Humana PPO is sucking the life out of me!!

C

CANIS

New member
Maybe some of you guys can share your own insurance experiences. Here is mine:

I have Human PPO through my work which, all told, costs me approx $300/month. We just had a baby and I thought that it would pretty much be covered since everything went as planed and we used approved doctors and hospital. What a shock! I daily have received bills from the hospital and everyone involved for amount ranging from $1000 - $300! All told, I'm out of pocket about $1500 ADDITIONAL over and above what I pay monthly to be covered in the first place!!! Today, I received even more bills for anesthesia ($360.00) AND my baby's first immunizations are costing me another $170.00!
WTF?!! Did my bosses just absolutely screw us with a miserable plan or what? When we had Kaiser, it was pay $10.00 and that was it! Now, I get bills every time we go to the doctor under the excuse from Humana that we have not yet met our family deductables.

Do I have any recourse? Am I getting screwed, Does anyone know of a good independant health insurance plan?

I spend half of my day trying to find out why I just seem to keep paying more and more money and yet I am supposedly one of the lucky ones WITH Hlth Ins.!!!


AAAAARGH!!!

Thanks for listening and sharing your experiences...

Chris Canis
 
Canis...

I think your getting screwed...

We just moved to Cali 6 months ago and we are pregnant...we both have Kaiser and so far so good...the doctors have been great and all of the deductables and copays have been as planned...(fingers crossed)...Inform the HR dept at your employer about these problems and they should shed some light...I have had two different jobs since we've been here (don't ask) and at both places, many people have advised me to choose Kaiser over the PPO plans available for various reasons.

Back in Ohio I had ChoiceCare and nothing could have been easier...I really miss that.

Good luck....
 
Alot of the health insurance companies are playing the deny coverage game.

They will forward the cost to you,
and if you pay it thier profit margin goes up.

You may have to resubmit it 2 times before they accept their obligation.

i hate health care plans.

dZ
 
Thanks for the replies so far! I intend to not pay another dime until I get a very clear and concise statement from Humana as to what I am paying for and why it is not covered under my plan.

I'm the third highest paid person here and it's killing me - I hate to think what my hard working production people are going through with this crap! I guess the battle will have to be fought with the HMFIC's (military term for the guys in charge :))

canis
 
I expect this to be shut down, as it's WAY OT, but...

Have your kids at home. $900-$1000 for a good midwife. Comfortable stetting, refrigerator in the next room. :D

$200 for Husband coached childbirth Bradley method class. (It's like taking a college course in fetal development).



------------------
John/az
"When freedom is at stake, your silence is not golden, it's yellow..." RKBA!

See The Legacy of Gun Control film at: www.cphv.com

Do it for the children...
 
"I intend to not pay another dime until I get a very clear and concise statement from Humana as to what I am paying for and why it is not covered under my plan."

CANIS aren’t you worried that the hospital will repossess your new baby if they don't get paid? :) My advice is to take the invoices not paid into your HR department and ask for an explanation. If no HR, then payroll. Your CFO is usually in charge of insurance. If no CFO then your controller. Most will be happy to help you out or explain what your ins. does or does not do.




------------------
Richard

The debate is not about guns,
but rather who has the ultimate power to rule,
the People or Government.
RKBA!
 
I had a problem with Saginaw. They were jerking me around. I went to the website of my state's (IN) attorney general's office and filed a complaint on-line. In 4 weeks I got a check from the @#$%^%^ insurance co. AG's office is always good to threaten and to do in any circumstance. Has the same effect as getting sued on them, but at no cost. Most people don't want to screw with the state, have them poking around, etc. Hope this helps...
 
<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR>Originally posted by CANIS:
Did my bosses just absolutely screw us with a miserable plan or what? When we had Kaiser, it was pay $10.00 and that was it! Now, I get bills every time we go to the doctor under the excuse from Humana that we have not yet met our family deductables.[/quote]

I feel for you. We have the Aetna HMO out here on the west coast, and my daughters birth, including pre natal care, well baby checks, and immunizations cost us a total of ten dollars. Plus we picked the doctor, and hospital.
 
I have Humana HMO and they have been OK tillnow, but then I have not had any major work that needed to be done. Thank GOD. Wife has some MetLife BS policy through the school district. Every time we have had to have something done with her it has been a hassle. We get billed by the hospital and the told that the insurance company will reimburse us. Fell for that once, fortunately it was only $30. Since then I have the hospital bill through the mail, Sorry i forgot my checkbook at home. Credit cards, I dont believe in them... When the bill gets to me I simply forward it to the insurance company. God forbid you actually have an accident out of state or something. we got bills from the hospital and the doctors for months. Insurance company even faxed me a copy of the cleared check for the bills we were getting. what I have noticed lately, is that the doctor's office will tell us that the particular thingie is fully covered, when they ahve not even bothered to check. Wife needs jaw surgery. Surgeon and his staff insist that it will be covered and she should get it done ASAp so her teeth wont continue to get misaligned... Called the insurance compny to find out that they have not even talked to this doctor and they dont cover the procedure. I think we are being screwed by both the hospitals and insurance companies.
 
John/az2, you took the words right out of my mouth!! Only here in Utah, the going rate for a lay midwife with assistant is around $800. If you absolutely can't get to a Bradley class (and that price varies, too), get Natural Childbirth the Bradley Way by Susan McCutcheon et al. Much better book than Husband-Coached Childbirth by Bradley himself.

CANIS, I know this doesn't help you much, now. I do sympathise with your plight. Sounds awful. But for the benefit of others . . .

I've had three babies at home with a lay midwife, after 2 in a freestanding birth suite with CNM attendants, and I very, very, very, very, very . . . (you get the point) highly recommend a home birth for any healthy pregnancy.

Independence and self-reliance from day 1. :D

It's tremendously comforting/stabalizing to be in control, instead of at the mercy of the on-call attendant with whom you *didn't* discuss your birth plan and she does things differently. No insurance hassle, either (though it's worth inquiring if your insurance covers home births with a professional attendant. Some do.).

The reasons in favor of a home birth are myrid, including better health. At home we have only the family germs we've been accustomed to living with. In a hospital or birth center, we're exposed to lots and lots of other people, including sick people. My first baby was born about 10 minutes before a shift change. During that shift change, there were so very many people in my room as, of course, everybody wanted to see the baby, say goodbye to me, or find some excuse to be in there, that I truly did not think we could *fit* a couple more people in there. Not very modesty-friendly nor family-friendly.

Home birth.
Home school.
Train 'em up right.

--Denise
PS We don't immunize anymore, either. I used to think this position nutty, until I became more educated on the subject. Start with National Vaccine Information Center: http://www.909shot.com/. Vaccines do injure children. Vaccines do kill. Standard media outlets won't tell you about it. Read up on it yourself.

[This message has been edited by sbryce (edited October 16, 2000).]
 
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