<http://schema.org/articleBody>
"Four-month-old Alex Lange is 25 inches long and weighs 17 pounds. According to the Centers for Disease Control and Prevention, he is in the 99th percentile for height and weight for his age. Rocky Mountain Health Plans says Alex has a &amp;quot;preexisting condition of obesity&amp;quot; and is uninsurable. This story made national headlines, and the insurance company recently announced (big shocker!) it will now provide health insurance for Alex and all &amp;quot;healthy infants regardless of weight.&amp;quot; Have any of you had to deal with bossy insurance companies? I&amp;#x27;m in hell right now...JD had surgery last year. The insurance company paid the surgeon and the hospital but not the anesthesiologist. Why? The insurance company changed its story several times. First, it maintained that JD had a preexisting condition. My response: &amp;quot;He did not have a preexisting condition, and, um, OK, if he did have one like you&amp;#x27;re saying, then why did you pay the surgeon and the hospital--are they preexisting condition immune?&amp;quot; The line went silent. The claim was resubmitted. Some 45 days later, I called and checked in because I received another bill from the anesthesiologist, this time with a scary red stamp on it that said &amp;quot;PAST DUE.&amp;quot; The insurance company now maintained that the anesthesiologist&amp;#x27;s office &amp;quot;coded something wrong&amp;quot; and I needed to tell them this and have them resubmit the claim on their end. OK. I called the office and they resubmitted the claim in January 2009 with the correct coding. It is now October 2009 and closing in on one year since JD had surgery. I recently received a letter stating that if I don&amp;#x27;t pay the (substantial) bill in full, it is going to, wait for it, collection. (I have really good credit, so this bothered me, plus months had passed and I assumed without word from the insurance company or doc&amp;#x27;s office that the bill was paid. Yeah, no.) So I call the insurance company. I wait on hold for 31 minutes. Music over a film of static plays on the speakerphone and every now and then JD hears this music and does a little dance with just his upper body and it makes me laugh. Now the insurance company maintains that it received the correct information from the doc&amp;#x27;s office in January 2009--and never resubmitted the claim. I asked why. WHY? I was sassy. The phone went silent. Then I said: &amp;quot;I&amp;#x27;m self-employed. Every month I send you a check for XYZ to cover my son. If I stopped sending in those payments, what would happen?&amp;quot; (I knew the answer.) &amp;quot;We&amp;#x27;d drop you after 30 days of not receiving the payment to date,&amp;quot; the customer service rep said. &amp;quot;Exactly. I&amp;#x27;m holding up my end of the bargain.&amp;quot; The latest: They won&amp;#x27;t pay the anesthesiologist because he&amp;#x27;s &amp;quot;out of network.&amp;quot; I searched for a highly recommended surgeon that was in-network. I made sure the hospital was in my plan. I had no control over what pediatric anesthesiologist walked into the OR that morning--none. I recently found a caveat to this and demanded in a letter that the insurance company resubmit the claim for XYZ reasons. So I wait. I alerted the anesthesiologist&amp;#x27;s office to this and I&amp;#x27;m pretty sure they think I&amp;#x27;m just trying to buy more time and not pay the bill. I&amp;#x27;m just trying to get justice! I pay a lot of money so that JD has good health benefits. (And because I feel like this might come up in the comments--no, I do not qualify for state-aided health care for my son regardless that I am a single mother. It&amp;#x27;s based on income.) Like I said, I&amp;#x27;m in health insurance hell. Do you have health insurance? Does your job provide you with health insurance? Do you pay out-of-pocket like me? Have you had any drama with your health insurance company? What do you make of the story about baby Alex who was too heavy for health insurance? Keep talking: Does your pet have health insurance? (Seriously asking!) "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.glamour.com/sex-love-life/blogs/storked/2009/10/four-month-old-alex-lang-is-25>