We Just Had Our 1st Problem With Insurance

Before we purchased insurance through my husband's work, I called the insurance company and told them about Sam, about his therapy, etc...I asked which would be the best insurace coverage, that would cover most and I asked if he would by any means be excluded for a pre-existing condition...The were very helpful, he will not be excluded...

I asked again about his therapy...I was told that there were limits but they would cover it, except for the co-pays...WELL, guess what...I got 3 bills in the mail...coverage denied, coverage denied, coverage denied, patient is responsible for payment...

So, I called...turns out our therapist group is out of network for the POS (which is what we chose because of what it covered), but is covered under the HMO and PPO plans...

Being that it is out of network, there is a $1000 deductible, then they will pay 70%, and the limits to the number of times he can visit is 50 times per type of therapy per year...50 TIMES is 25 weeks...what about the other 27 weeks in the year...WE HAVE TO PAY...

Then, the lady was nice enough to tell me that I could fill out the paper work and appeal the decision if I want...I told her to send me the "book" so I can get started...

Crazy Insurance...They should have told me the HMO was better for our situation...I would have went with it (it was cheaper, too)...We can't even change until they have open enrollment again,

GO FIGURE...