Saturday, March 1, 2008

Getting Screwed by Anthem

In Colorado, Anthem is the main health insurance provider. United is here as well, but it's pretty expensive and not as comprehensive for single payer plans.

In short, we are getting totally screwed by Anthem. As some of you may know, Jade had some minor surgery this winter. That has red flagged our account, and we are now subject to harassment. They claim that Jade had two pre-existing conditions that she concealed from Anthem.

Okay - first off, we've had continuous coverage, and Health Insurance providers don't get your detailed medical history information from you - they get it from your care providers. So how would Jade selectively conceal conditions? Are they postulating that we made some devil's pact with doctors to hide things.

Second - one of the conditions was over seeing a doctor for dry skin. Dry skin. We live in one of the driest parts of the country. I can tell you, there was no dry skin being hidden in Massachusetts. And on top of that - Jade's first visit to the doctor to get diagnosed and treated was AFTER coverage started.

Third - without outing the nature of Jade's surgery, Anthem has inferred that it was connected to other issues that Jade has had, and that she was concealing those. Okay, two things wrong there. The inference is totally false, to the point that Jade's doctor balked when she heard it. It would be like saying shortsightedness was the cause of having an eye infection. The second is that the ongoing issues that Jade has are well known to multiple doctors, and Anthem should have easy access to all of that information.

Fourth - the way Anthem is treating my wife is totally bullshit. They sent her a 31 page document to verify, and told her not to expect to be covered for up to 90 days until this is cleared up. And that's if they find us not guilty of fraud, or whatever they are not openly accusing us of. And of course, I still have to PAY for coverage.

Fifth - a couple of months ago, Anthem inexplicably raised their monthly rates by about 20%. There was no improvement in coverage, I can tell you that. Doctor's visits are barely covered, and apparently you can count on them turning on you in the event you need surgery.. Surgery that I paid 60% of after I reached by deductible. So basically, I pay 600 bucks a month for cheaper prescriptions. Wow, thanks Anthem. Did I mention Anthem sucks? (trying to get this blog post to show up on google searches for "Anthem sucks")

Sixth - there were inaccuracies in the forms that Jade filled out. Major ones. Tatum's birthday was wrong; Jade's weight was wrong, and the YEAR of Jade's birth was off by 3 years. Who filled this out, a drunken chimpanzee? And of course, Anthem's stance will be that it is our responsibility to make sure that information is correct. Right, because they collected the information, and they are getting paid to manage our medical histories and distribute claims based on that. Really, makes sense. I would think that if we were going to try and rip off Anthem, we would make sure everything else was accurate to minimize suspicion. So they are insulting our intelligence, not just our integrity.

Seventh - After we faxed the form back yesterday, we received a DUPLICATE form. Another 31 pages with the same nastygram cover page threatening coverage being revoked if we don't fill out and return. Jade spent an hour on hold, getting disconnected, to have a low level customer support person tell her that she: A. thought Jade didn't have to fill it out again, but wasn't sure, B. Could not transfer her to a supervisor who could say, and C. told her that a supervisor would call her back. Oh, and that's a day or two after another rep told her that a supervisor would call her, and never did. And D., she thought that it was a computer generated error, sending duplicates. Yeah, um, no - computers don't make mistakes. They operate as they are instructed. So somebody has duplicate information on file, or did something wrong to cause the computer to send it twice. A computer glitch? Who is buying that - what is this 1982? That's like saying you didn't get somebody's voicemail.

There is probably an 8 or 9, but I'm tired of writing about it. It's just so lame and stereotypical. What is the point of insurance - its like a gamble that you make on getting sick. And then the health provider reneges on their end of the deal. What the fuck, Anthem? You are hanging your paying customers out to dry, and I am going to make sure everybody knows it. Yeah, people get screwed over way worse than us, but that's the point. I want to call the local newspaper, the local public radio station. Just to raise the profile of what's wrong with healthcare in this state. Bottom line: they didn't have all their information, and the information they did have was wrong. So they turn around and make it our fault. They use a posture that is very adversarial, and their infrastructure is unequipped and uninterested in providing assistance to its customers. But they are really, really good at taking my money every month.


Jess said...

maybe you could get Hilary to help you out

Giuseppe Jonathan Jones, CPA said...

Sure, do you have her number? I don't know what all the hullabaloo is about privatized health care - or even just privatized health insurance. I don't like the fact that health insurance companies act like credit card companies, and that they push their profit margins at the expense of people's health and well being. At least with lending organizations, they are taking people for a ride based on their level of irresponsibility. Bad lifestyle habits notwithstanding, insurance companies are messing with people based on things they have no control over.

Jess said...

unfortunately health insurance companies are only interested in the bottom line - and not only the insurance companies, but health care in general.
I sure don't know what the solution is.