Aetna and UNC Healthcare are in a debate. Their contract ended on February 5th. Basically, UNC wants Aetna to pay more money. Aetna wants to continue cutting fat checks to stockholders. I'm pregnant and caught in the middle.
I dutifully filled out a transition coverage form and faxed it to Aetna's office on February 15th. I called to follow up on the 18th, when it was put into the system. Today I called again. The representative was so "glad" I called, because the form had been sent to Claims, incorrectly. This is THEIR form, but they couldn't process it correctly. So I'm no closer to finding out if I can continue to see my OB at in-network prices.
But there's more!
The coverage request only covers 90 days, unless Aetna decides that since I'm pregnant, I should get care for a full 9 months. After that point, I can continue to see my OB and deliver at my hospital, but I will have to pay out of network prices. Fine, I have an out of pocket maximum. But wait! If Rex charges me more than what Aetna thinks is "reasonable & customary", then I legally have to pay it all, and it won't count towards my out of pocket maximum. Yes, that's right. And let's remember, Aetna and UNC are in a debate because they can't agree on what's reasonable & customary. Which means that I'm practically guaranteed to pay more than my out of pocket maximum. How much more? Well, I'll have to see what Rex estimates to be my cost of care.
How am I supposed to be fiscally responsible if I can't find out how much my care will cost? Why does Aetna continually screw over the OB's and Gynecologists I choose? (My gynecologist dropped out of the program a few years ago).
At 17 weeks pregnant, I'm a big crying mess. Thanks, Aetna.
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1 comment:
It is a dirty, rotten shame. And let's all remember that the republicans are committed to keeping us in thrall to this outdated, ruinous system. Republicans forget what it means to be Christians.
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