Wednesday, April 14, 2010

Fighting With Kaiser

So its been an ongoing fight with Kaiser about my insurance coverage. I got to thinking about what happens after I reach the $250 deductible and the $2000 out of pocket amounts. So last week I called Kaiser to ask. I was told different answers. I called the representative that works for the credit union with Kaiser. She told me she was told some different, but was going to get to the bottom of it for a solid answer. (Still haven't heard back from her). Today I decided to call again and ask. I talked to a woman named Leslie. We were on the phone for about 25 minutes. She was very nice, and took her time reading all the coverage, what applies when and what doesn't. She put me on hold, and spoke with her supervisor about it. When she came back on she said they both agreed that since I have met both the deductible on Feb. 10th and the out of pocket amount on March 23rd, that from March 23rd forward I should not have to pay the co-payment of $25 every time I go for chemo or radiation. They said on my member number, the computer never switched over to another mode once I reached the out of pocket amount so they were going to manually have it changed. I asked about the two times I had paid the co-pay on March 25th and April 1st. They told me that I will be refunded for those two visits. Good thing I have a little notebook with everything in it, and I do mean everything wrote down .. appts dates, what happened on that day, the co pays, notes from my Dr. visits, phone numbers, meds and the side effects, etc. I don't think I can go a day with out my book! (Thank you Kris for the note book) And good thing I took the time to repeatedly call Kaiser to check on it since it turned out to be a benefit to me.

2 comments:

  1. It's rare that you win when an insurance company is arguing with you. Keep writing everything down! You're so good at that. I think a year of your high school education should be devoted to reading fine print and figuring out loan papers, insurance papers, tax papers, etc! I can never make heads or tails out of any of it. Love Ya! Missy

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  2. Hey Nancy,

    Just found out about your traumatic ordeal. Crystal sent me your blog page so that I could keep tabs on your condition. I wish that we had kept more in touch before something like this to happen. Just reading about all that you have gone through brought tears to my eyes. I hate it that I haven't kept in touch with you more so that I could have been there on your support team. I'm here now so don't hesitate to keep in touch. How's your mom and husband handling matters? I hope that they are strong for you. Rest assured that you are in my prayers and may Jehovah grant you the strength to endure this trialsome time. With lots of love and support, your long-time friend, Peggy Brown

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