Rower Michelle Posted September 14, 2020 Share Posted September 14, 2020 Just got back from the pharmacy without my prescriptions because for the second time in less than a month I’ve been dis-enrolled from COBRA even though we paid the $2400 premium! This time I filed a complaint with my former employer but I’m entirely mystified how someone gets dis-enrolled twice ten days apart.... I’ve got complaints filed in all the right places but really don’t like spending time and energy on this stuff. Arggg!!!!! Tom Galli, LouT, Lisa Haines and 1 other 1 2 1 Quote Link to comment Share on other sites More sharing options...
LexieCat Posted September 14, 2020 Share Posted September 14, 2020 OMG, Michelle, it's deja vu all over again. I KNOW they will straighten it out, but patients should NOT have to go through this kind of crap. I always figure ONCE can just be a legit mistake/oversight. TWICE is negligence at best and bad faith at worst. Tom Galli 1 Quote Link to comment Share on other sites More sharing options...
Rower Michelle Posted September 14, 2020 Author Share Posted September 14, 2020 Just got a call from the COBRA carrier, saying to wait 48 hours for this issue to be resolved, my response, why? Why should I have to wait another 48 hours for something that was supposedly resolved last week? A supervisor has committed to calling me this evening... tick tock... I shall persevere! LexieCat and Sabacat 2 Quote Link to comment Share on other sites More sharing options...
LexieCat Posted September 15, 2020 Share Posted September 15, 2020 Exactly. Nothing like feeling we're the only ones with any sense of urgency about this crap. Quote Link to comment Share on other sites More sharing options...
Sabacat Posted September 15, 2020 Share Posted September 15, 2020 Hold their feet to the fire! They’re the ones getting paid to do their job! Quote Link to comment Share on other sites More sharing options...
Tom Galli Posted September 15, 2020 Share Posted September 15, 2020 I wish there was a way to sue medical insurance companies for malpractice...malfeasance...malsomething! Just when I felt the worst from treatment side effects, an insurance company would enter the picture and make everything worse. Ironic, we pay for this madness! Stay the course. Quote Link to comment Share on other sites More sharing options...
Babs Posted September 15, 2020 Share Posted September 15, 2020 Michelle, Thats terrible!! First that you have to pay such a ridiculous amount, and second that you have to expel energy on this that should be spent on your cancer battle!! I just recently had an issue I’ve been fighting for over a year resolved between my clinic and the Insurance company! After numerous letters, etc. I wrote to the Minnesota Attorney Generals Office and it was written off after 10 days. Thats what I asked for in the first place. It was a coding problem that I’m sure fairly intelligent folks should have been able to figure out. Your situation just ticks me off to no end!! So sorry you have to deal with this...... Babs Rower Michelle 1 Quote Link to comment Share on other sites More sharing options...
GaryG Posted September 15, 2020 Share Posted September 15, 2020 I am all for free market but insurance companies and Pharma get away with murder. Good thing you are smart enough to know how to remedy the situation. Think of how many people can't do that. I hope it gets resolved soon. It's hard to fight cancer and crooks at the same time. Quote Link to comment Share on other sites More sharing options...
Rower Michelle Posted September 15, 2020 Author Share Posted September 15, 2020 Thanks guys, I've been re-instated (again). I've learned each benefit has a separate eligibility system (medical, dental, pharmacy and vision) for the same company. My medical benefits were okay, but the pharmacy plan was inactive. Since it was their screw up, I had Anthem call the pharmacy to re-process the claim while I waited on hold. So for the first go round, this issue took 6 1/2 hours to resolve. Round two: 24 hours. There will NOT be a round three. I've printed out the DOI complaint forms and they are ready to go if need be. Attorney General's Office is next. Thanks for letting me rant! GaryG, Tom Galli, LexieCat and 1 other 4 Quote Link to comment Share on other sites More sharing options...
Roz Posted September 15, 2020 Share Posted September 15, 2020 Michelle, Phew that it worked out. Sorry you had to spend so much time to fix it! Horrible system!! Best, Ro Quote Link to comment Share on other sites More sharing options...
Lisa Haines Posted September 15, 2020 Share Posted September 15, 2020 That's crazy and must be very frustrating. You're paying a small fortune for insurance and it's totally unfair this happened again. Grrrr Sorry to hear, hope it's quickly resolved. Quote Link to comment Share on other sites More sharing options...
Rower Michelle Posted September 15, 2020 Author Share Posted September 15, 2020 Hey Lisa! I just got a call from the COBRA Administrator, boy they are late to the game today! Anyway I was speaking to one of my girlfriends this evening, she indicated her husband's MRI was denied (with no rationale) and thought that was very odd. I responded, sounds like EviCore. She said. "HOW DID YOU KNOW THAT!" I smell a rat!! I'm still ticked about your experience! Quote Link to comment Share on other sites More sharing options...
Lisa Haines Posted September 16, 2020 Share Posted September 16, 2020 Evicore sucks, something eeds ti be 12 hours ago, Rower Michelle said: Hey Lisa! I just got a call from the COBRA Administrator, boy they are late to the game today! Anyway I was speaking to one of my girlfriends this evening, she indicated her husband's MRI was denied (with no rationale) and thought that was very odd. I responded, sounds like EviCore. She said. "HOW DID YOU KNOW THAT!" I smell a rat!! I'm still ticked about your experience! Something needs to be done with Evicore, this is very concerning. I hope they called their insure ? And hopefully he'll get the MRI. Quote Link to comment Share on other sites More sharing options...
LouT Posted September 19, 2020 Share Posted September 19, 2020 Wow! what a hell of a way to run a business. Knowing how unresponsive some of these insurance companies are now I am even more afraid of a time when the federal government might take over our healthcare. So glad you got your problem worked out. Lou Tom Galli and Rower Michelle 2 Quote Link to comment Share on other sites More sharing options...
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