I have been with the same medical company for nigh on ten years, I have faithfully paid my premiums month after FAAAAARKING month, and I have calculated that during that time I have claimed back less than 20% of the premium amounts I have paid.
Now everyone knows that the minute you cancel your medical cover, you get some sort of rare and drastic disease that costs a small fortune to treat. It’s a fact. It just happens. Well, maybe not every time, but it could (blame woman’s magazines and medical insurers for planting that boogey in our brains). I am convinced it WOULD happen to me, so instead of cancelling the bloody policy years ago like I’d have liked to, I continue on, paying for premiums on cover that, all things going well, I have very little call for.
So the day arrives when I have a REAL need to claim. I may have mentioned once or twice (ok, several times…) that I’m a starving real estate agent and part time artist…and I need a procedure that’s going to cost around $400. Not big bikkies, but definitely not available in the budget for the immediate future and I kinda need it NOW.
I know this because I took myself off to my GP who told me what we needed to do, I called the insurance company and asked about pre-approval, they said they need a letter from the doctor as to why, wherefore, how and all that crud, so I call my GP, she writes said letter and I call my insurer back and this is where the fun starts…
It MAY be covered under my policy IF its carried out by a particular type of specialist. Never mind that the GP I see specializes in this field and performs the procedure every single day of the week, NO, she doesn’t have the right letters after her name so she’s not allowed to do it. Instead, I have to go back to her, get her to refer me to said specialist, who will need to write the same letter my GP just wrote for me, THEN I might be able to claim for the cost. Only problem is, the GP visit and the specialist visit add up to more than the $400 and they may still decline the claim, so I might as well flag jumping through all the hoops and pay for the freakin thing myself.
The pre-pubescent (probably pimply) male, who sounded about 12 on the end of the phone, repeated all the reasons whey they could decline pre-approval and possible post-approval, he did this in his best practiced “be nice to the rabid lady and she’s bound to calm down” voice that he no doubt learnt at WANK training school, which of course only made the situation worse.
It’s what I call a LOOP HOLE and I told him so. Loudly. Plain obstructive gob shite that insurers use to make claiming as difficult or cost prohibitive as possible. And I told him that too. Loudly. Its Crap (you’ll notice I used a capital C for Crap) and I now fully understand that these people are the reason some species eat their young. I didn’t tell him that, but did suggest a yoga position that I thought would be fitting for him right now…
So. I am currently shopping for another medical insurer. I don’t care that they are probably all as bad as each other, at this point my main objective is to ensure I don’t give one more cent of my money to the nasty thieving bastards I am currently covered with. And I told them so. Loudly…
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