What more can they do?

[Punkin]

BC/BS is really getting me down. First, they denied rehab on the day I was to be discharged from the hospital and sent to Anchor Health & Rehab. They said I was "too healthy!" They wanted me to be sent home! I called them and told them what I thought of their decision. I also told them that, if they sent me home and I fell and I died, THEY were liable!!! The woman told me that their medical director had gotten involved and before I got off the phone, she told me that they had changed their decision and I would be allowed to go to rehab. THEN, they said they would not pay for Tuesday and Wednesday (following the surgery on Monday) because the doctor should have sent me to rehab sooner!

Because Bob is still working BC/BS has to be my primary insurance and Medicare is my secondary. I just can't wait to see what BC/BS is going to do to me next! I HATE BC/BS!!!!!!!!!!

[Paula A]

Appeal, appeal, appeal! That was always what we had to do. With Gary's health problems throughout his life, you would think they would put a green sticker for Go on his files, but we had so many turn downs before the Go got ok'd.
Keep on them! And if you have a medical person to keep on them, too, it will help.
I kept getting billed for his air ambulance to Stanford, because BC said there were closer hospitals (SF and DAvis). Finally, the secretary at the rehab hospital got involved for me and told them the other hospitals ALL Passed on his surgery. It took some time, but they finally, listened or read the info they were receiving and the
bill was resolved...
Bless you, and don't let this get in the way of your healing, positive thoughts.
When I think of how much money I paid Blue Cross the last two years when I have not used it at all, and then see how you are being treated, it just makes me think maybe socialized medicine is the way to go....

[determined]

Oh BC/BS had a run in with them years ago. X's job didn't offer health insurance plus we were apart, my job offered insurance so I put the kids on mine no problem until my oldest had to have a bunch of test only to find out she had Bell's palsy then they wanted to question why if her father didn't have insurance on her??? and wanted to deny the claim. I told the woman that I had been paying them for 2 years and hadn't had anything else questioned and if they wanted to deny the claim that my next phone call would be to a lawyer and would sue them, they had no problem taking MY money to pay for coverage that they now said that we weren't entitled to, so if that was the case I wanted what I had paid in plus interest. They paid and never questioned again.

[JoS]

This just amazes me! We have Anthem Blue Shield through Hershey Co. and they have been fantastic! The liquid arterial feedings I was on for 6 months were $2,500 each plus med, rooms, rehap, surgery, etc. Once we met our deductible they paid all, no questions asked.

[JoGee]

I'm amazed at what hospital/medical charges are. If you really think of it, it shouldn't cost that much.

It's like eyewear. You pay the doctor a small fortune for your glasses. Yet you can get them online for $10 with your prescription. When I picked mine out on-line, my fancy frames and special coatings on my prescription lenses came to just $39.00; plus its not plastic, but glass which I prefer. This is a $200-300 savings in my case. Nobody warns you at the eye doctor's that your frames might come loose and cannot be repaired, so I needed new ones. That was a $250 pair of glasses! (E repaired them.).

As for insurance, they all play that game of who owes what. We have military TriCare For Life. They do not cover brand names, only generics. So the pharmacy gave us a nice discount on the brand name (the generic is unstable in my system).
So TriCare said if we have a discount on that one prescription, it's considered an additional insurance, and they won't cover the rest. So we pay full price on the brand name one. My doc said if I want to try the generic again. I need blood tests weekly til it's determined..........no thank you. My current blood work produces enough surprises without dealing with the generic again.
There was a time we had 2 insurances, and they'd go back and forth on who covers what. My hospital docs said I need a surgery, and the local doctors refused, so the insurance did, too. Then the two companies of the two insurances switched to my preferred company. The local docs hospitalized me and gave me the wrong blood. I did have to go to the big hospital for that to get fixed, and the big hospital doctors took over; I got the surgery, which they fully covered, no more questions. Frankly, I never expected to make it through the surgery. But I did. Funny how something can go your way when its least expected.