posted
I have been in treatment for about 8 mo now. My employer had a quick meeting Thursday (12/7) saying that UHC p*&^%ed him off so that he was changing all of us to BCBS.
He pays 100% of the plan so there are no worries with my paycheck. But I have no idea what to expect with the "pre-existing condition" stuff. I tried to read the tiny print they give you as best as I could. I still don't know anything definitive. The owner said that most of the time they cover this kind of stuff????
I filled out my history truthfully being diagnosed with Borreliosis and attached a list of about 15 scripts I have taken over the past year. I turned in the form and crossed my fingers.
UHC covered none of my doctor visit's because it was out of network (Dr.C in MO), but they did cover most of the scripts.
Anyone else ever made a similar type of switch or have any ideas of what to expect?
Thanks
Posts: 20 | From Platte City, MO | Registered: Jun 2006
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
They legally have to cover pre-existing conditions. The only time pre-existing conditions are not covered are if there is a gap in insurance, meaning you don't have any insurance for a specified period of time.
However, they can choose not to cover a treatment if they do not deem the treatment medically necessary. BCBS does have a history of limiting Lyme treatment. I believe they are better with orals than IVs.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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posted
To further what Aniek said, I currently have BCBS and I have not had any issues with them covering oral abx (knock on wood) or reimbursement for out of network doctors. I have not done IV treatment up to this point so I don't know about their policies regarding that. Actually, now that I think about it, I actually have Caremark as the prescription plan and not BCBS. Do you know if BCBS will be covering your prescriptions?
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