Tuesday, August 10, 2010

Legal Mombo Jombo

We recently got new medical insurance. Joy! And now we are trying to figure it all out. Bottom line, we have to pay and pay and pay and eventually there is an end in sight. Well we hope anyway.
So we started trying to think ahead (I know, noble idea) for the delivery of baby #3 and how much the whole thing is going to cost so we can budget accordingly. Not that it wont be worth every penny, we just have to start planning.
I for one don't understand all the lingo these insurance people use. Maybe I am uneducated or just slow but it seems to me they talk with terms that only they understand. I called on the phone only to be frustrated so Mandi sent an email. So we can go slow and try to digest it all.
Here is an example of one of the phrases we heard:
"For covered In-Network services that are currently considered at 90% of the allowed amount, the benefit level would increase to 100% of the allowed amount once you have met both the deductible and out-of-pocket maximum."
See what I mean? That's crazy talk!
Now here is the final paragraph that I thought was particularly interesting:
"The information provided in no way represents a guarantee of payment. The benefits quoted are general and based upon the information present on our computer records and may not reflect information recently received. Benefits for any claim will be provided according to the eligibility, terms, and conditions of the participant's contract at the time the service is rendered. All services must meet medical criteria for coverage and are subject to all contract limitations or exclusions."
Is this just on long way to say if something changes between now and then don't rely on what I just said? What a good way to cover your tracks.
I think I will start including something along those lines at the end of everything I say. And I'm going to say it real fast, under my voice, and with my fingers crossed. Ha. Gotcha.

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