
We do not have good insurance. We are self-employed. Our insurance does have great prescription coverage and emergency or extraordinary medical cost coverage including the big ticket items. We do NOT have doctor visit coverage, with all of us it would have been double the price which it is now.
So, I was a little confused when hubby's visit was partially covered, but assumed our doctors office prepared the claim correctly by stating it was an injury and not a check up visit. Which would render a few dollars paid. Not to mention the confusion created when his MRI was covered all except $40 - I still haven't figured that one out - doesn't match our declarations page at all. I have calculated over and over again and can't figure out how they covered so much. But I am thankful.
Then, DS2 had his big Freshman Physical which cost $185 and the insurance just saved us $13.29 as a PPO Discount. This looked very much like all the past claims. So, I am assuming hubby's differences are due to an injury.
In walks DD3's physical claim. Now, I don't know if the folks at the insurance company are smoking some wacky-tobbacky, but they have stumped me completely with this one. DD3's sports physical cost $60. We received a PPO Discount of $15.43 and the insurance company paid the balance of $44.57. Which means we are paying ZERO. No lie.
I'm thinking these people are going to wake one day and see the error of their calculations so I should be prepared to pay some big bills. Or should I just rest easy and enjoy the return of some of our huge premiums?
3 comments:
If it will make you sleep better at night, I would call them to "confirm" the amount listed in your insurance statement. Don't say anything about you thought you were responsible for more of the cost, etc. Then get the name of the person you were speaking to.
If they confirm that you indeed owe zilch, it's time to celebrate =)
Rest easy. Enjoy it.
I have found there is no logic to what they pay or don't pay. Enjoy the savings this time, because next time they will not pay anything. Go figure....
Post a Comment