A few years ago I had to have the fillings that cover the front of my four front teeth replaced -- there are braces-resultant cavities on those teeth, and the filling material used was at that point over 25 years old and starting to disintegrate. The technology is different now, so to fix the teeth they use porcelain veneers -- a pain-in-the-butt expensive process (at the time $750/tooth), but the best thing to do according to three separate dentists (including my father, who did the first set of fillings).
I had no choice in the matter -- I needed to have the fillings replaced. But this wasn't an emergency, so I put aside the money in my health care expense account for the next year, had the procedure done early in the year, and sat out the whole year while the account built up enough for reimbursement.
And they rejected the reimbursement, because sometimes people get porcelain veneers for cosmetic reasons alone. Now, I'm used to insurance companies second-guessing my own doctors when it comes to things like what drugs I should be taking (which is something I think should be illegal and for which I think the insurance consultants making those choices IN OPPOSITION to your own doctor should be flayed alive while being given an ineffective but cheaper pain medication), since it makes them lots of money to play around with my comfort and health. But the health care money is my money, my own, taken out of my paycheck. I couldn't believe that eyeglass frames are covered while dental surgery is not.
I did eventually get the money -- it took some pretty serious letters from my dentist to do this (and I offered to provide dental xrays from 1969 showing the medical issue) -- but I was sickened by the whole thing.
The other problem I once had with this absolutely absurd mechanism (of not getting the money back if you don't use it): I once had to pay a visit to an emergency room. One of the incidental bills from that visit got lost somewhere, and was issued to me about 16 months late. By which point it was too late for me to get reimbursed from my health care account, which for that one year (and that one year only) I had put away more than I used. I felt as if the money had been stolen from me, twice.
It's a really really stupidly administered program.
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Date: 2005-10-31 08:44 pm (UTC)I had no choice in the matter -- I needed to have the fillings replaced. But this wasn't an emergency, so I put aside the money in my health care expense account for the next year, had the procedure done early in the year, and sat out the whole year while the account built up enough for reimbursement.
And they rejected the reimbursement, because sometimes people get porcelain veneers for cosmetic reasons alone. Now, I'm used to insurance companies second-guessing my own doctors when it comes to things like what drugs I should be taking (which is something I think should be illegal and for which I think the insurance consultants making those choices IN OPPOSITION to your own doctor should be flayed alive while being given an ineffective but cheaper pain medication), since it makes them lots of money to play around with my comfort and health. But the health care money is my money, my own, taken out of my paycheck. I couldn't believe that eyeglass frames are covered while dental surgery is not.
I did eventually get the money -- it took some pretty serious letters from my dentist to do this (and I offered to provide dental xrays from 1969 showing the medical issue) -- but I was sickened by the whole thing.
The other problem I once had with this absolutely absurd mechanism (of not getting the money back if you don't use it): I once had to pay a visit to an emergency room. One of the incidental bills from that visit got lost somewhere, and was issued to me about 16 months late. By which point it was too late for me to get reimbursed from my health care account, which for that one year (and that one year only) I had put away more than I used. I felt as if the money had been stolen from me, twice.
It's a really really stupidly administered program.