Thursday, February 14, 2013


With a new job comes all sorts of new, strange, and oftentimes, head-ache inducing things. 
One of those new things that came with going back to teaching was having different insurance.  For the first time in many moons, I have my own health insurance, instead of being covered under my husband’s.  When we were crunching the numbers, it just made sense financially for our household that I use one of the ‘perks’ of my new gig.

So with brand spankin’ new insurance comes crazy paperwork, keeping fingers crossed that my current doctors will be in-network, and hiring a weekly housekeeper with all that money we’re saving!!  (okay, I made that last part up.  Seems like we are quite adept at finding other places to spend that newfound cash.   Namely, the orthodontist.  And Spec’s. ;)

Fortunately my primary care physician was in-network, as well as my OB-GYN (with emphasis on the GYN, as I am ‘all-done’ with the OB part of her title.  Fo sho.)  So this is fabulous news, since I am kind of attached to those two.  Not only because I am very loyal, but also because, well, um… change?  Not so much.

But it was a fairly seamless switcheroo, as far as insurance goes.  Until today, that is. 

Today?  I got a letter in the mail to let me know that a claim is ‘on-hold’.  Evidently the services were provided for a PRE-EXISTING CONDITION, and my health care coverage includes a PRE-EXISTING CONDITION WAITING PERIOD.  (By the way, are all those capital letters really necessary??  I don't think I like being CapsLock-yelled at by my insurance company.)

Anyway...   It did not list what the PRE-EXISTING CONDITION was,  but oddly enough, the claim was submitted by my OB-GYN’s office, and the service date was for the day that I had my regular, yearly check-up for all that regular, yearly ‘stuff’ we ladies are required to do on a regular, yearly basis. 

So, what I am getting from this is that my ‘pre-existing’ condition... is the fact that I am a WOMAN?  Yes, I guess that is definitely a pre-existing condition.  It has existed, for… well, for a pretty long time now.  

The good news is that my doctor can re-submit the claim if they can provide the information about when they first began treating me for this ‘condition’.   And if that doesn’t do the trick, then I am invited to appeal the decision.   I plan to make a couple of phone calls tomorrow to try to get this all straightened out.   I hope that it is just a glitch or technicality that is easily remedied, and that I don’t have to appeal to anyone’s common sense in terms of said ‘condition’. 

But then again, we are talking about an insurance company…  I may have to come unhinged and yell at some poor customer service representative over the telephone.  In the end… proving that not only am I, in fact, a woman,  but that I have been a woman ( and a crazy one at that), for a good long time.