Tuesday, February 17, 2009

And the chicken wire canoe of the day is.......

TRICARE!

Yes, Tricare... that lovely insurance we get through the Army. Now, I'm not one to complain about it in general. I know our coverage is way better than that of most civilian insurance, and since we don't even have to pay monthly premiums for this coverage, we really have nothing to complain about compared to a lot of people, but with that being said, Tricare has dropped the ball.

When we went to the birth center yesterday, the lady who takes care of the financial end of things called us back to her office, and told us that Tricare had screwed up on paying for like a dozen recent births, and Orren's was one of them. See, the plan that the kids and I have is called Tricare Standard, and it works like civilian insurance, except that we don't pay monthly premiums, and the deductible is WAY lower than any civilian policy out there. Beyond that, it's pretty, well, standard. They're supposed to pay 80%, we're supposed to pay 20%. So for my care, and Orren's birth, they were supposed to pay $3300, leaving us to pay $825. What REALLY happened is that they paid out $1100, which is obviously a lot less than $3300, and you can imagine what that does to our share. Nothing good.

Well, we are actually not being billed for that amount right now since this, apparently, is a common glitch in the Tricare system. We just have to call Tricare, and argue with them until they pay what they're supposed to. This has been going on, on and off, for the past three years. You'd think they'd have fixed the glitch by now, but no...

The thing that slays me is that Tricare pays out just fine on tens of thousands of births each year. Most of those take place in military hospitals, and most of the remaining take place in civilian hospitals. These, they pay out on without a hitch, but for the other 1% of us who choose to have our babies in birth centers or at home, they don't pay out worth a crap, and we have to fight them over it. This is extremely ironic to me since, on average, an uncomplicated hospital birth (and mom's care with an OB/GYN) costs about twice what my care and Orren's birth did. Of course, when you take into account the sky high c-section rate in this country, and how much more that costs, it's more like 3x or 4x as much as what me and Orren cost. You'd think the insurance companies would be giving incentives to anyone willing to avoid the hospital racket and save them several grand, not screwing us over.

Of course, that would make entirely too much sense.

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