Desperate Working Parent Seeks Insurance Help Desperately
Susan, played by Teri Hatcher on the ABC hit series Desperate Housewives, has a wandering spleen, which requires immediate surgery. But from the trailer promoting next week’s episode, it looks like Susan—who is a neurotic freelance children’s book illustrator—doesn’t have health insurance. Reduced to desperate measures, I have a hunch Susan is going to try and marry a man who has health insurance in the coming weeks.
Susan’s plight rings familiar—almost 46 million Americans don’t have health insurance.
I have health insurance, and I’m desperate, too.
To understand why, you first need a little background: My son Leo was born on Halloween 2004 with a giant birthmark covering 80% of his back. The mole, known as a nevus, is big and ugly, but it can also be cancerous. Thus, it has to be removed. In the past year, Leo has had three surgeries to remove the mole.
And here’s where the desperation comes in. Aside from the angst, the insomnia, the eye tick, and the weekly doctor’s appointments, there's the sticker shock: Leo’s surgeries have totaled more than $100,000 so far—and my husband and I have paid, with the help of my parents and credit cards—our fair share of that. The ordeal isn't over, either. Leo still has at least two more surgeries to go. When it comes to dealing with UnitedHealthcare, our insurance company, I’m at my wit’s end.
Being a savvy personal finance reporter as well as a working parent with little time to burn, I figured at the start of Leo’s medical madness that I could fight the system and win. I planned to chronicle my experiences and write a story for the masses called: “How to Fight Your Insurance Company and Win.”
But before you can fight the system and win, you need to get organized. Here’s my organizational check list:
1) Keep a list of every important number (doctor’s offices, insurance claims, human resources, etc. with the names of contact people at each place) near the phone and by your computer.
2) Keep a notebook by the phone to log in every phone call you make relating to your insurance. Write down who you spoke to, as well as the time and date of the call and what was said.
3) Bookmark your insurance company’s website (most claims can be found on online). Visit the site frequently to monitor claims status—much faster than waiting for statements to arrive in the U.S. mail.
4) Keep a folder with insurance claims (filed by date) near the phone for easy reference.
5) If you work for a large company, find out if there is a team of nurses assigned to your company’s account. United has three nurses who monitor McGraw-Hill employees, and while they don’t work in the claims department, these nurses can be invaluable in getting things accomplished. (A shout out to Tina Hagar at United who has been wonderful to work with in the past few months!)
6) Some large companies offer patient advocate services as an employee benefit. That means your employer pays for someone else to deal with all the insurance legwork, so you don’t have to, which means you can actually come to work to do your job. I’ll highlight some companies that offer this benefit in the coming weeks.
In addition, you can hire your own patient advocate. See “Your Guide to the Medical Maze.”
7) Don’t give up. Last week, the head of human resources at one of the nation’s largest financial services companies told me insurance companies expect us to “Give up and go away.”
They don’t know who they are dealing with.
By my count, I’ve logged at least 70 hours trying to get Leo’s surgeries covered by insurance, most of it on my company’s dime because insurance people only seem to be available between the hours of 9 and 5. I’ve learned plenty from my mistakes, too. In the coming weeks I plan to share my tips on navigating the system with you in depth.
I’m on a crusade to improve the insurance system, and I invite you to join me in making difference. Because we want this blog to be educational and interactive, please share your experience about health insurance—the good, the bad and the ugly.