How do they discover your health insurance and add to your profile?
Since I work two jobs where both employers provide health insurance at no out of pocket cost to me, I have two healthcare policies and also two prescription and dental policies as well. My question is this – I've worked for the company with the best insurance for 18 years (a part-time job) and it is the only insurance card I have ever provided to a hospital, clinic, doctor's office, dentist, or to a pharmacy. The other full time job I've worked at for 9 years, their health insurance is adequate but will provide retirement coverage where the part-time job will not.
PT job prescription costs are $5.00 for 30 days, free for 90 days. FT job prescription costs are over $30 for 30 days and on up for 90 days – why I've never shown the card at the pharmacy, because no need to and it will also be secondary to the PT job benefits. (18 years vs 9 years.) One day when I go to pick up my 90-day prescriptions, I'm given a total of over $200!! Well, I just stared at the tech like they were pulling a joke and said, "HUH?! That's impossible, it should be free." They checked to verify, said, no, that's what your Medco benefits are (FT job). I obviously was 1) confused 2) annoyed 3) irate 4) very concerned about my HIPAA / insurance information getting poached – and said, "No, my benefits are through Caremark and PT Employer" then the pharmacist came over who knows me and said, "hmmm, it updated your insurance last week."
"Who did? I never gave any card or permission to do so – how did this happen, please?" Apparently the pharmacy's computer system just scans the great insurance database and looks for insurance information and populates your information with what it finds – and doesn't both validating with you, the patient/customer. Fortunately, there's an amazing pharmacist who updates my insurance monthly when this happens – but how can this be legitimate/legal?
At the hospital for a procedure last month and they're going over my benefits and what I might owe. PT Job's insurance is absolutely amazing, okay? I will owe $0.00 for the procedure – surgeries are covered at 100%. BUT listed as my secondary insurance is my FT job's insurance plan – again, I've never ever ever shown the card anywhere because I didn't want to ever have the FT job's insurance mistakenly charged as primary!! (My PT Job's insurance is where people who work as consultants, contractors etc work PT for just the insurance.) Again, there seems to be some type of insurance data mining that is occurring and they scan for your insurance policies and add them to your patient records without asking your permission. How is this legitimate and legal?
Last, but not least, yesterday at the dentist – a small practice – THEY even had my FT Job's dental insurance added to my profile! My PT Job's Dental plan pays 80% for crowns and implants and has NO ANNUAL MAXIMUM, okay? My FT Job's Dental pays 50% for crowns and implants and has a $1,500 annual maximum. Yeah, exactly, little to no value. Again, what happened to our HIPAA privacy and patient rights?
If I'm missing something or something changed in the industry, I'm all ears and would appreciate the knowledge anyone can share with me. Part of the issue is also due to my working at one of the hospitals where I am a patient and don't like the fact I'm an employee there added to my profile added – the insurance is clearly related to the hospital so it's a give away you're an employee. I feel like it is a privacy issue and as you can see the insurance from my PT job pays for every medical expense so the only reason to have the FT job's insurance is for the long term, retirement, along with the pension. But even the PT job has a pension!! LOL
How do find this and add to our patient information without 1) verifying with us and 2) our permission? Your help and thoughts are greatly appreciated!
submitted by /u/reaperdawg
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