Why I’ll Never Understand Them

The “them” in the title referring to insurance companies, of course. Can’t live without ‘um, can’t for the life of you figure ‘um out insurance companies. And although those two sentences could probably be the whole post and you all would still understand me and leave your comments, never you fear – I also have a story.

A few weeks ago I received a check in the mail from my health insurance company. A reimbursement check, they called it. For what, I wondered? The check claimed to be reimbursement for service I’d paid for at the beginning of January. Here’s the catch… I didn’t pay any deductibles in the beginning of January. How can I be reimbursed for a payment I never made? I decided to hold on to the check and call about it. Someday.

Then, last week I received another check for the exact same amount. Still a “reimbursement.” But this time for a different date of service, at the end of January. Again, I didn’t pay any deductibles at the end of January. And again, how can I be reimbursed for a payment I never made? I decided I would call. Soon.

Today, I called. I actually called the number they gave as the “questions” number on the check itself. (The check they sent to me, a customer). The number was a question line for providers only. I could tell this was going to be a productive phone call!

After locating the correct number on another form, I was connected to a nice young woman who put me on hold for approximately half of Dylan’s morning nap while she went and “looked up” my information. Do they not use computers, I wondered? I feel sorry for this poor woman who had to either wait for a server powered by one of the Flintstone’s handy little dinosaur helpers or risk life and limb to scale an impenetrable wall of patient hanging files. But, I digress…

When she returned to the phone (the third time), her verdict was thus: My patient co-share for services received was only 98 cents compared to the $20 deductible I had paid (twice) and thus I had received two reimbursement checks, each in the amount of $19.02. I should keep the checks.

At this point, I felt compelled to reemphasize the fact that at no time during the month of January had I paid a $20 deductible, much less two. Her rationale? The provider had forgotten to collect my deductible at the time of service. I then felt I should mention that the provider had told me on both occasions that I did not need to pay a deductible. Her retort? The provider would most likely bill me for the “missed” deductibles and I should keep both checks.

If the provider does indeed bill me for these deductibles in the amount of $20 for each visit, then I have no problem keeping the reimbursement checks. After all, at that point I will actually need to be reimbursed. But here’s the part that really confused me. In fact, I’m still confused. What if the provider never bills me? Or what if, as the nice young customer service lady suggested might happen, the provider only bills me for 98 cents (twice)? What should I do with the checks then? Her response? Keep them. The checks are the balance of the cost-share against my deductible. They (the insurance company – and I use her word here) will never ask for that money back.

And there you have it folks! My insurance company is paying me for having my blood drawn. Maybe January was “Customer Appreciation Month.” Maybe they heard how much we had to pay for our health insurance while Alexander was in school. Maybe they just want to go bankrupt. Who knows?! I, for one, will never understand them. But I do know one thing. I don’t plan on buying shares of their stock anytime soon.