Monday, January 26, 2009

Dealing Boldly With Blue Cross

Oboy. Health insurance Catch-22,000.

Here's what I emailed to my friend Angela Friday when this happened:

"I ordered the $200 serum for the shingles vaccine after checking to see that it was covered. When I went to get it to take to my doc, the pharm. said they hadn't covered it because it had to be ordered by the doctor from the serum company not by prescription to be picked up by the patient.

So I left it at the drugstore and went to my doc's and they called BCBS and said our patients always get it at the drugstore. (According to the nurse,) BC said, well, that's changed now.

My doc's office continues to work on it.

So irksome. Driving around Cary all afternoon for nought. My mother had her shingles shot scheduled and woke up with shingles on the morning she was to get the shot. Bob pointed out to me that at least I wasn't dealing with insurance at the same time I was terribly sick. (Like Obama's mother. He has talked a lot about her spending her last months upset about insurance.)

Thank you for allowing me to vent."

Update: So this morning my doc called and said she doesn't order serum through her office. She did kindly offer to administer the shot at no charge, once I get the serum.

I have to pay the drugstore, because after having been told by BC that my policy covered it, I agreed to. (I'm not going to claim that my own policy toward paying bills has changed to not paying them, or now includes a disclaimer that says I don't have to if I don't want to.)

And now to discover my appeals possibilities, with BC BS and the Department of Insurance person.

I don't like this. And it's not right. Am all over it. (Meaning "in action," not "recovered.") Will keep you posted.

If you like this post, please bookmark it on, share it on StumbleUpon, vote for it on Digg. Thanks so much.


mamie said...

I deal with that kind of BS on an almost weekly basis. It's all I can do to have a good attitude when I dial 1-800 anything.

Peggy Payne said...

That's a serious test of character, Mamie.

Peggy Payne said...

Update: 1. Talked with an uncommonly nice person at BCBS. She said that all the doctors they work with have been notified that they have to order (not prescribe) the vaccine.

She told me drugstores that would give me the shot for the copay, and thought the one that ordered the vaccine for me wouldn't charge me. One of the two pharmacies says they can give me the shot. And the one that ordered it for me says they can easily sell it to someone else, thus letting me off the hook.

So I get my shot in the morning, the store files for the insurance, and I'll see if I get a bill to pay more.

Hasn't this just been fascinating?

kenju said...

Just wait until you are entitled to Medicare. It gets worse.

Peggy Payne said...

I'm excited, Kenju. Right now I'm at the public library in a town 45 minutes from my office, near a drugstore that was supposed to be giving the shots starting at 9 this morning. But when I called to confirm this morning, nobody mentioned that today the time had been changed to 1. I should have asked: and is the time the same as always?

There's a plot to keep me from getting this shot. But I will prevail!