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
 

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.
 

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