42

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.

Signed,
A Furious American in Ireland