LymeNet Flash: If you can count past 28......

This is topic If you can count past 28...... in forum Medical Questions at LymeNet Flash.

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Posted by can not remeber (Member # 6520) on :

I believe that there is an unwritten rule that insurance companies will only hire people that can count to 28. It is nothing personal against us, they are just felony stupid. They think CDC stands for the Crazed Disease Circus Inc.
Now a more serious subject to deal with, and I could really use your input [bonk]

; I currently have UHC and have the opportunity to change health care bene in NOV. My other option is BC/BS Empire Blue. Has anyone had any experience with this carrier?
Both BC/BS and my LLMD can not answer this. Just your experience with them would be useful.
Be well,
T.

Posted by hurtingramma (Member # 7770) on :

I have BCBS of Vt. It all depends on the policy they're offering you. We have several different plans to choose from. the one I have I do not need a referal to see a specialist (which the other plans do.

They also have different plans with different copays and deductables. Read carefully before you sing onto anything new.

Posted by daniella (Member # 6753) on :

bcbs is the best in IMO

Posted by Corgilla (Member # 4066) on :

Hi,

I have BC/BS PPO and it's pretty good. I know for sure they won't pay for more than 60 days of IV.

There's a copay for in network docs and I have to submit my out-of-network bills.

I'm really bad about paperwork so I haven't submitted one in over a year. I'm pretty sure they pay somewhere between 50-80% of out-of-network costs.

I have to pay extra out of my paycheck to be able to go out-of-network.

I really should get those bills in. My house is strewn with papers that I don't know what to do with. It's one of my biggest flaws.

Hope this helps,

Corgilla

Posted by Mishelly00 (Member # 5897) on :

Hello, I have BCBS Blue Choice New England. I don't want to jinx myself but all I have had to pay is 20.00 co-pays for doctors visits and scripts. They paid for 7 months of IV ( I had to pay nothing). They didn't even try stopping it. They are now paying for Bicillin injections also with no cost to me.

So I can say BCBS has been a life saver for me. I guess it depends on what plan. I hope it all works out for you. Thanks, Michelle

Posted by Andie333 (Member # 7370) on :

I'm on Keystone BCBS (self-employed, out of pocket). I have high option personal choice...

The terms of my plan are very similar to Corgilla's -- deductible, then 80% co-pay on generic scrips, high deductible then either 50 or 80% co-pay for out-of-network docs. For in-network doctors, the co-pay is much much less, but my LLMD happens to be out of network. (of course, since my abx run almost a thousand, the co-pay isn't minimal).

I seem to recall someone on the boards (Tincup?) posting that exemptions can be negotiated with BC to shift designation of LLMDs, but I haven't had the stamina yet to pursue this.

As far as IV, the BC web policy for my plan states
they will cover one month.

I am just sticking with orals...I figure it isn't worth the fight.

Of course, all this should include the fact that I now pay more than $500 a month for this "top of the line" plan.
[shake]

Andie

Posted by HEATHERKISS (Member # 6789) on :

Hi,

I have one of the lower BCBS plans. Direct HMO. So far they have paid for all meds.

but they seem to be making "mistakes" and I have to call to let them know I don't owe for and in network hospital or Doctor, stupid stuff.

It getting to be a pain. Recently they denied payment on 3 tests from MDL Labs that an in network LLMD ordered.

I called and they are going to get the LLMD to explain why the tests we medically nessassary.

These are "dummies" who are going to determine what is medically nessacary over a Doctor.

Can you even image that???!!!!

Oh yea by the way....... They have a Healthline audio tapes on different aliments. The Lyme audio talks about a lyme vaccine!!!!!!

Unfriggin believeable!

Posted by livinlyme (Member # 3773) on :

So long as it is not HMO program you will probably do better than most.. many insurance programs are HMO and this is where the lack of care comes in and why most LLMD's wont deal with Insurance....

I know I have heard many complaints from a few LLMD's about the lack of interest HMO's provide to the welfare of the patience,, they place time limits (since they only pay a small fraction of what an MD would charge for there time in an office viist) and restrictions on how many and what kind of tests and treatments...
Just my two cents