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Luskin: Health Insurance

09/21/11 5:55PM By Deborah Luskin
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(HOST) Commentator Deborah Luskin fears that even good health insurance coverage - may be bad for her health.

(LUSKIN) In college I took a course in Human Biology, where we measured our pulse rate, blood pressure, and lung capacity at both the beginning and the end of the term. During the twelve weeks in between, we had to engage in aerobic exercise. The improvement was dramatic even for a healthy twenty-year old. As a result, I've followed a heart healthy regimen of diet and exercise ever since. Until recently, I've been pretty smug about my good health. Then, my blood pressure started to rise.

My husband, a physician, says, "It's normal to develop elevated blood pressure after 50." This failed to console me. I upped my exercise and cut my calories - to no avail. So my doctor prescribed medication, which does the trick - most of the time. But not even modern medicine can keep my blood from boiling when I have to tangle with the insurance companies that pay my claims.

I have top-drawer health insurance; I'm not complaining about that. Our family has a high deductible, but we have a secondary policy that pays it, which is a pretty sweet deal. The catch is the paperwork.

My doctor bills my primary insurance. Because we haven't met our deductible, the claim is denied. The company generates an Explanation of Benefits - or EOB - and the doctor sends me a bill.

I pay the bill with the credit card supplied by our secondary insurer, who then demands a copy of the first company's EOB. I have fifteen days to comply.

In a laudable effort to cut costs, my primary insurer only mails these EOBs once a month, so I have to find it on-line. It's been so long since I set up my account that my password has expired and access is denied. I follow the instructions to register and still can't get in, so I phone the help number. As I listen to the menu options, I can feel my blood pressure starting to rise.

Eventually, Mary comes on the phone and tells me I'm not allowed access to my husband's account. I politely explain that everyone in my family has signed consent forms so I can manage the insurance and pay the bills. Mary says she's only in charge of the website and tells me to call the insurer.

By the time I've punched my way through their phone tree to get through to a human, blood pounding in my ears makes it hard for me to hear Heather, who tells me I can access the EOB on line. I tell her I can't. She insists I can, I just need to set up an account of my own. I'm doubtful, but I give it a try.

It works. I print the data I need and send it to the secondary insurance company. This whole process had cost me a half hour. Out of curiosity, I take my blood pressure - and I'm not surprised that managing my health insurance claims has sent it right through the roof.
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