• Another 100 Days of Good Karma: Day 131 (Today’s PSA: Beware of Medical Underwriting)

    God, I hope so.

    God, I hope so.

    Wednesday, November 19, 2014

    Run/ Walk/ Bike/ Elliptical (Today:  3.01 miles;  Running Total: 47.55 miles)

    Day 131 of *Another* 100 Days of Good Karma.

    Justin and I applied for a new insurance policy since our old one is being a nightmare.

    Last night he got a call from the new insurance company.

    The caller first presented the call as ‘verifying information’.  They verified name, phone number, address, etc.

    Then they asked him if he would be willing to provide his prescription history.  They asked how many times he’d been to the Emergency Room in the last year.  They asked about medical conditions.

    I mean, they really dug in there.  They were slick about it.  They had the ‘I only want to help’ tone paired with the implication he had to answer the questions to be covered.

    Justin answered a few questions before growing suspicious.

    “Why do you need this?” he asked.

    “Oh, so we can better assist you with our programs.”

    Once he realized they were just fishing for medical information Justin stopped answering questions.  He told them he was driving and had to hang up.

    When he got home and told me about the call.  He said the insurance company required me to call in and verify certain information before the new ID cards were mailed out.

    “But don’t tell them anything,” he cautioned.

    Nervous, I called the insurance company.  I put them on speaker phone so Justin could listen, too.

    After confirming my name, phone number and address she asked for my permission to document my prescription history “to better assist me in utilizing my insurance.”

    Justin shot me a look and shook his head.

    Heart hammering in my chest, I said, “I’m not comfortable sharing that information.  I’d like to keep that private between me and my doctor.”

    She paused.  I could tell in the pause that she was caught off guard.  Probably most people she talked to just provided the information willingly.  I probably earned myself a red flag in their computer system by not answering her questions, but that was better than providing too much information.

    “Can we go over the kids’ medical history?” she asked.

    “I’d prefer to keep that private, too.”

    She paused again.

    “Do I have to answer the questions to get coverage?” I asked.  “Are the ID cards still going to be sent out?”  I tried hard not to sound desperate.

    She didn’t answer the first question, but addressed the second.  “Yes, ma’am, they should be sent out in the next few weeks. If you haven’t gotten them already.”

    The ‘if you haven’t gotten them already’ line threw me off.

    When they’d talked to Justin earlier the caller made it sound like Justin had to answer her questions to have the ID cards sent out.

    This lady was telling me the ID cards might have already been sent out.

    In my mind, this discrepancy only confirmed that the questions being asked were optional and I didn’t have to answer them.

    But I could certainly see how it would be to the insurance company’s benefit if I provided the information willingly.

    I asked her if she needed anything else from me.

    “No, ma’am.  But please give us a call back if you don’t get your insurance cards.”

    I assured her I would.

    We hung up the phone.  The stress of that five minute phone call made me want to throw up.

    After a Google search I discovered that this is the lovely process of insurance underwriting.

    Basically insurance underwriting is how insurance companies determine if they will cover you or not.  They can either deny coverage (although I’m not sure how that works with the Affordable Care Act) or they jack up the premiums so high it’s unaffordable and they get rid of you anyway.

    You can get the quick and dirty on insurance underwriting here.

    Today’s silver lining:  I’m glad they called Justin first.

    I honestly don’t know if I would have had the presence of mind to cut off the conversation before giving too much information.  They probably would have caught me off guard with the friendly tone and the implication of ‘having’ to answer the questions to obtain coverage.  I’m sure they get all kinds of information from people in this manner, and then find ways to drop them later.

    Now, we wait (im)patiently for the policy cards to arrive in the mail.

    Keep your fingers crossed for me.

    What’s your silver lining today?  I love comments!

    Don’t want to leave a comment, but have something you want to share?  Send me an email at gettingthewordswrong(at)gmail(dot)com.

    xoxo,
    Meghan

    Post Tagged with

4 Responsesso far.

  1. Epbj says:

    Don’t answer the survey questions either. Not by mail, text or email. Always challenge things ‘not covered’ they usually cover it the second time it’s submitted. Your health is NONE of their business. Insurance companies have a special place in hell for the underhanded crap they pull. Obviously if you need health insurance you are dealing with enough, then they add on the cleverly disguised bs. (insert Daniel Son’s karate kick to their throat)

    • pwsquare says:

      Been there. Good for Justin! I told the person “Are you suppose to be asking me these questions? I thought that was illegal.” That shut them up real quick. But eventually they did jack-up our prices. I hate insurance companies – with a passion!

  2. Sara says:

    That is sneaky of them! I am glad you were able to keep your information private, and I think your response was perfect! Thank you for sharing this…it was interesting and eye opening.

  3. Tina Smith says:

    I wonder how some people working in insurance can sleep at night–they must know they’re messing with people’s lives in a way that severely harm someone. I’m sure they get abuses of all types, but really?

Leave a Reply