I have been going toe to toe with my insurance company regarding a bill for when I was in the ER TWO years ago. In total with doctor visit + later going to the ER, the total bills accumulated to about $3000 dollars.
Because I was working 15 hours a week in retail with a minimum wage job at an apparently unionized store, suddenly my insurance was no longer applicable to me, rather I was auto enrolled on the Union insurance plan. Because I only worked 15 hours a week, sometimes as low as ten, I was classified as a Wage III worker, which meant even though I was listed under the Union insurance, I had no coverage at all. No dental, no vision, no prescription, no doctor.
Every quarter the union looks at your hours work per week average, and then classifies you as Wage III , II, or I. III meaning no coverage, II is coverage minus dental/vision, I being everything. Well since I was only working 10-15 hours a week, I got classified as a Wage III with no prior notice, no explanation. To be reclassified would mean waiting until the end of the next quarter, no exceptions. So if you are a Wage III but suddenly you start working 30 hours a week, it will be 3 more months until you see that Wage II Insurance status, because it is only checked at the end of each quarter. But the story doesn't end here.
I try to be wary with doctors and hospitals and all that like, having a father who has been in and out of treatments I know just how cruel this system can be. Well, before I went to my doctor I had called to make sure my insurance was covered for the visit as I could not pay out of pocket, I was assured it was. But for an added measure, I called the insurance company to make sure I was still covered with my doctor. I got the A ok to go and I did. Once there my doctor wanted to take some tests, added in a few others to see what was wrong with me because she had no idea why my testicle hurt and why I pissed blood earlier that morning. Just do some tests, pee in a cup, take some blood. Ok, so I did. "I will get back to you in a couple days with the results", she said, as a sharp jarring pain overwhelmed my right nut.
That night the pain was unbearable and I knew something was wrong. Tylenol wasn't helping, I couldn't sleep it off. I thought I was going to die. It was 11 PM at night and I needed to go to the ER. Again, called the insurance company to make sure that it was covered, I was told that it was and so off I went.
When it was all said and done, I ended up having a kidney stone and passing it while at the ER. I had a IV put in me, some pain killers, and I dozed off for a couple hours. That was that.
Or was it. Turns out I got all the bills not only from the ER, but also my doctors office. Around 3000 dollars. I had to refute the claim but while talking to the insurance company, the same that told me I was ok to go to the doctor and ER, that I had no insurance coverage. I was baffled.
I talked with the Union, I talked with the insurance company, and the only solution that would allow the insurance company to cover the costs was if I quit my Union job, in retail, to get back on my old insurance prior to all this union crap. And that's what I did, at a drug store I had been working at for a couple of years.
The problem was, I was classified as a Wage III worker with no insurance coverage from the union, and because of this my old prior insurance I was kicked off of. Even though I had no coverage, I wasn't even allowed to use this union plan as a supplemental plan to my original. The whole system is backwards.
This was two years ago and I am still dealing with the insurance company regarding a $300 bill, the other bills have been cleared but they are still trying to collect $300 from me despite countless hours poured into this.
I am fairly certain I have an infection in my mouth, caused by an incoming wisdom tooth and I am absolutely terrified to go to the dentist. Not because of sharp needles, or drills, but because of the likely possibility of this all happening again. I know this was a long story and may get buried in all the posts...but this is my story regarding American Insurance, I just thought I would share.