Got Quads?

On January 1, my husband’s employer switched insurance companies. I didn’t think it would be a big deal… the premiums are about the same and the coverage hasn’t changed. Yesterday I got my first Explanation of Benefits (EOB) for a few appointments my daughters had and I’m realizing I will need to go over every EOB with a fine tooth comb.

If you’ve been following this blog, you know about a month ago we had a terrible stomach bug hit all 6 of us. At one point I was so concerned about three of my daughters that I had to take them to the pediatrician. They just weren’t eating or drinking much, and what they consumed came right back up. That’s a $20 copay for each. Yet on the EOB I read yesterday I was charged $25 each. Hey, that’s a total of $15 I hadn’t banked on, which is nothing to sneeze at. I called the customer service line and the agent I spoke with looked everything over and even consulted a supervisor. Turns out the company doesn’t want to cover $5 on each claim because the girls were given a prescription medication during the visit. Excuse me? The pediatrician gave each of them an anti-nausea medication to try to settle their stomachs so they could start getting nutrients. The insurance company argues I should have just picked up the prescription. OK… so picture yourself at the doctor with three very sick three-year-olds, all of whom have been barfing for days on end (don’t forget about the fourth sister who is no longer sick but started the whole process). The pediatrician wants to immediately give them medication to calm their stomachs and give them (and you) some relief. Do you a) have your daughters take the medication or b) say “no thanks. I think I’ll drag this out and go fill a prescription”? (For the record, we still needed the prescription, but getting the medication right then and there gave us a chance to get the girls home first. Then I filled the prescription without a bunch of sick kids waiting in the car).

I really shouldn’t be surprised. When my daughters were first born our insurance company rejected every single claim filed on their behalf. Why? Because the hospital filed the first dozen as “Baby A,” “Baby B,” “Baby C,” or “Baby D.” When I panicked at the bills I was receiving and called the insurance company I was informed no one by the name of “Baby A” was on our plan. Really? Really???? It all got straightened out after lots of paperwork and phone calls.

Before my daughters came along I didn’t look too closely at my EOBs. I just wonder how many times I overpaid!

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