The rules of health insurance are deliberately made so complex that they can be interpreted in whatever way the insurer chooses. They are also intentionally impossible for anyone to understand. I work in the business, and I met with one of our own internal sales representatives to try to get an explanation of my benefits.
After several hours of attempts to get it straight, we both gave up.
That's a feature, not a bug. Just as it's quite deliberate when health insurance companies say that co-pays and high deductible benefits are ways to "educate the patient to be a wiser health consumer"—as If the average patient could tell the difference between an MRI or an x-ray. It's all magic to most of them. And don't even get me started about elderly patients!
We are all nothing but chum in the water in a world full of sharks.





