GRRRR!

Last week, a rep from BSBS called and told us we need to find a new dialysis center. After 3 years, his current center is suddenly out-of-network and and BCBS hasn't been paying the claims. We have accrued a $113,000 bill, and this is all news to us.

The 30 month coordination of benefits period has elapsed. Medicare now pays primary, BCBS pays what Medicare won't cover. Simple enough, right?

Now we are having a hard time finding a center that in in-network with BCBS, AND accepts Medicare. The rep from BCBS does not seem to know what she is talking about and keeps referring us to centers that won't even accept us. The social worker at the dialysis unit places the responsibility on BCBS and is angry about not getting paid. Either centers don't accept Medicare, or they are out-of-network. My husband's policy has out-of-network benefits. and we have been paying the same premium. So why would BCBS screw us over now?

He is on staff-assisted home dialysis, but after 30 months, BCBS won't pay for that. I heard Medicare was supposed to help us, but it's been a huge pain in the ass. We are not in a position to make drastic changes. I have been speaking with several people from BCBS, Medicare, and dialysis centers. I have written letters of appeal, and asked his doctor to make an argument on his behalf. BCBS and Medicare are still jacking us around, and we have no answers about our benefits, or which dialysis center we are being kicked to.

Today, I got an email from the same BCBS rep, and she said we can remain with our current unit and pay out-of-network benefits. Why would she call us last week and tell us to make a switch?!

Anyone else deal with headaches from insurance and medicare? I am NOT paying $113,000 for something I didn't know about!