Friday, April 16, 2010


Yes, 42. That is the number of times I’ve spoken to our health insurance company since January. Yes, I’ve kept track, not only of the number of times I’ve called, but the length of each call. Most were well over an hour, or close to.

For those of you in the Foreign Service, you know that we have the choice of two health insurance companies for overseas coverage. For the purpose of this post, we shall call them Company A and Company B. We have Company B.

Overall, I’ve been very pleased with Company B. They don’t offer ANY infertility coverage (another post for another time) and yes, their rates are high, but the coverage in the U.S. is phenomenal. All of my specialists in Scottsdale, Arizona are on the “preferred provider” list and rarely do I owe much more than the copay. Happy. Overseas, Company B has caused many, many tears, panic attacks, fits of rage, etc, etc, etc.

So, why have I called Company B 42 times? In January when I booked my first appointment with the high-risk OB, his secretary explained the billing set up to me. Prenatal care (not delivery) is €4,000. The first payment of €1,000 is due at the first visit. Remaining payments of €1,000 are due at subsequent visits. Sounded fine to me, ALL of the other OBs I’d called, or our health unit had called, had similar billing practices. I called Company B and asked what paperwork I would need to be reimbursed. (For those not familiar with the Foreign Service, overseas we have to pay for all of our medical care upfront, then go after the insurance company for reimbursement. Um yeah, NOT fun). Company B told me that I would need to submit the receipts and dates. Ummm, “Are you sure”? Oh yes, I was reassured during FOUR separate phone calls. Believing this to be too easy, at the first visit/ first €1,000 payment, I asked the secretary to type up a specific letter for me to submit to Company B, clearly spelling out the payment practice. Over the next few months, Company B received the claims for three payments of €1,000, with receipts, with the standard explanation of payment given to all patients, AND with the letter written specifically for me. DENIED, DENIED, DENIED

And so began the phone calls……

First I was told, many times, that I needed CPT codes. WHAT????? I live in I.R.E.L.A.N.D; there are no CPT codes. CPT codes exist in the U.N.I.T.E.D S.T.A.T.E.S (remember, I am speaking with the “federal overseas customer service department”). After much frustration, they seem to finally believe that CPT codes indeed don’t exist in Ireland. Then I was told that I need to include dates of service. Err, did you NOT see the paperwork included that spells out the payment set up? Then I was told they wouldn’t cover “prepayment of services”. Again, did you NOT see the paperwork included?

Throughout the phone calls I have remained calm, avoided “choice” words that I sooooo felt like using, and somehow managed not to scream at anyone. I have asked for supervisors, read them the paperwork, offered to get additional letters from my doctor, letters from the embassy health unit, etc. Nope, nothing is good enough. I have tried to explain that as an American, I can’t go into another country and expect them to change their billing scheme to fit my needs. I’m paying (a lot) for “overseas coverage” and I expect to be, you guessed it, covered overseas. Then I hear, “You do have overseas coverage”. No, “I’m paying for coverage, but clearly, I’m not covered.”

As of last week, I was told to just resubmit everything after the baby is born. Err, so I’m supposed to be out almost $6,000 for several months with no guarantee of reimbursement? Don’t think so. Plus, what Company B can’t seem to grasp is that the €4,000 (roughly 6K USD based on exchange rates at the time) does NOT include delivery fees, even though all of the paperwork clearly states “does NOT include delivery fees” in BOLD letters. So then I ask, “So, if I wait until late July and submit all maternity expenses and delivery charges, I will be reimbursed”? (at least €8500+) Answer, “No, that would exceed your plan allowance”. My head is going to explode, explode I tell you. I haven't even shared with them the joyous news that I might be delivering in the U.S., I'm sure their main office of operations would internally combust upon hearing that.

Phone call after phone call has ended with tears, hanging up, and sobbing in frustration. Call Washington and ask for help you say. Been there, done that. I was told that this has never been a problem before (riiiiight), to call and speak with a supervisor, and here, try this number. I immediately tried the number and reached Company B “of Georgia”. At that point you could probably see steam coming out of my ears.

Today I’m giving myself the day off (from speaking with Company B). The ‘fun’ will resume on Monday.

A Furious American in Ireland


  1. Oh. My. Gawd. I think we have the same insurance company. Can't wait to have to deal with all that.
    Things went surprisingly smooth when I had to have a polypectomy with a local OB/GYN last year, but we never paid the doctor/hospital up front. The co-pay was through the roof though.
    I take it there are no military hospitals around?

    You are one strong woman. Get them basterds!

  2. You poor thing!! So frustrating!! You did well in keeping cool, I definitely wouldn't have been able. You are in my thoughts my friend, I'm telling you, they'll reimburse you eventually, keep at them!! Fran

  3. I am so irritated for you! I completely understand your frustration. Overseas coverage! They should easily understand about the CPT code thing. You're right! And that's just the tip of the iceberg.

    I think you have two things working against you:
    a. you're dealing with corrupt health insurance (i'm not for the hcr, either, bc that has major problems too)
    b. You're dealing with the corrupt gov't. You would think federal employees would have soooo much better health care, bc after all, Obama's looking out of you. :::rolling eyes:::



  4. CP- My husband's not with the military, and I don't think there are any military hospitals in Dublin anyway.

    MZ- Exactly ;)

  5. It's Friday, and that means that the Weekly State Department Blog Roundup is up - and you're on it!

    Here is the link:

    (If I quoted your text or used your photo(s) and you would rather I had not, please let me know. Please also be sure to check the link(s) that I put up to you, in order to verify that they work properly. If you would rather that I had not referenced you, and/or do not want me to reference you in the future, please also contact me.)


  6. Man that is frustrating! I mean just in the US dealing with insurance is frustrating, add on you are in Ireland and calling the cust ser that is suppose to be able to help you! So sorry for this C. It all sucks. I have no insurance, everything is cash, although cheaper than in US for sure, still it adds up. Enjoy the weekend and let it rip Monday girl.

  7. Here I was thinking thst was your age - it's mine so I can relate! isn't Government a synonym for mazelike bureaucracy ( sp) that has no end! Not that private would be any better!
    Keep your persistence and keep fighting and don't give up till you get some money. You won't want to do any of this when your baby is born!
    Hope you have a great weekend off!

  8. Ugh. I faxed a 14 page, tear-stained, hormonally-driven, handwritten letter to our insurance company and the state insurance commissioner before the basic fees for our first were covered. All that frustration comes up, just reading your post. But, perseverance does tend to pay off when it comes to stupid insurance companies.

  9. Feeling your pain over here. I think it was company B that refused to pay when I had to be medevaced on a little hospital airplane. 60 THOUSAND dollars, and they refused to pay, because they considered it an ambulance, and I was supposed to inform them within 24 hours of service. Ummmm - I was in surgery in a foreign country, people.

    Here's something, though, and maybe you already know this. When I delivered in Beijing, the nurse told me that the State Dept would kick in as secondary insurer for anything NOT covered by my insurance company - even including taxi fare to appointments. So save every scrap of paper, and talk to the nurses there. They should be able to open up a fund site after baby is born and reimburse you for every bill your insurance company refuses to pay. Same if you decide to deliver in the States. If so, you'll actually give the hospital a form listing State as your secondary insurer, and the bills will go directly to State after insurance pays up (or, errr, doesn't pay up).

    Good luck...

  10. Donna, good to know I'm not alone in the nightmare of dealing with Company B. I can't imagine a 60K "ambulance" trip. Eek!!!

    I was told that a "fund site" could only be opened if I deliver in Dublin, so I will definitely check on that again. Thanks so much!

    Amazing what we have to put up with.