General Category > Insurance
BC BS of Tennessee Blues
Soundy:
I just learned today that my husband's work place is switching insurance...we are
on CIGNA and although I cannot get them to approve BAHA they have paid well on
everything after w few paper work glitches were cleared up...
I was sent a questionnaire and a phone number to call... I was singles out in our family as a
"potential liability" ... in other words I may cost them money... I talked to the woman at BC BS
and was told that my AN would put me in pre-existing status for BAHA and further MRIs and
visits concerning the AN would not be covered for a year under the new plan ... this sounds
like light years to me ... I can deal without BAHA...what I can't deal with is the headaches and
no coverage for doctor visits... was also told that the deafness would probably not be covered
if not addressed before switch over... but I can take out a supplemental policy on myself to be covered
but it will still not pick up til their waiting period is over...also told I can appeal this
Cover sheet explaining the cost of new coverage and changes in co-pays said it would be a seamless
transitions...I see nothing seamless about this... change will take effect July 1st so gut says fight fight fight to
get BAHA pushed through under CIGNA... crossing eyes on that (if I cross fingers I can't type) ...
Any ideas from anyone who may have been in a situation of losing insurance??? where to start fighting?
I don't know what I want to ask... just a bit peeved and depressed over the whole mess
sgerrard:
It seems to me that if the company switches insurance, existing conditions in the process of being treated must continue to be treated under the new plan. They can't tell someone in the middle of recovery that they will have to put it on hold for a year. This isn't an optional change, is it?
What if the company changes insurance provider every year? Does that mean that no one ever gets any treatment, because each insurer has a one year waiting period? It seems to me that if you get to the bottom of it, with the HR department at the company,and the new and old insurance companies, there will be some provision for completing treatment.
Hope it works out.
Steve
Soundy:
That is what I thought when told the transition would be seamless ...that what
was already being treated would continue to be taken care of...but then told
all the other stuff by BC BS people
HR person's husband had open heart surgery about 6 months ago and he is on
her plan and is going through same thing... she is a fighter... several of us with
ongoing health issues , met today with her and I feel alot better about it all... not that
I glad her husband is in bad health but his case will help us all as she fights to keep us
covered seamless as promised...
Still going to continue on getting BAHA paid for just incase... CIGNA will pay for implantation
but not hardware unless I can prove it necesary...which so far the reasons I have stated as
needing it have not satisfied them...trying to get a letter of necessity from doctor...
People around me thought ... OK she had the AN removed and it is over now... can't make them
understand that surgery was just the beginning of a battle... been fighting someone
(usually insurance ) ever since surgery... tired but feeling better ...
keeping eyes crossed that we win this
jerseygirl:
Soundy,
Don't give up! Insurance is there to cover you when you are sick, otherwise it is not needed! BCBS is known to do this. I just read about the California insurance companies who do exactly the same thing. The governor's office got involved and many people are reinstated. I am not even sure it is legal if it the group insurance. Hope to hear good news soon.
Eve
leapyrtwins:
Soundy -
don't give up on getting the BAHA approved. Lots of insurance companies turn down the first request for it; usually they change their ruling on the second request.
Good luck,
Jan
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