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Deducing the benefits of re-enrolling

November 18, 2002|by JoEllen Barnhart

By JoEllen Barnhart

How does that song go? "It's the most wonderful time of the year it's the most wonderful time of the yeaaaaarr.." Obviously Andy Williams (the best known singer of my much younger years ever to wear a cardigan sweater) never, ever, not on his life, with a cherry on top has to fill out those forms.

What forms? Health benefit forms. It's that wonderful time of the year when you have to re-enroll for healthcare coverage.

I have read through the materials provided by my employer. I am quite sure I would have a better chance of understanding what the caveman carved on the inside of his under shorts than this epistle. I believe they actually had to add an extra level of benefit to cover all recovery and post-traumatic stress treatments you have to go through if you read the entire 89-page manual. Not since they added three additional languages to the manual for my VCR have I had to wade through so much gibberish.

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It's not that I do not take my health benefits seriously. Or take them for granted. Unfortunately my family uses our benefit coverage extensively. As the mother of three sons with unique medical needs, there is an addition on my pediatrician's office named after our family. We visit the doctor's office so often; they started offering us frequent flyer miles.

There's a special language that goes along with the health benefits language. There terms like "EOB," which stands for Explanation of Benefits. And "reasonable and customary charges," which stands for: we've squeezed every penny out of this bill before we pay it. And the ever-popular term, which defies all logic: the "deductible."

I have studied my deductible. My study continues at present; I have three calls into MIT to see if they can crack the code and one to the Vatican for divine guidance. The deductible is much like infinity: you know the end is out there somewhere, but there's no chance you'll ever reach it.

My family often crosses over the line with our insurance. Sometimes we go "out of network," otherwise known as the "Forbidden Zone." Screams of fright rise up when we let our insurance carrier know we must travel to the dark side.

But, out of network, deductible, EOB and even reasonable and customary are phrases and words we really do not have to fear. The insurance company provides a helpful 800 number to call; complete with all the classical music you would ever want to hear.

I'm listening to it right now, waiting to learn about the new acupuncture coverage. You also get to play a game called "Push 4,743 buttons on your phone before you may talk to a live person."

JoEllen Barnhart is assistant to the director for Frostburg State University's Hagerstown Center. She has three sons.

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