(My daughter requires glasses to see, so we go in for our regular eye appointment in November. Everything goes well until it comes time to pay for the appointment and glasses, at which point the staff inform me that my daughter’s vision insurance has already been used this year, and therefore won’t cover her new glasses. Confused, since her last appointment was fourteen months ago — definitely over a year — I head home to contact our insurance company to get things straightened out.)
Me: “I’m trying to figure out why my daughter’s insurance has been marked as used this year. Our last appointment was in September of last year, fourteen months ago.”
Insurance Rep: “Oh, we have an appointment on file from January of this year, so her insurance has already been used.”
Me: “But we didn’t have any eye appointment in January. Something’s not right here.”
Insurance Rep: “I don’t know what to tell you. You had an appointment in January, so you have to wait until next year to use her insurance again.”
Me: “And I’m telling you her last vision appointment was September of last year. We didn’t have any January appointment. Your records are wrong.”
Insurance Rep: “Give me a moment to check.”
(She puts me on hold for a while as she looks into this.)
Insurance Rep: “I don’t know what to tell you. You used her coverage for an appointment in January at a clinic in Missouri.”
Me: “We live in Georgia. We haven’t been to Missouri in the last year, let alone for a vision appointment. Who was the appointment for?”
Insurance Rep: “Oh, [Male Name, nowhere near my daughter’s relatively unique name].”
Me: “That’s not my daughter.”
Insurance Rep: “Oh. Let me look into this some more.”
(She puts me on hold again.)
Insurance Rep: “Okay, so, it looks like that vision clinic put the wrong patient information in when they filed his appointment.”
Me: “So, this is going to be fixed, and my daughter can get her glasses, right?”
Insurance Rep: “Unfortunately, it’s going to take six weeks or more to correct this error.”
Me: “But that puts us in next year, and my daughter needs her glasses.”
Insurance Rep: “I’m sorry, but that’s the best we can do.”
Me: “Even though it was your company’s mistake?”
Insurance Rep: “I’m sorry. Perhaps you can work something out with your vision clinic in the meantime?”
Me: “Fine.”
(Luckily, the vision clinic is at least willing to work with me on a reimbursement plan that will allow us to get the glasses now and have the insurance company cover the cost once they finally get around to fixing the problem without it applying against the next year. But aside from our insurance company not realizing that an adult man in Missouri is not my 10-year-old daughter in Georgia, the real gem is what happens when my husband calls the insurance company for a follow-up.)
Husband: “So, how can we be sure this doesn’t happen again next year?”
Insurance Rep #2: “You’ll just have to call in every now and then to make sure her insurance hasn’t been used yet.”
Husband: “You mean you don’t have anything in place to make sure that my daughter’s insurance doesn’t get accidentally applied to someone else’s appointment in another state?”
Insurance Rep #2: “No, sorry.”
Husband: “So, you’re making us do your job.”
