I am so F***ing pissed at Blue Cross

[earthmama]

I want to apologize ahead of time if I don;t make much sense. I am really pissed off!!

My Husband finally got hired full time. Health insurance is offered to us. Before that, just him and my daughter had a plan ( self paid) because we could not afford to cover me.

My daughter had a whole bunch of stuff done this year, ear tubes, 5 day hospital stay for the rotovirus, etc. Her deductible is met and she reached the 2000$ out of pocket max already for this year. GREAT!! Now her speech therapy will be covered 100%.

When my hubby's company sent the info about the health insurance, we decided to move him to the group policy and also to add me to the group, but keep my daughter where she is. I spoke with 3 different people at BC-BS and they all told me that all I have to do is cancel my husband and then our daughter will move over to her own policy. They also said that the amount that we have paid toward the deductible and out of pocket will roll over.

So we call to confirm that this all done. The rep at BC-BS said that there is no chance to our policy until we pay for the following month. We need to may from 4.14 until 5.14. Then they will cancel the coverage for my husband, then send us a check for the difference. I asked them how much I owe them , they said that I owe from 4.12 to 4.30 but I still need to send a check for the coverage until 5.14.

That is 375$ on top of the 403$ that was deducted from his check today to cover our share of the group premiums. ( his company only covers 25% of me).

This is fucking crazy. First I can not pull 375 out of my ass to send them and then wait 4-6 weeks for the refund and second Why the fuck would I give them money that I do not owe them. My husbands policy is canceled as of April 30th so I shouldn't have to pay up until 5.14.

On top of all this crap, as of May 1st the out of pocket max can not be rolled over to my daughters new policy.

[Selatius]

1. You're a working example of why health care is collapsing in the US

Your story is a nightmare of red tape and paycheck raping. I call it "paycheck raping" because I dunno how to describe it any other way.

[earthmama]

2. oops meant for the DU lounge

[Radio_Lady]

12. Not necessarily in the Lounge. I think it DEMANDS the GD group!

[earthmama]

15. yes you are right

after I posted I thought the lounge was a better place for my rant.

But this rant is serious. Those bastards are just ruling so many lives and draining families. Just like the oil companies.

[bunkerbuster1]

3. Could be worse.

You could have a 5K deductable, like us.

Yeah, our healthcare system blows chunks all right. There are really just two groups of people in this country--those who are getting shafted by it at the moment, and those who will.

[earthmama]

8. wow

5K. That is crazy!!

Sending you all healthy vibes!!

[magnolia]

4. I got ....

...Anthem Blue Cross last year. My first bill covered two months so that it's paid one month ahead. That means if a person dies in June, they'll still be covered in July. So Anthem has a whole month of premium without having to pay out anything.

[ThomCat]

5. Please make sure that they said IN WRITING

that your deductible will roll over and that your daughter's coverage will not be affected. Otherwise, you could be in for some very nasty surprises.


Please be careful. Insurance companies will do horrible things to make you pay the deductible again, and to remove coverage for someone who costs them money.

[earthmama]

7. thank you

for reminding me of that. I need to get something is writing to cover my ass.

That is the main reason I did not have health insurance. After I had my Daughter I had PPD really bad. I took control and got myself some help. I was going to a therapist every week.

They pulled my coverage cause I was using the mental health benefits to much even tough I had to pay 50% of everything.

[Gregorian]

6. Hey, get this!

I just cancelled my Blue Shield after they bumped my premium up 56%. I wrote a letter and told them I was going without insurance until we got universal health care. I had been a paying customer for nearly twenty years.
So yesterday I get a letter in the mail. (I have moved to Oregon about two years ago, meanwhile paying premiums the whole time.) It wasn't until I cancelled that they made it sound like they wouldn't have covered me anyways, living outside of California.

I guess we pay taxes for bombs, and bombs alone. I don't see many other benefits.

[Kansas Wyatt]

10. The United States has the best military in the world

To protect it's citizens form being attacked (military, not - nobody could have imagined flying civilian planes into buildings). Now the military industrial complex will be replacing FEMA, as a means to help justify their continued welfare contracts from the government.

Meanwhile the rest of the industrialized nations have national health care, as American citizens go without health care because they cannot afford it. Americans rotting and dying off, because the United States cannot afford the military industrial complex and national health care for it's citizens (like the rest of the civilized world) at the same time.

[Radio_Lady]

14. If you're in Oregon, you MAY qualify for the OMIP plan. I used it for

several years.

OMIP stands for Oregon Medical Insurance Pool. This is NOT the Oregon Health Plan; that's another entity.

Here's the link:

http://www.omip.state.or.us/

It is not cheap, but at least you can explore some options with them. If any questions, please PM me.

In peace,

Radio_Lady

PS. By the way, your California company should have told you that you wouldn't be covered if you changed your address to Oregon. Did you ever USE the plan you were paying for?

This whole transaction might be unlawful -- you paid premiums to a company legally unable to pay your bills while you lived in another state!

[Gregorian]

27. Thanks. I'm not elligible.

I'm appauled that humans don't care about each other. We just want to cheat and hurt. Well, enough of them to make like not very fun.

I'm not poor. Even if I get sick, it won't bankrupt me. I just didn't like the fact that suddenly my premiums should go up 56%, let alone not have something to show for the taxes we pay. I'm mostly concerned about those who need health care and don't have it. Or like my sister with MS- no stem cell research. Total clowns.

[Radio_Lady]

28. Income has nothing to do with OMIP. Just wanted to clarify that.

I hope you do qualify for some kind of insurance here in Oregon.

My husband was just planning to start a job on July 10, 1995. The preceding Friday, 07/07/95, he was trimming branches off a tree when he fell off a ladder more than 30 ft. He almost died from blood loss from a compound fracture of his elbow (the bones came through the skin) and a broken wrist.

Luckily, he was call able to call 911 before he collapsed in the house. The police and medical attendants called for a helicopter to transport him to a Massachusetts trauma center, where they saved him in an 11 hour operation.

The insurance company paid $85,000 to the hospital for 18 days there. The compensation went on to cover plastic surgery for scar revision, as well as physical therapy for almost a year.

If that had happened when we weren't insured, we'd be bankrupt.

Frankly, I wouldn't walk across the street without insurance. Your mileage may vary, and I'm so sorry for your sister. I do hope she has insurance.

In peace,

Radio_Lady

[Gregorian]

31. Oh no!

That is very frightening. Poor guy. I'm glad it worked out.

Now here I sit this morning, about to reinstate my insurance, regardless of the cost. And I partly say that because at 50 I am suddenly not as chipper as I once was. I'm getting migraines. I think. And without going to a hospital, I won't know what I have. I think it's Bushitis. But your post has given me a new sentiment toward insurance. I guess I'm only hurting myself by taking the risk of being uninsured.

I really appreciate your help on this. Thanks.

[Radio_Lady]

33. Good! I'm glad you thought it out! Best of luck in the future!

[0007]

9. LIfe sucks.

[Lindacooks]

11. And in Minnesota, AG Mike Hatch found that Blue Cross has more than

1 BILLION DOLLARS in reserve, while they're raising premiums.

The health insurance industry in this country is a moral disgrace. I'm still amazed that nobody has ever 'gone postal' on one of these companies. They have literally and actually killed people by refusing to pay for treatment and meds. They're all a bunch of crooks and murderers.

[earthmama]

13. 1 billion dollars in reserve OMFG

and they upped our premium by 55$ in 2006.



that is just fucking wrong. how can they sleep at night?

What can we do about this? Anything?

[Lydia Leftcoast]

16. If they raise my premiums $90 per month AGAIN

I'm seriously considering going without. I could pay for a lot of medical care by simply putting aside what they charge me every month.

[earthmama]

17. it is like that with maternity coverage

here.

Additional maternity coverage would run me oh about 300$+ a month and who knows if you are gonna get pregnant right away. Also I heard that you have to be on the maternity plan for 6 month before it kicks it.

[Lindacooks]

26. You know, that's really true. My dh and I pay almost $600/month

That's a good chunk of change at the end of a couple of years. Of course, one hospital visit can cost you $30,000, so that's it for your savings.

[Lindacooks]

25. Try to get Dems elected, I guess.

Repukes don't give a shit about the average American and they want corporations to be filthy rich.

[xiamiam]

18. well..heres my story.., 55, healthy..blue shield charges me 600 a mo

and thats down from 800 because i took a higher deductable and other than a knee surgery a few years ago..I NEVER use..thank God, I've been healthy...last month I had an emergency...gall bladder surgery...the hospital has been sending the bills and so far for the 2 and one half day stay in the hospital...the bills total $64000 dollar and that has yet to include the room charges...unfriggin believable...who is to blame?..i dont know but it sure does seem like something is not right...

[earthmama]

21. agree

that is not right.

My daughter had ear tubes put in. The actual surgery was 7 min and she was in the recovery room for 15 min. They used gas on her.

Hospital bill 2674$
Doc bill 1289$
sleep doc ( gas) - 664$

She was also in the hospital for 5 days with the rota-virus, haven't seen the break down of that bill yet.

[RWBPatriot]

19. I'm sorry this is happening to you! There definitely needs

to be some changes made. Doctors/hospitals increase their fees to pay their insurance coverage and insurance companies raise our premiums to make more profit... Go figure. Does any one know their eoy profits?? Anything like the gas companies 400% profit??

[NNadir]

20. My son had thirty surgeries with Blue Cross as a back-up.

All I needed for them to do was to send a letter saying they did not cover the procedure to the main insurance company.

I didn't want any money from them, just a letter.

The process had my wife in tears, and we almost had to cancel the medical procedures.

I finally got the matter resolved by it literally took weeks of full time work.

Blue Cross sucks.

[earthmama]

22. that had to be hard

I am sorry you all went through that.

[kurth]

23. Insurance companies are worse than oil companies

Seems their job is to kill off the poor, sick, and injured in America by delay and denial.

Our health care system is a goddamned fucking disaster. This in the greatest and richest country on earth.

[knitter4democracy]

24. Sheesh. That's bad.

It sounds like the time we had to have my daughter on the Ohio CHIP program--practically a full time job to get her on it and to keep her on it.

That's foul. They shouldn't mess around like that.

[dorktv]

29. The insurance industry is now profit driven.

Health care accross the board is actually.

[BrownOak]

30. What state do you live in?

Feel free to drop me an email. I'm in the insurance industry (group only, not individual so I don't have anything to gain from this - other than feeling good about helping someone) and I can help you sort through the bullshit.

Just so I have my facts straight-

Husband and daughter are on a individual BCBS policy
For some reason, the rep at BCBS is telling you that you need to pay a premium into May for your husband's coverage as well as that of your daughter
Your daughter will move over onto her own policy on 5/14?
Your husband's coverage with BCBS will end on 4/30

The first thing that screams out at me is why you would need to pay through 5/14 on anyone. Most coverages (at least in my group world) are based on the start of the month, not the middle.
The second thing I would want to know is if the new policy which they claim will not recognize the OOP amounts, will recognize your deductible contributions.
Have they given you the new premium for your daughter only on the BCBS plan?


couple of thoughts and suggestions -
The first thing I would do is pull the policy and find out what the grace period is. Most have around a 15-day grace period in them. If they are going to issue you a new policy for your daughter (as it sounds) you could simply pay for your husband and daughter through 4/30 and then just ride the grace period.

The other thing I would do is to look to see how your husband's new policy handles takeover benefits. They may recognize your contributions thus far to your individual plans. It may be easier to add your daughter to the group plan rather than keep her on the BCBS plan. I would imagine that you've already discussed this and the cost to go from Employee + Spouse coverage to Employee + Family coverage is greater than what her BCBS premium would be.

What is the cost of the group plan for Employee + Child along with an individual plan for you as compared to the arrangement you're currently looking to do with you on your husband's group plan and your daughter on her own plan?

Have you looked at other individual carriers in the state to see if they have takeover benefits?

Drop me a line and I'll see what I can think of for you. You're getting abused here.

[lonestarnot]

32. Down with insurance companies! Fuckers all!