Long story short, my family switched insurance in May… I thought everything was fine. I’ve been to a few different doctors for a few things since the switch, no biggie… those claims were paid with no trouble. I’ve been filling Rx’s since May with no trouble (nearly $3k worth at this point).
I saw my endo and eye doctor two weeks ago… and now my insurance won’t pay for those visits because they were for a “pre-existing” condition! I called my isurance last week because I got a letter in the mail, requesting my previous insurance info before they would pay the claim… okay, fine, I gave that to them, they said everything would be fine, and asked specifcally if they needed a certificate of coverage from my old insurance and they said NO. At the same time, I had them correct the spelling of my duaghter’s name since it was wrong on our insurance cards. They said everything would be taken care of, and it would take 24-48 hours to get updated in their system… okay, no biggie. I got another letter 2 days later for another claim, and I called back, just to make sure, and again, I’m told that it should be cleared up in 24-48 hours, and they’re not sure why it wasn’t updated. MMmmmkay, that’s a little weird, but I know things happen. My daughter’s name WAS fixed though… which really makes me wonder. They never said ANYTHING about having any pre-existing limitation on my policy… didn’t even suggest it.
I’m trying to get back on a pump too, and my animas rep told me that my insurance told him Friday that I have a pre-exisiting condition limitation in effect until 12/31!! What?! I was not uninsured when I went on this new insurance… I moved from one group plan to another, I thought they could NOT do this? I fully disclosed everything on our insurance application, including that I was diabetic along with my prior insurance information… so they should have already HAD that. I was never notified in any capacity that there would be a problem… I had no reason to suspect there would be. Why would they offer this information up to my pump rep, and NOT tell me?!
I called up my insurance again yesterday, and they simply told me it hadn’t been updated yet… again. That’s call #3. I see that another claim (for labwork) also went through yesterday, and it’s also listed as “pending review”. What the heck?! According to the first person I spoke with it should have already been taken care of!
I don’t have a spare $862.89 to just shell out if my insurance isn’t paying these… especially since I really had NO indication that they wouldn’t or shouldn’t, and I am so ticked off! Not to mention there will be another claim going through soon for the appointment i just had with my CDE on Wednesday… ugh… just ugh