Wednesday, 16 November 2011

The health insurance saga

Living in a western country, you need to adjust to lot of new systems. Well, health insurance is one of them.

In India we fall sick, we go to doctor, doctor sees us, prescribes medicine, we pay the bill by handing out the currency notes, end of the story.

But due to a turn of events, I had to discover the whole system of how the above is done under a health insurance system. (Well, not exactly but here is my story anyway!)

I fall sick in the first week of my arrival in Germany, I go to doctor without a second thought because my health insurance provides me full cover. (Not true! At least I thought so then)

The doctor sees me, prescribes medicine, I go to Apotheke and buy medicine. (German for pharmacy, most expensive place to be in Germany. In fact in Germany they make fun of expensive places by calling them Apotheke. I would have got a surgery done in India at the price I paid for the medicine)

I wait for Doctor's bill (They say, they would send the bill in post.). Months later I get the bill. (This is because, the bills at Doctor's place is handled by an agency called "PVS", who send bills at the end of every quarter. Yes, there are different sets of quarters in Germany where your insurance and other stuff are valid/expire, phew! sweating already!)

Now I ask my international officer, what to do with the Doctor's bill and also the bill from Apotheke.
I am now told to pay Doctors bill by transferring the amount to account of PVS. I do that, and send the bills with the filled form to my insurance agency "die Continentale".

Weeks later, I get letter by Continentale. First I get to know I don't get all my money back and I have to pay a portion of expenses myself. Secondly I see that my insurance agency, instead of transferring me the money, has paid the doctor directly!! (Now the doctor is paid twice)

I rush back to my International Officer for help, she says they should have paid you as you have paid the doctor. This has been the procedure she says, at least since last six years I am working with this insurance company.
Now she says, go back to doctor and ask for money!

I go to doctor, doctor who doesn't like handling the bills, says call PVS, I don't handle "abrechnungs"!

Calling PVS, the answering machine blabbers in a fast speed, says BEEP BEEP and goes off.

I go back to International Officer again, she calls the number herself, speaks in fast German for 15 minutes and says to me, Oh no! the PVS have transferred the money back to you insurance company as they had already received payment from you.

Wow! Now we need to call die Continentale!!

She calls my insurance company, again some regular formal greetings exchanges, Guten Tag.... ending with Vielen Vielen Dank!

She turns to me and says, now the money is stuck with the insurance agency and they don't know the exact procedure to deal with it. Keep having a look at your bank account, you may get your money in a month.
Your case is under "processing".

I am sure if I had kept the same money for a short term deposit, I would have had substantial amount as interest in India and would have saved a lot of time. Time of mine and all the people who were involved in this saga.

I am still waiting for my money, I wanted to write this before it gets anymore complex from here!

This might be a one odd story of health insurance system and the system might be much better than this, but this is my story and this is what I had to go through and I reserve the rights to share it and express my views on it.

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