Sunday, January 20, 2013

Insurance Hell

I was struggling to come up with a title for this post, because how can I even begin to describe this nightmare we are now dealing with?  Turns out all it took was two words to sum it all up.

Our story so far-  My employer, Locally Owned Bank (LOB), had their benefits re-enrollment this past November, like most companies.  My insurance provider (rhymes with Poo-nited Wealthbear), was offering for the first time, a high-deductible health care plan or HDHC.  On the surface, the benefits of the HDHC look pretty good: my portion of the premium would be half of what was normally deducted from my paycheck.  Also, to participate in the plan, you had to enroll in a Health Savings Account, or HSA, which LOB (since they're a bank and all) generously offered to open for their employees.  The HSA looked pretty darn attractive.  In addition to what was deducted from my pre-tax pay, LOB also contributed money to the account.  Also, an HSA rolls over the money at the end of the calendar year.  Unlike the old Flex Spending Accounts (FSA, I'm getting tired of all of this alphabet crap), there's no 'use it or lose it' penalty.  The HSA just keeps building and building. 

Despite how good all of this sounded, I still had questions for LOB and Poo-nited.
  My question for LOB- "How would this plan benefit me over the traditional PPO plan?"
 LOB benefit flunkie's actual answer- "Well, you'll just have to crunch the numbers and find out"
Me- "What numbers would those be?"
LOB- "Um, your healthcare costs"

Thanks for that LOB.  So later that night at home, I read over all of the info, watched the videos and 'crunched the numbers'.  I had nothing from LOB or Poo-nited to show me what the actual costs of doctor's office visits or prescription costs would be, so I calculated our expenses using our current PPO co-pays, because that's what I had to go on.  Were these co-pays going to be the same as what I was paying on the PPO, or more or less?  I decided to ask Poo-nited to clarify.

The next day, I went back to the conference from where the 'benefits fair' was being held.  The rep from Poo-nited was sitting alone at her table.  Now, this was back in November, so at this point, I can not tell you Poo-nited's rep's name, or even what she looked like.

 I asked Poo-nited rep-  "Under the HDHC plan, do my co-pays for doctor office visits or prescriptions change?" 
Poo-nited rep- "No, the co-pays do not change"

Woo-hoo! Because I was told that the co-pays do not change, I signed us up for the new HDHC plan.
Cut to January 1, 2013.  The HSA plan has $0 in it.  This was a shock, because from everything I had read on HSA accounts, at least the employer's contribution for the year would be in the account as 'seed money'.  In the traditional FSA accounts, ALL of the money from employee's pre-tax contribution is there at the beginning of the year, and then deducted from each paycheck as usual. Red flag #1.

On January 14, The Husband had to go for his monthly doctor visit.  He had to give the doctor's office our new HSA account info, but tell them not to run the charge until the next day, because there was $0 in the account.  Nice.  Then he gets to the pharmacy.  One of his scrips normally has a co-pay of $50.  So imagine his surprise when the pharmacist tells him that his cost today is $320! HUH??!!  The husband was in a panic when he called me at work, and needless to say, I was surprised too.

I called LOB HR the next day.  I told HR that Poo-nited had said that the co-pays don't change.  HR said that Poo-nited told me wrong, because this plan has no co-pays.  Everything, including prescriptions, goes towards the deductible, which is $4k. I asked HR (and jinxed the Husband) by asking if  I had a hospital bill for say $6k, would we have met the deductible?  LOB HR tells me "yes, then you have met the deductible".  But no, that's WRONG. Yep, we have to pay four thousand dollars out of pocket before the plan kicks in and pays 90/10 on everything.  I explained to HR that I work for LOB, I don't have an extra $4k just lying around.  HR tells me that I can use the money in the HSA to pay these costs.  Yes, that's wonderful, but it's kind of hard when the money is only deposited in there each pay period and not all at once.  We weren't able to use the HSA at all before January 15 because there was no money in there.  What if we had had a medical emergency?  I told HR that I need to switch back to the PPO plan because this HDHC would bankrupt me.   HR told me, that no, I had made a commitment, and even thought Poo-nited gave me the wrong info, LOB's info was correct, so basically, too bad and suck it.

This past Thursday, while I was home recovering from the flu, the Husband fell backwards off of a stepladder.  He fell on to his toolbox, hitting his back and the back of his head.   Chickenhead and I ran in to the living room to find the Husband in a crumpled heap.  He told me his back hurt, and more seriously, he was having chest pains.  I immediately called 911 and they took him to the hospital.   The hospital did a CT scan and kept him overnight, and did a stress test on his heart the next day and released him.  The tests came back normal, which I'm glad for.

In the midst of all of this, I feel duped by LOB and Poo-nited.  I'm not a stupid person, I don't have comprehension problems.  I researched the shit out of this insurance plan, using all of the information provided by LOB and Poo-nited, and asked direct and pointed questions about the aspects of the plan I wasn't sure about.  I asked specific questions, and based on Poo-nited's answers, which turned out to be wrong, I chose this plan.  And because LOB has taken a 'suck it Trebeck' attitude, my family finances are screwed.  We have to figure out where we're going to come up with $4k so that the bills are paid and the deductible met. 

I know that things always have a way of working themselves out, but damn.  This pisses me off to no end, and to know that LOB, which prides themselves on their employee satisfaction ratings, doesn't seem to give a crap when it comes to their employee's best interests.


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