Friday, September 26, 2008

Coventry Health Care Doesn't Care About Babies!

Okay, that's a little strong, but I just got off the phone with their customer service folks earlier today and had promised myself that if I got the answer I thought I was going to get, that I'd be sure to let the world know.

This is a good place to start.

Here's the deal. Our health insurance is through Coventry Health Care of Nebraska. Our plan covers preventative care at 100%, up to $500 per person annually...after which there is no preventative coverage at all.

So far, not MUCH of a problem. I'd rather see it be subject to deductible and coinsurance after hitting the $500 limit, but okay. I'll deal.

Here's my problem. Unlike EVERY other health care plan I've been on, the $500 limit ALSO INCLUDES CHILDREN UNDER A YEAR OLD. When you consider that just setting foot in the doctor's office runs over $100, not to mention all the vaccinations they receive...that's a hell of a lot of uncovered care.

My kids' pediatrician sees children about a week after coming home from the hospital, then at a month, 2 months, 3 months, 6, months, 9 months, and a year. Each time we've gone in since the one month point, there's been at least one immunization, and usually more like 3 or 4. Some of these vaccines run over $100 a pop.

I don't want this to turn into a debate over immunization safety, so please don't go there. The point is that subjecting children under a year old to the same $500 limit WITH NO COVERAGE AFTERWARDS makes it real tempting for parents to not get the kind of preventative care their child ought to have. Basically, you use up your entire year's allowance by the second visit, then you're stuck paying the rest out of pocket.

Not only is it not in the best interest of the kids, I'd think from a business standpoint if you're responsible for paying claims if kids get sick, that you'd want to encourage parents to do everything they could to have their kids NOT GET SICK. And those first year checkups are vital...not just for the immunizations, but also for catching problems early that could grow into bigger ones later. Not covering those first year appointments just doesn't make sense to me either from a care standpoint OR a business standpoint.

I'm going to be writing a letter to Coventry, and this way when I tell them that I've started informing people what their stance is on early childhood health care, I'll be telling the truth.



Hot Cup Lutheran said...

seriously? yikes...

if you were at the game last night... hope you still had a good time, even if the big red couldn't pull out the win.

Rev Scott said...

Yikes is right. I'm guessing you're not with ELCA BOP (like Mmmm-Bop without the catchy tune) because you're not rostered? Or are you rostered now?

That ff-ing sucks anyway. If there's anything we can do to help, let us know.

Heather said...

Are you sure it's not your employer's plan that they are administrating for? Just making sure you're writing your letter to the right people. The employer often just pays insurance companies to process claims & do customer service for THEIR plan.

Anonymous said...

We have coverage with Coventry of Georgia and it is the worst insurance company I have ever dealt with. We bought the top of the line plan offered and we did NOT get the coverage expected. Their list of in-network providers is pitiful; in a city like Atlanta there are so many doctors and good hospitals. None want to take the crap reimbursement offered by Coventry. Our primary care physicians are on Coventry, one of the doctors is on the Coventry GA Board and used to be the Medical Director. They say it is crap too. They are denied reimbursement for routine procedures as well. I hope they go down the tubes in the next few years and the companies less interested in gobbling up other companies will survive.