Rower Michelle Posted October 28, 2020 Share Posted October 28, 2020 Well folks what can I say, I'm not able to refill my targeted therapy this month because Anthem strikes again. I've been disenrolled for a FIFTH time since September 1st. Not able to obtain a new pair of eyeglasses either at this point. I've filed yet another complaint with my former employer and this time with the State Department of Insurance. Unbelievable. Link to comment Share on other sites More sharing options...
Tom Galli Posted October 28, 2020 Share Posted October 28, 2020 Michelle, What can I say! Unfreekingunbelievable.... Please, try and... Stay the course. Tom Link to comment Share on other sites More sharing options...
Jennedy Posted October 28, 2020 Share Posted October 28, 2020 And my insurance is also with Anthem..... Link to comment Share on other sites More sharing options...
Judy M2 Posted October 28, 2020 Share Posted October 28, 2020 2020 strikes again. Ugh! Link to comment Share on other sites More sharing options...
GaryG Posted October 28, 2020 Share Posted October 28, 2020 Michelle: Anybody who can fight cancer like you do can fight a difficult insurance company. Keep at it. We are behind you. Link to comment Share on other sites More sharing options...
Babs Posted October 28, 2020 Share Posted October 28, 2020 Michelle, I’m not sure what the State department of Insurance does, sounds Important, but I went to our Attorney General’s Office! It was a year long bill that had a coding error between the Clinic and Insurance and they corrected it within 10 days and wiped it off my bill. Wished I would have gone that route much sooner. Good luck to you, Babs Link to comment Share on other sites More sharing options...
BridgetO Posted October 28, 2020 Share Posted October 28, 2020 Sue the b-----ds! Or at least get a lawyer and have him/her threaten to sue. And hang in there, Bridget O Link to comment Share on other sites More sharing options...
Lisa Haines Posted October 29, 2020 Share Posted October 29, 2020 Unreal..... this is insane! Hope when you resolve this (again) for the last time. It's horrible this continues to happen and causes stress and way too much time to fix...☹️ Link to comment Share on other sites More sharing options...
Lisa Haines Posted October 29, 2020 Share Posted October 29, 2020 Thank goodness you're in top of this, still crazy and what if you were very ill and not well enough to deal with this nonsense. Grrrrr! Insurance really sucks at times, but it's so vital in our care. This BS needs to end....🤬 Huge Pet Peeve for me.... I'm really sorry Michelle and glad you're fighting this in every way.... Link to comment Share on other sites More sharing options...
Rower Michelle Posted October 29, 2020 Author Share Posted October 29, 2020 Well it’s another day, there was an emergency override placed in the eligibility system by my former employer (which takes 24hours to update). The targeted therapy will be shipped overnight (on their dime), so at least there’s a temporary fix in place. Some of you guys know I spent nearly 30 years in the healthcare industry. One of my “bridge jobs” was for a Business Process Outsourcing tech company that managed eligibility and claims platforms for the largest health insurance companies. I was flabbergasted to learn all of these “platforms” are vintage circa 1980s!!! It was a crazy place to work and I lasted a whopping seven months! It really comes as no surprise my COBRA is screwed up on a now weekly basis. Next week I hope to avoid all this drama since I’ve got scans..... Thanks guys! Carry on. Link to comment Share on other sites More sharing options...
LexieCat Posted October 29, 2020 Share Posted October 29, 2020 Good grief Michelle, you and insurance is like me and inanimate injury-causing objects. Glad it’s fixed for now, but I’d talk to your lawyer about how to prevent this. I know you had a settlement—was that filled with the court? If so you could probably move to hold them in contempt. If not, your lawyer could threaten to take them back to court to enforce it. That would cost them time/trouble and possibly put them on the hook for your attorneys fees. Link to comment Share on other sites More sharing options...
LUNGevityKristin Posted October 29, 2020 Share Posted October 29, 2020 I'm so sorry you had to go through all of that but happy to hear it is resolved. Hopefully for the last time! Link to comment Share on other sites More sharing options...
Deb W Posted October 29, 2020 Share Posted October 29, 2020 Oh no, Michelle. The endurance one needs to deal with the insurance and cancer! Glad it has been resolved for now. I have Anthem as well. As Tom says, stay the course (and I know you will)! Deb Link to comment Share on other sites More sharing options...
Rower Michelle Posted October 29, 2020 Author Share Posted October 29, 2020 I don’t think I’m going to need a lawyer this time, yesterday I got so fed up with this (not so) merry go round a Department of Insurance Complaint was filed. I fully understand they have no jurisdiction but I felt like I had to do something. HA. I just got a call from the Department of Labor! The KS DOI was so concerned about a Stage IV lung cancer patient not being able to obtain meds they filed a federal complaint on my behalf. My former employer is in violation of the Federal COBRA laws!! The DOL is opening an investigation and assured me they will resolve this issue (plus the employer will probably get a decent fine to boot). Stay tuned!!! Link to comment Share on other sites More sharing options...
BridgetO Posted October 29, 2020 Share Posted October 29, 2020 I'm tuned! Good for you for keeping after these *%#!*(% s. And good for thr Kasas DOI and the DOL. Link to comment Share on other sites More sharing options...
LexieCat Posted October 30, 2020 Share Posted October 30, 2020 Let's hear it for gov't lawyers! Most of them are the good guys. Michelle, I'll have to tell you sometime about an interesting KS case I worked on over several months (most of the heavy lifting done by the people I was helping). It's really not on topic here, but it was a seemingly hopeless situation that finally turned out right for the young sexual assault victim who couldn't get the local prosecutor to take her case. Link to comment Share on other sites More sharing options...
Lisa Haines Posted October 30, 2020 Share Posted October 30, 2020 Way to GO Michelle!!!! (Clapping my hands very loudly)!! I truly HOPE this is a step in the right direction for ALL of us who have battled with the BS these insurers add to our lives. This is not something ANY cancer patient should have to be dealing with -- especially a medication problem. They should have "hand delivered" it to you in white gloves! We will ALL stay tuned and we all MUST continue to stand up for what is right -- especially our health!! Link to comment Share on other sites More sharing options...
LexieCat Posted October 31, 2020 Share Posted October 31, 2020 The issue here doesn't seem to be with the insurance company, but rather with Michelle's former employer who is not holding up their end of the deal to make sure her coverage is continued. Yeah, the insurance companies have their own problems/issues in terms of how they treat their members and cover (or don't cover, or cause delays in or create obstacles to) necessary treatments, but this one I think is on the employer. Link to comment Share on other sites More sharing options...
Rower Michelle Posted October 31, 2020 Author Share Posted October 31, 2020 We’ll see what the DOL investigation turns up- right now it’s an equal opportunity blame game for all involved parties. Now that the Feds are involved the finger pointing has begun! My guess is that every company has a contributing role. Link to comment Share on other sites More sharing options...
LexieCat Posted October 31, 2020 Share Posted October 31, 2020 It will be interesting to see how this plays out. Hopefully without further problems for YOU. Link to comment Share on other sites More sharing options...
Roz Posted October 31, 2020 Share Posted October 31, 2020 Michelle, This is crazy! So smart of you to take charge and go after your former employer! There's no reason you should be put through this and I'm so sorry you have to deal with it on top of everything else. Hope it's all resolved soon! Best, Ro Link to comment Share on other sites More sharing options...
JamesB Posted October 31, 2020 Share Posted October 31, 2020 Ii am so glad this has worked out for you but all the added stress must be just awful. I told my partner yesterday that I am so glad to be dealing with this here in Sweden rather than back in the USA. None of these problems with the medical system here. It truly needs to change in the USA. Link to comment Share on other sites More sharing options...
LouT Posted November 1, 2020 Share Posted November 1, 2020 Michelle, OMG!!! I just read this from the top and it's bad enough that this happens once to somebody, but FIVE TIMES!?! This is beyond the normal, "our systems seemed to have a problem", to just plain outright algorithms kicking in to get rid of accounts costing them too much. I hope this all get straightened out and that there is no "Sixth Time". You deserve better than that. Lou Link to comment Share on other sites More sharing options...
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