Monday, May 08, 2006

ADVANTAGE; OXFORD



Shana gets upset when I yell on the phone.
I tell her that I get upset when I yell on the phone.

As a freelance writer, money is obviously very important to me, I explain. I try to spend it sparingly and urgently. So when I pay nearly $500 a month for a health insurance policy, I expect it to be worth every exorbitant penny. But according to Oxford Health Plans, I am delusional.

The first Oxford representative I speak to has no answers. Tricia tells me that I have to, in fact, pay the $100 deductible in order to begin using my co-pay option.

"Let me understand this, Tricia," I use her name in an attempt to personalize the call. "I am paying over $6,000-a-year for the opportunity to pay $100 more to begin employing my insurance benefits."

"This is the way all personal policies are established."

"You don't think that's absurd? Because it sounds kinda absurd to me. It's like buying a car and then being told later on that you have to pay extra for the engine."

I ask her why I am paying the $100 for a co-pay. A basic question. Because, from my perspective, it seems like another ploy for taking even more money from me, a lowly $6,000 blip on their huge corporate radar.

"I don't know the answer to that but maybe the policy department would be able to respond"

Astonishingly, I speak to six more people and spend a total of an hour and six minutes on the phone with various Oxford employees. No one knows the answer to my simple question: why am I paying another $100? It's as if I'm asking them the impossible. As if I was asking them to raise the dead.

But I do piece together the following information: my $100 deductible is paid to help alleviate Oxford from increasing costs. More lawsuits are being brought against pharmaceutical companies, which therein makes medication and treatment more expensive, which therein makes it more costly for insurance companies to pay for their clients. Essentially, my $6,000+ isn't enough to cover that discrepancy. They need even more. I also learn that this particular aspect of my policy is only applied to private policies. Most corporate policies do not have the $100 deductible. One customer service operator, Mary, admits that they wouldn't want to discourage a company from employing their services. "So, we give them less deterrent." At the end of the day, losing one consumer isn't a big deal. Losing 300 of them is.

Michael, an executive supervisor, tells me there is no way to change any of this. All personal policies have this $100 deductible.

"Was this always the case?" I ask him.

"Well, it used to be less so. But now, it's pretty much across the board, for all prescriptions."

Michael speaks with me like a talking policy manual. Everything is on-the-record. Everything is very official sounding. At one point in our conversation, I try to appeal to him as a human being.

"Let's say for a second--hypothetically--we're the same person. We're frustrated with this arbitrary and unfortunate deductible policy. What do we do next?"

"We write a letter to the Correspondence Department," Michael plays along.

I laugh. "You're--excuse me, we're kidding, right? You want me to write a letter? This is 2006. Isn't there an email address? Someone I could talk to on the phone?"

"Unfortunately, all complaints and concerns are handled through letter correspondence."

I explain to him how I am suffering from allergies and all I want is to do is waive the $100 deductible retroactively so I can begin using my co-pay. I don't want to wait weeks for my Oxford pen pal to write me back. Our conversation, like the ones before it with the others, is fruitless and full of bureaucratic double-talk. Exhaustingly, I tell him, I'm getting nowhere here.

"It's my impression, that after an hour, I am wasting my time. "

"Well, I just don't know what else to tell you. I don't have the answers to your questions nor can I help."

I hang up exhausted, angry and still without my allergy medicine.

Moments later, I call my mother. "Welcome to the middle class," she says. "See, you're neither poor nor rich and that's the problem. If you were poor, the government would pay for your health benefits. If you were rich, the $100 wouldn't make a difference in the grand scheme of things. You are just experiencing yet another painful lesson from being middle class."

We're being punished for being included within the majority of America? I ask.

"Yup," she says. "So pay the $100 and move on."

5 Comments:

Anonymous alisa said...

Where are your Canadian jokes now?? Seriously, there are about 45 million uninsured people in this country and most of them are middle class. Mom is right. And health insurance is evil.
And in Canada, all those allergy drugs are available over the counter.

1:21 PM  
Anonymous Anonymous said...

I used to do customer service for a state Medicaid program. Try not to take it out on the customer service reps; They can't help it that our nation's health care "system" is screwed up.

7:30 PM  
Anonymous Anonymous said...

go to ehealthinsurance.com...use your nj zip...quality plans are offerred at around 1/3 of the cost of plans offerred in ny state.
KR

12:12 AM  
Anonymous ilana said...

okok, im paying you for half that ticket.

5:56 PM  
Anonymous sara said...

dude. join the freelancer's union. i pay 200 bucks a month for insurance and they even got me a cheap new pair of glasses, in addition to paying for my recent, horrible emergency room experience.

www.workingtoday.org

and yes, it's the same union that has those ghetto advertisements on the subway. everyone always asks.

4:45 PM  

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