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Stupid medical insurance.
I'm in the process of switching my health insurance from Blue Cross to Aetna. In NJ, coverage is mandated by law. The plans, the options... pretty much everything is specified. (There's even a law that the company has to pay out $0.75 in benefits for every $1 they get in premiums.) Aetna's rates are considerably lower than BCBS, and some other stuff was going on with Blue Cross, so the switch seemed like a good idea.
Theoretically, I should have had a smooth transition on Feb 1 (meant to do it for Jan, but got a late start. That was my own fault). Of course, nothing is ever that simple with insurance companies.
I called Aetna a week early, to make sure I was in the system. I needed to call BCBS to tell them to stop my old policy, but I wasn't going to do it until I had confirmation of the new one. I went through a bunch of different numbers, but no one at Aetna could find me in the system. This despite the fact that I'd already gotten a statement that they'd cashed my check for the first month's premium. (The statement, BTW, listed a credit for overpayment.)
Finally, I got through on one of the numbers listed on the bill. It was for the entirely wrong department, but guess what? They had me in their system. No idea why my application had gone through their dept. I also had to point out to them that I hadn't overpaid my premium. New rates went into effect in January. (I figured it was better to have that straight than to have them suddenly deciding they wanted the rest of their money and giving me grief for it.)
I wish that was my department. The person I spoke to was friendly, helpful, and competent. Shocking.
She said she'd take care of everything, and would call back in half an hour or so. A little more than half an hour later, she called back with my new ID#, assurance that a card would be on its way shortly, assurance that I was now in the right system, and a number for a pharmacy to call in case they needed to verify my coverage. Amazing.
The next day, I got a packet (which had been mailed out the day before I'd called up) with a standard brochure explaining the plan. (I already knew all that. I'd downloaded a copy and read it before starting the application process.) Not helpful, but promising.
Two weeks later, I still don't have my ID card (they say it takes 7-10 days, and coverage technically started on the first). I am in the system, though. I can log into their website. That even let me print out a temporary card. Great. All set. The new card will come soon, and the temporary card will get me by.
Today, I went to the pharmacy. Wanted to stock up on supplies before leaving for Florida. Pharmacy wouldn't take my info over the phone. I told them I just had a temp card, but they wanted that. Fine.
Went in, gave them the temp card. Coverage denied.
Pharmacy calls Aetna (using the number in their system, which did indeed match the one I'd been given by the helpful person). We wait around on hold for who knows how long. A dozen or so people come, get their prescriptions filled, pay, and leave. Finally get through to Aetna. The rep tells the pharmacist that I only have medical coverage, not prescription.
Except that that's wrong. The plan clearly states that prescriptions are treated as medical expenses (applied to the deductible, etc).
Pharmacist thinks that maybe they farm their prescription plan out to some other company, and that's why they can't help. Whatever. I say I'll take my prescription, since I don't want to leave home without it, and fight out the claim myself. He says fine and hands the stuff over to an assistant to check out. The assistant helps someone else, then walks away. Another pharmacist comes, glances at the quantity (3 month supply), says "oh, they'll never cover that," and proceeds to help the next three people in line before getting back to me.
I convince her that I want it as-is, and get out.
Come home, log into the website, and find that there's no explanation of my policy in the member services area. Go outside to look up the brochure as if I was not yet a member, and verify that I am supposed to have prescription coverage. Go back to member services with a different browser and find an area which randomly didn't show up in Firefox (adblock? Maybe, but I don't think so). That says I'm covered for medical and says nothing about pharmacy coverage.
So here I am with a whopping receipt (insulin is not cheap) and a system that thinks I'm not due for anything.
I'll need to call up and hash things out with the company tomorrow... except that we're flying out tomorrow and will probably have a hectic morning before spending the rest of the day in transit.
Meantime, I glanced at a pharmacy claim form (available online), and it's asking for all sorts of info I'm not sure I have. Don't want to send it in yet, anyway, because I need to make sure they'll actually process it.
And, of course, I'm realizing that I never got verification from BCBS that they terminated my policy. Nor have I gotten a check to reimburse me for the portion of Feb coverage I'd prepaid.
All in all, could be worse, but it's a frustrating hassle. Can't wait to find out what goes wrong next... *sigh*
I'm in the process of switching my health insurance from Blue Cross to Aetna. In NJ, coverage is mandated by law. The plans, the options... pretty much everything is specified. (There's even a law that the company has to pay out $0.75 in benefits for every $1 they get in premiums.) Aetna's rates are considerably lower than BCBS, and some other stuff was going on with Blue Cross, so the switch seemed like a good idea.
Theoretically, I should have had a smooth transition on Feb 1 (meant to do it for Jan, but got a late start. That was my own fault). Of course, nothing is ever that simple with insurance companies.
I called Aetna a week early, to make sure I was in the system. I needed to call BCBS to tell them to stop my old policy, but I wasn't going to do it until I had confirmation of the new one. I went through a bunch of different numbers, but no one at Aetna could find me in the system. This despite the fact that I'd already gotten a statement that they'd cashed my check for the first month's premium. (The statement, BTW, listed a credit for overpayment.)
Finally, I got through on one of the numbers listed on the bill. It was for the entirely wrong department, but guess what? They had me in their system. No idea why my application had gone through their dept. I also had to point out to them that I hadn't overpaid my premium. New rates went into effect in January. (I figured it was better to have that straight than to have them suddenly deciding they wanted the rest of their money and giving me grief for it.)
I wish that was my department. The person I spoke to was friendly, helpful, and competent. Shocking.
She said she'd take care of everything, and would call back in half an hour or so. A little more than half an hour later, she called back with my new ID#, assurance that a card would be on its way shortly, assurance that I was now in the right system, and a number for a pharmacy to call in case they needed to verify my coverage. Amazing.
The next day, I got a packet (which had been mailed out the day before I'd called up) with a standard brochure explaining the plan. (I already knew all that. I'd downloaded a copy and read it before starting the application process.) Not helpful, but promising.
Two weeks later, I still don't have my ID card (they say it takes 7-10 days, and coverage technically started on the first). I am in the system, though. I can log into their website. That even let me print out a temporary card. Great. All set. The new card will come soon, and the temporary card will get me by.
Today, I went to the pharmacy. Wanted to stock up on supplies before leaving for Florida. Pharmacy wouldn't take my info over the phone. I told them I just had a temp card, but they wanted that. Fine.
Went in, gave them the temp card. Coverage denied.
Pharmacy calls Aetna (using the number in their system, which did indeed match the one I'd been given by the helpful person). We wait around on hold for who knows how long. A dozen or so people come, get their prescriptions filled, pay, and leave. Finally get through to Aetna. The rep tells the pharmacist that I only have medical coverage, not prescription.
Except that that's wrong. The plan clearly states that prescriptions are treated as medical expenses (applied to the deductible, etc).
Pharmacist thinks that maybe they farm their prescription plan out to some other company, and that's why they can't help. Whatever. I say I'll take my prescription, since I don't want to leave home without it, and fight out the claim myself. He says fine and hands the stuff over to an assistant to check out. The assistant helps someone else, then walks away. Another pharmacist comes, glances at the quantity (3 month supply), says "oh, they'll never cover that," and proceeds to help the next three people in line before getting back to me.
I convince her that I want it as-is, and get out.
Come home, log into the website, and find that there's no explanation of my policy in the member services area. Go outside to look up the brochure as if I was not yet a member, and verify that I am supposed to have prescription coverage. Go back to member services with a different browser and find an area which randomly didn't show up in Firefox (adblock? Maybe, but I don't think so). That says I'm covered for medical and says nothing about pharmacy coverage.
So here I am with a whopping receipt (insulin is not cheap) and a system that thinks I'm not due for anything.
I'll need to call up and hash things out with the company tomorrow... except that we're flying out tomorrow and will probably have a hectic morning before spending the rest of the day in transit.
Meantime, I glanced at a pharmacy claim form (available online), and it's asking for all sorts of info I'm not sure I have. Don't want to send it in yet, anyway, because I need to make sure they'll actually process it.
And, of course, I'm realizing that I never got verification from BCBS that they terminated my policy. Nor have I gotten a check to reimburse me for the portion of Feb coverage I'd prepaid.
All in all, could be worse, but it's a frustrating hassle. Can't wait to find out what goes wrong next... *sigh*
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Hope everything gets sorted out in the least painful manner. And try not to worry about it in Florida. Have fun instead. :)