Sunday, March 30, 2008

It's a Miricle - I Have Health Insurance!

I was waiting to post this because I thought it was too good to be true. It seems that Golden Rule has some administrative issues over there. I received a denial letter last month and I thought that was that.

Then a couple of weeks ago I received an acceptance letter. Strange. I was skeptical, but I received the paperwork and insurance card last week! The same day that I got the card in the mail I received another letter from Golden Rule saying that they were still processing my application and sorry for the delay. I'm thinking that their autogenerated mailings are screwed up or they have entered my application more than once. Don't really care because I have health insurance!

They did place a rider on my policy which says that they won't cover any expenses related to treatment of depression or insomnia. They also provided a manual that spells out in great detail other things that aren't covered. I thought I'd share a few. Some are funny and some are just wrong.
They don't cover:
  • a hospital room stay for the first Friday or Saturday of an inpatient stay which begins on one of those days. Translation - if you are admitted to the hospital during the weekend they won't cover the first day. Very strange.
  • charges or prep for tissue or organ transplants. Not cool.
  • a type of chemotherapy called ABMT/BMT. And if that's the chemotherapy that you need, you're out of luck.
  • expenses "due to pregnancy." I just like they way they phrased it.
  • preventive care including routine physicals.
  • emergency medical expenses that take place outside of the US.
  • injury caused by an act of declared or undeclared war. Survivors of 9/11 you're out of luck with Golden Rule.
  • an injury that happens while I'm taking part in a riot. I love this one.
  • an injury that happens while I'm committing a felony (whether or not charged). I'll keep this in mind the next time I'm considering robbing a bank.
  • an injury that takes place at work.
  • tonsils, adenoids, middle ear disorders, etc., etc. are not covered for the first six months of the policy. I'll make sure to tell my body not to have any of these problems until the fall.
  • anything related to HIV or AIDS if you are diagnosed in the first 12 months of the policy. Very uncool.
There are 15 pages of more things they don't cover.

As a side note, here's an interesting article about a healthcare lottery in Oregon. Something has got to give. This industry needs to be completely overhauled.

1 comment:

Jen B said...

Mazal Tov! Although -- some of their exceptions seem a bit over the top. They don't cover preventive care like routine physicals? Ummmm... wouldn't that be beneficial to them? Just a thought! And the pregnancy one is a bit of a bummer. I guess it covers some (?) major unknowns which is good... I guess we take what we can get!