No I’m Not Paying That and Other Stories of Ridiculous Copays

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I’ve taken the same birth control for ten years. And I’ve been lucky all that time. First I was on my parent’s private insurance. Mostly Blue Cross, Aetna, Coventry…and then a few months before R.J and I got married I was able to get on his insurance plan as a domestic partner (now as his wife.) I have Blue Cross and I’ve only come across one specialist who doesn’t take it.

Our plan is reasonable through his work. Our deductible is fair, a few thousand dollars that’s usually met by February. It doesn’t take long to rack up the bills with all of my treatments and medications. Not to mention that I see a concierge doctor who costs about $1600 a year that is not covered by any insurance.

But frankly, if I don’t have them by the balls—Blue Cross would float away with all my savings. And they would do it humming innocently, typing in my credit card numbers.

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See, today I had a hell of a migraine and as I was laying myself down to sleep I get a call from an 866 number.

Annnnd, I picked up.

Earlier in the day I’d been to my doctor to get my depoprovera shot. But the shot had never arrived to my doctor’s office from the pharmacy. But no one had called me either to say I was responsible for picking it up from a regular pharmacy. Now the specialty pharmacy was calling to tell me that my insurance wasn’t covering my shot.

And that it was going to cost me a copay of $200.

“No.” I said, simply. “You’re wrong. It’s supposed to be delivered to my doctor’s office with no copay.”

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“That’s not how we have it here. It’s a specilality medication.”

“Right, but I don’t pay copays anymore, I’ve met all my deductibles.”

“Well, see no. We covered the one for Botox but not for the shot.”

“No, you covered both. I never paid a dime for this shot. I don’t have a copay”

And on and on and so forth.

I was on the phone for 45 minutes arguing and waiting while the woman checked with her supervisor and guess what!?

The medication was supposed to be sent to my doctor’s office just as I’d initially said. Oh! And I didn’t have a copay. Let alone a $200 copay.

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So let me ask you: what would have happened if I’d just gone with the flow on that one? R.J said that he guessed I’d probably get a refund check. I’m not so sure that would have ever come to be. Where does all the money we accidentally pay go?

To be honest, this isn’t something I worry about all that much since I rarely pay bills that come in the mail unless I read clearly that they’ve billed my insurance company and this isn’t just a made up fee.

For those I wait for their lawyer to contact me. Then I tell their lawyer that they should call my insurance company and if they say that doctor who treated me was from an institution that treated me but HE wasn’t specifically covered by my insurance I say —my well isn’t that nice? My medical care, once inside the hospital, is covered  by my insurance.

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What are your craziest health insurance stories?

Ever been BAMBOOZLED by Blue Cross or Aetna or some other agency?

How many boxes of Twinkies would you have been able to buy with the money you misappropriated to copays that were never your responsibility in the first place?

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