Rules Are Rules With Insurance
When my son was in first grade, he was in the after school program playing on the playground waiting for my ex-husband to pick him up from the after school program. Just before his dad got to the school, my little boy cut his knee very seriously. The after-school program coordinator told him where the closest hospital was. My ex grabbed my son and rushed off to the emergency room. Someone called me at work and told me to meet them at the hospital, and I left immediately.
The emergency room staff comforted my son and calmed down his panicked dad. My little boy was stitched up and ready to go by the time I got to the hospital. We got all of the home-care instructions and left the hospital. After we brought our little guy home and calmed ourselves down from such a scary ordeal, I asked my ex how the trip to the emergency room was paid for. Since my son was covered by my insurance, and my ex didnt have a copy of my insurance card, I expected to have to show the hospital staff my card before we left the hospital. But they never asked to see it, and I forgot all about it. My ex told me he gave the hospital his insurance card without thinking. No problem, I thought. I would just call the hospital the next day and give them all the information they needed.
The next day I told my boss what had happened and said Id have to call the hospital to straighten out the minor mishap. My boss said if I was covered by the HMO plan there might be a problem. He said with the HMO I could only use doctors and hospitals on their plan. He said they wouldn’t cover the expenses unless there was a life-threatening emergency or the doctors or hospitals on their plan weren’t available, and I would have had to get permission.
I called the insurance company and found out my boss was right. It turned out that only a few blocks away from the hospital was another hospital, which was on the HMO plan. I explained everything to them and told them how panicked my ex was, but I was told the expenses wouldn’t be covered. The person I talked to said I could appeal the decision in writing if I wanted.
I wrote a very nice letter to my HMO outlining the seriousness of my little boys injury, the panicked state my ex was in when he saw the how bad the cut was on his sons knee, how my ex was sure our son was covered by his insurance plan and how the hospital he took our son to accepted his insurance. I told them it was a simple mistake and could they make an exception and pay the emergency room and doctor expenses in this case. We got a very nice letter back denying our request, and we had to pay the expenses ourselves.
Actually, I like HMO plans. They have plenty of doctors and hospitals to choose from. But when it comes to asking for exceptions for going out of their plan, especially after the fact, rules are rules.
If you get tons of health insurance quotes you will have all the info that you need before purchasing. Any medical insurance can be costly, so you want to look around before purchasing. Article Source:http://www.articlesbase.com/health-articles/rules-are-rules-with-insurance-1646179.html
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