Insurance rant!

[Jill D.]

OK, I am currently 10 weeks post-transplant and a couple of weeks ago I found out that the company I work for is changing insurance companies. I tried to not let it stress me out until I had more info about coverage, but things are not starting out very well! I was told that the new policy would take effect 3/1/07, then I find out that it took effect 2/1/07. Of course, I do not have a card or any billing info but have prescriptions that I called in since 2/1 that are in limbo.
Also,the new company (BC/BS) is trying to say that I have to pay $350.00 PER MONTH in additional premiums because I have Medicare for ESRD (this would make my monthly premium $1200.00). Has anyone else had that happen? I don't understand this at all...I already pay extra for Medicare, which then covers my immunosuppressants as primary, which is less money that my insurance will have to pay....right? I am trying to get some answers from them, but they are not very responsive which is not good!!!
The last insurance we had (which we had for the last 15 years) was AWESOME! I never had any issues or problems with them and had great coverage. In fact, I had a Care Coordinator that the insurance company would assign to ESRD/transplant patients that I would call if I had questions, and she would even call me to see how  was doing! With Blue Cross, they are trying to say that I need to give all of my questions to the insurance broker, who will then contact BC/BS. Huh? Trust me, I am trying push through this BS and get it sorted out without going into 'roid rage - but it ain't easy!!!! 

[Ohio Buckeye]

Hope it gets all sorted out satisfactorily for you.
Most insurance companies are the pits to deal with.
Seems like being on Medicare would make the coverage less instead of more since
Medicare would be covering as primary and ins. secondary.
I'm still on ins. and not medicare yet.
Not looking forward to having to deal with both of them.
Good luck.

[goofynina]

I too hope everything works out AND SOON,  i am sorry they are putting you through all this BS, just hang in there and keep on pushing girlfriend... Most importantly remain calm and do not stress (i know that is easier said then done)    But just wanted you to know i am thinking of ya..... 

[kelliOR]

Jill,

I can TOTALLY relate to the insurance bombs that get dropped in your lap!  Most companies do not have all the facts to start with and usually you start dealing with a lower end representative.  Plus........no company wants to pay anything!   It gets especially stressful post txp. worrying about the drugs.  Hang in there, you've got a great kidney, and things will work out. 

Sending you some good karma,
Kelli

[Rerun]

Jill,  I have BC/BS and I do fine AND Medicare is still secondary for me.  They pay what they are supposed to and Medicare picks up the rest?  I don't pay additional.

Your company probably couldn't afford the other company so picked up a cheap form of BC/BS??

[BigSky]

I am not up on how different insurance works but I do not know if it would be legal for them to make you pay more just because you have Medicare   It is none of their business if you have Medicare.  Maybe tell them if they don't watch it you will drop Medicare and stick them for the cost of the immunsuppresive medication.

[Jill D.]

Jill,  I have BC/BS and I do fine AND Medicare is still secondary for me.  They pay what they are supposed to and Medicare picks up the rest?  I don't pay additional.

Rerun - that is good to hear. I am still trying to get some answers. I have spoken to my "independent insurance" guy, and he is trying to get answers for me, as well as have someone from BCBS call me so I can speak with them directly. I know it's never a smooth transistion when switching health insurance, but with my situation it makes it even more of a mess! BCBS is saying that we won't be getting our membership cards for a couple of weeks and of course I get labs drawn weekly and am ordering Rx almost every week. They gave us our contract number, but I am finding that the membership card is what health care providers really want.

Your company probably couldn't afford the other company so picked up a cheap form of BC/BS??

It is true that the other company that we had did raise their premiums 25% this year...family rates (premiums) went from $796.00/month to $980.00/month. The coverage and service were fantastic. The Blue Cross is still not cheap...$825.00/month and the coverage is very similar. Same deductibles, but slightly higher co-pays and things like mammograms, diagnostic tests, labs and x-rays are covered 80% after paying the $1000 yearly deductible, whereas with the old insurance these things were covered 100%, no deductible. Paying out of pocket for these things will probably make the new insurance more expensive for me in the long run, but I use the insurance more than anyone in my company.

My most burning questions have to do with my coverage at Mayo Clinic, since I will continue to have to go out for follow up tests and appointments.

I'm trying to stay positive...like Kelli said, I have a great kidney and I am thankful that I have a job and even have insurance! Also, my boss told me he will pick up the additional premium costs that they are trying to charge because of Medicare, but I am still pursuing it because I don't think it's right.

Thank you so much everyone for your supportive comments!