posted
This doesn't apply specifically to lyme patients, but this Blue Cross (owned by Wellpoint, a for-profit company) is notorious for its refusal to pay for lyme treatments.
Blue times at Blue Cross - Wednesday, October 18, 2006
ANYONE who isn't yet convinced of the dire need for a comprehensive American health-care plan should look at Blue Cross of California.
Last week, Blue Cross got hit with a class-action lawsuit on behalf of all California hospitals. The lawsuit claims that Blue Cross routinely violated state law by refusing to pay for authorized patient care. Blue Cross has also been accused of canceling individual policy coverage for sick patients -- even retroactively -- thereby leaving them saddled with debts that they are unable to pay.
Blue Cross claims that its payment and policy practices are in compliance, and that its goal for cancellations is to reduce fraud. We don't have any doubt that there are people who have lied about their medical histories in order to get coverage, and class-action lawsuits are notorious for digging up large numbers of dubious plaintiffs.
But Blue Cross's record on this issue -- just last month, the state Department of Managed Health Care fined it $200,000 after finding it had illegally canceled a woman's coverage, and the chief of enforcement said that they're still investigating more complaints -- and the list of enemies it has made makes us believe the hype.
"There's absolutely merit to (this lawsuit)," said Jan Emerson, a spokeswoman for the California Hospital Association. "Our hospitals have been penalized unfairly, and there are patients who've been penalized unfairly." It's worth noting that the California Hospital Association isn't involved in this lawsuit -- it just got a favorable ruling in its own, unrelated lawsuit with Blue Cross -- but stands in support of it.
More than 2 million Californians buy their own health policies, a number that is likely to grow as more and more of us find ourselves unemployed, self-employed or employed in a business that's not offering health care. And while Blue Cross certainly needs to shape up the way it cares for its individual policyholders -- something's it's moving to do, with the announcement of an initiative to revise its recision policies last month -- we all need to lean on our leaders to provide the political will and creative solutions it's going to take to care of all of us.
Wellpoint was bought out by Anthem Blue Cross Blue Shield based in Indianapolis, Indiana in 2004 or 2005 -- I forget the exact date. Anthem is one of the 3 largest private insurance companies in the U.S. if not the largest.
Hubby has BCBS of Virginia -- also owned by Anthem. Premiums went up around 25% each of the last 2 years after the buyout of Wellpoint.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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