BCBS MICHIGAN PPO
So I went through all the rewuirements I just needed to get my surgery date.. Waiting for insurance approval which was told it would be no prob i had all my ducks in a row then they send back paperwork they want a paper filled out compleyely different from the normal... So my doctor re-does it sends back all paper work by Nov. 21 got a letter about 1 1/2 weeks ago BCBS PPO no longer covers bartirac suregry for indivudal and small business people... I have $3000 in medical bills and now this, now what anyone have any suggestions... I have wrote an appeal so pray for me...
i HAVE BCBS PPO INDIVIDUAL
BETH
i HAVE BCBS PPO INDIVIDUAL
BETH
Ok so... here is my situation:
I am self employed and have blue cross insurance. I have paid about 10k in total to this insurance over the last few years out of pocket. I have individual PPO.
They had been telling me for mths that I was covered with the code that I gave them.
One day I called and found out that I am NOT covered for the same code- I was upset because I have been asking them all along and they even had it on RECORD that they had told me this incorrect information. They said that they had been telling people this and there was some descrepency and now they are telling all the people they actually are not covered.
The lady said that she would ask her supervisor to let it be covered anyways since I was told repeatedly that I was covered. She called me back and said they would allow it as long as everything was done within 6 mths.
However, the catch 22 is: you need 12 months consecutive visits to a physician to be covered. Of course, I didn't get that done because I wasn't aware that I was going to NOT be covered all of a sudden...so now I don't have enough time. Criteria never phased me much because I thought I had all the time in the world since I was COVERED. Now, not so much.
SO, this brings me to this day where I am going to ask for an extension due to needing time to fulfill the requirement...
If they say no, do I appeal at that point? Or what? This is kind of a different situation because I guess I was never covered in the first place but the whole thing is SO fishy because I even gave them a CODE and the people --3 of them at least --told me I was covered. Isn't coverage kind of black and white especially when it comes to giving the actual code??
If this doesn't pan out, I have to drop this insurance (and essentially lose my 10k investment into it... should have just put that in a bank account instead and I would be on my way to paying CASH for the surgery) and get a part time job that will give me insurance.
This brings me to my next plan..... if i get a part time job.... i have heard Starbucks has the majical DS surgery insurance but what if I can't get a job there? They might not have openings or they might close stores. I read today on Forbes that they are closing a bunch of stores this year.
I looked into Blockbuster which gives part timers insurance, but how do I know they cover DS specifically? I don't want to waste any more time... I want to be assured that I am working for the right job that coveres this under their unsurance. So, I need advice.
Anyone get a part time job to get the insurance? Please tell me your story. I am dedicated to getting this done SOMEHOW.
I would rather work for blockbuster or something like that (i am a movie finatic) or a pet store like Petco or Petsmart would be AWESOME... but how do i know that they cover DS? I can't really mention this right from the get go or they might not even want to hire me.
And I am not trying to be a bad person and USE them for their insurance... I need the extra money as well. MI 's economy is reaaaalllly bad with the highest or one of the highest unemployment rates in the u.s. Therefore, my business is suffering and half the time i don't get paid from it. It would really help to not have to pay the insurance payment every mth out of pocket as well.
I am self employed and have blue cross insurance. I have paid about 10k in total to this insurance over the last few years out of pocket. I have individual PPO.
They had been telling me for mths that I was covered with the code that I gave them.
One day I called and found out that I am NOT covered for the same code- I was upset because I have been asking them all along and they even had it on RECORD that they had told me this incorrect information. They said that they had been telling people this and there was some descrepency and now they are telling all the people they actually are not covered.
The lady said that she would ask her supervisor to let it be covered anyways since I was told repeatedly that I was covered. She called me back and said they would allow it as long as everything was done within 6 mths.
However, the catch 22 is: you need 12 months consecutive visits to a physician to be covered. Of course, I didn't get that done because I wasn't aware that I was going to NOT be covered all of a sudden...so now I don't have enough time. Criteria never phased me much because I thought I had all the time in the world since I was COVERED. Now, not so much.
SO, this brings me to this day where I am going to ask for an extension due to needing time to fulfill the requirement...
If they say no, do I appeal at that point? Or what? This is kind of a different situation because I guess I was never covered in the first place but the whole thing is SO fishy because I even gave them a CODE and the people --3 of them at least --told me I was covered. Isn't coverage kind of black and white especially when it comes to giving the actual code??
If this doesn't pan out, I have to drop this insurance (and essentially lose my 10k investment into it... should have just put that in a bank account instead and I would be on my way to paying CASH for the surgery) and get a part time job that will give me insurance.
This brings me to my next plan..... if i get a part time job.... i have heard Starbucks has the majical DS surgery insurance but what if I can't get a job there? They might not have openings or they might close stores. I read today on Forbes that they are closing a bunch of stores this year.
I looked into Blockbuster which gives part timers insurance, but how do I know they cover DS specifically? I don't want to waste any more time... I want to be assured that I am working for the right job that coveres this under their unsurance. So, I need advice.
Anyone get a part time job to get the insurance? Please tell me your story. I am dedicated to getting this done SOMEHOW.
I would rather work for blockbuster or something like that (i am a movie finatic) or a pet store like Petco or Petsmart would be AWESOME... but how do i know that they cover DS? I can't really mention this right from the get go or they might not even want to hire me.
And I am not trying to be a bad person and USE them for their insurance... I need the extra money as well. MI 's economy is reaaaalllly bad with the highest or one of the highest unemployment rates in the u.s. Therefore, my business is suffering and half the time i don't get paid from it. It would really help to not have to pay the insurance payment every mth out of pocket as well.
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