LymeNet Home LymeNet Home Page LymeNet Flash Discussion LymeNet Support Group Database LymeNet Literature Library LymeNet Legal Resources LymeNet Medical & Scientific Abstract Database LymeNet Newsletter Home Page LymeNet Recommended Books LymeNet Tick Pictures Search The LymeNet Site LymeNet Links LymeNet Frequently Asked Questions About The Lyme Disease Network LymeNet Menu

LymeNet on Facebook

LymeNet on Twitter




The Lyme Disease Network receives a commission from Amazon.com for each purchase originating from this site.

When purchasing from Amazon.com, please
click here first.

Thank you.

LymeNet Flash Discussion
Dedicated to the Bachmann Family

LymeNet needs your help:
LymeNet 2020 fund drive


The Lyme Disease Network is a non-profit organization funded by individual donations.

LymeNet Flash Post New Topic  New Poll  Post A Reply
my profile | directory login | register | search | faq | forum home

  next oldest topic   next newest topic
» LymeNet Flash » Questions and Discussion » General Support » What to do about Ins I have and some I may need?

 - UBBFriend: Email this page to someone!    
Author Topic: What to do about Ins I have and some I may need?
lookin4answers
LymeNet Contributor
Member # 4974

Icon 5 posted      Profile for lookin4answers     Send New Private Message       Edit/Delete Post   Reply With Quote 
ok, hear goes.....let me see if I can make heads or tails of this for you.

As of now without an official dx, I have BCBS thru my company. It only covers me and is free. This would be my Primary Ins.

My whole family is covered by Tricare which will only last about 8 more months. That would be my secondary and my husbands and 2 daughters primary.

Ok, well as I see it, not knowing anything about how long my girls may have to be on abx and they have not been dx yet, would you think I should go ahead and add them to my ins thru work? OR would having a test run already mean "pre-existing" to ins. It is NOT cheap, and I am not sure that with out of pocket expenses I would come out just as well.

Does any of this make sense? I am kinda confused myself.
How much does your ins if you have any, pay for your trip to the LLMD? Are they good about covering that visit?

Thanks, Amanda


Posts: 688 | From SW Arkansas | Registered: Dec 2003  |  IP: Logged | Report this post to a Moderator
PERRYK
Junior Member
Member # 5925

Icon 1 posted      Profile for PERRYK     Send New Private Message       Edit/Delete Post   Reply With Quote 
There's some good news and some not so good news.

With the new health care portability legislation in place there are fewer instances of "pre-existing conditions." Thank God for small favors.

The important thing to remember with this new law is NEVER let healthcare coverage lapse unless a new one is in place. The lapse in coverage can create "pre-existing conditions."

Check with BCBS to find out if and when you can add your daughters. Usually this is only during an open enrollment period or a 'life event.' Divorce, job loss, etc. usually count as life events.

BCBS should accept the kids without naming pre-existing conditions in these situations, so long as they have had health insurance 30 days prior to their enrollment into BCBS.

I believe the new law is called HIPA. I'm sure BCBS can hook you up with a copy of the act.

Of the 5 LLMDs I contacted in the NYC area none particpated in BCBS and all were out-of-network in Aetna. I had to pay up front for office visits and the lab work and then get out-of-network reimbursements.

The labwork was all out of network because the only reliable labs do not particpate in HMOs, etc. None of the LLMDs in this area would use LabCorp or Corning Labs. In the end it was $400 per visit out of pocket, including labwork.

If your insurance is a network type, try to get a referral from your PCP.

If money is a problem, call BCBS as many times as you need to confirm coverage. You don't want to get stuck with a surprise bill.

The insurance paperwork can be really tough. Be sure to attach all your doctor bills to the EOBs from BCBS. This is the best way to keep track of what you owe the docs.

I usually go out of network for my medical care because quality is important to me. It takes a lot of digging to keep the bills sorted out. Good luck.


Posts: 5 | From franklin, NJ, usa | Registered: Jul 2004  |  IP: Logged | Report this post to a Moderator
tabbytamer
Frequent Contributor (1K+ posts)
Member # 3159

Icon 5 posted      Profile for tabbytamer     Send New Private Message       Edit/Delete Post   Reply With Quote 
Does your BCBS allow you to pay a doctor/lab and submit the bill to BCBS for reimbursement?


Posts: 2098 | From San Diego, CA, USA | Registered: Sep 2002  |  IP: Logged | Report this post to a Moderator
SC
Member
Member # 5767

Icon 1 posted      Profile for SC     Send New Private Message       Edit/Delete Post   Reply With Quote 
Hello, I am also on BCBS. I am not too sure about adding your daughters but it is definately worth checking on.

My family sees Dr. C and we must get prior approval from BCBS for each appointment but so far so good.

They are doing a great job paying for our meds too.

I have been told that they are one of the better companies to work with.

Thank God for that!

Best wishes!
SC


Posts: 71 | From Indiana, USA | Registered: Jun 2004  |  IP: Logged | Report this post to a Moderator
   

Quick Reply
Message:

HTML is not enabled.
UBB Code� is enabled.

Instant Graemlins
   


Post New Topic  New Poll  Post A Reply Close Topic   Feature Topic   Move Topic   Delete Topic next oldest topic   next newest topic
 - Printer-friendly view of this topic
Hop To:


Contact Us | LymeNet home page | Privacy Statement

Powered by UBB.classic™ 6.7.3


The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:

The Lyme Disease Network of New Jersey
907 Pebble Creek Court, Pennington, NJ 08534 USA


| Flash Discussion | Support Groups | On-Line Library
Legal Resources | Medical Abstracts | Newsletter | Books
Pictures | Site Search | Links | Help/Questions
About LymeNet | Contact Us

© 1993-2020 The Lyme Disease Network of New Jersey, Inc.
All Rights Reserved.
Use of the LymeNet Site is subject to Terms and Conditions.