Health Insurance Vent

[macsmom09]

Y'all I am so mad at DH's new health insurance plan. He was hired by a federal gov't agency and we picked the nationwide BCBS plan. He signed the paperwork on Oct. 27 and the effective date was Nov. 7. As of today, his agency STILL has not sent our enrollment forms to the ins. company. They promised us they are being faxed tomorrow, but it will be 4-6 days before we can get a group number.

Ummm, problem- DS has an allergy appt. on Thursday! Plus, he needs his asthma meds refilled this weekend, and I need my prescription refilled as well. His asthma meds are over $100 without insurance. They wasted no time in taking out the premium on his first check, and then told us that our options are to pay for his visit and scripts out of pocket and then submit a claim for reimbursement, or to reschedule his visit.

I am so far past the point of being mad that I can't even see straight! What's worse is that DH's training is 12 hours away, so I feel like I'm the one who is going to be fighting this battle. We have the money in savings if I do need to pay OOP, but I am having such a hard time agreeing to do that since they have held onto the paperwork for almost 3 weeks now- and our coverage has been in effect for the last week!

Any advice? Do I suck it up and get the meds refilled/dr. visit OOP or hound them until they get our enrollment expedited and in the system???

 

[meriface11]

you say the insurance was supposed to be effective nov. 7. it's no uncommon for employer to feed data to administrators for all new employees within a certain period at one time. if this is the case, it's likely you are currently insured, but blue cross just doesn't have you in the system yet, and you will be reimburse retroactively for the difference between any OOP expenses and the costs under the plan. is there a way for you to find out if this is the case?

 

[LilyWDW]

Y'all I am so mad at DH's new health insurance plan. He was hired by a federal gov't agency and we picked the nationwide BCBS plan. He signed the paperwork on Oct. 27 and the effective date was Nov. 7. As of today, his agency STILL has not sent our enrollment forms to the ins. company. They promised us they are being faxed tomorrow, but it will be 4-6 days before we can get a group number.

Ummm, problem- DS has an allergy appt. on Thursday! Plus, he needs his asthma meds refilled this weekend, and I need my prescription refilled as well. His asthma meds are over $100 without insurance. They wasted no time in taking out the premium on his first check, and then told us that our options are to pay for his visit and scripts out of pocket and then submit a claim for reimbursement, or to reschedule his visit.

I am so far past the point of being mad that I can't even see straight! What's worse is that DH's training is 12 hours away, so I feel like I'm the one who is going to be fighting this battle. We have the money in savings if I do need to pay OOP, but I am having such a hard time agreeing to do that since they have held onto the paperwork for almost 3 weeks now- and our coverage has been in effect for the last week!

Any advice? Do I suck it up and get the meds refilled/dr. visit OOP or hound them until they get our enrollment expedited and in the system???

If the effective date was Nov 7, then you should be covered already. You will have to pay out of pocket for any visits or prescriptions until you get your cards/numbers. Even if they had sent in the paperwork, you might not have gotten the cards in time. The last time I had to get new insurance it took about a month for my cards to come.

If they fax the information in tomorrow do they have a way to print off a temporary card? Some insurance companies allow for this. However, it might not be usable for prescriptions.

 

[wide awake]

My son is autistic. If there happened to be a drug that would fix him I'd be selling my body parts to pay if the insurance didn't cover it. Count your blessings.

 

[marlynnp]

nice

 

[quentina]

Sorry. but it's totally normal. You are insured, they will backdate it. I would call insurance company and see if you can get number or contact your HR dept.

You will need to pay, keep receipts and then go back when you get info. They will refund difference.

Good luck!

 

[marlynnp]

OP, I would try to get the group plan number from someone at his work. Then explain to the doctor that you did not receive the card but you have the number you have a 50/50 chance that they will just process it for you and if work has really faxed over the enrollment info it will go through.

 

[snowy76]

My doctor has held off submitting the charges until I brought proof of insurance. It doesn't hurt to ask.

 

[Tink415]

My doctor has held off submitting the charges until I brought proof of insurance. It doesn't hurt to ask.

Yes, try this.

Our medical insurance was just switched and we had 2 appts with our regular drs and a prescription without having received new cards or numbers yet.

We had a HD plan w/ zero co-pay (cause we pay 100% of contracted rate until the deductible is met) & HSA with the old insurance and the new insurance is the same just a new company. The first dr visit the staff was not believing we still had insurance and were charging us cash price -cheaper for part of the visit until the dr saw me pay with HSA card; charges were reversed and I was asked to call in the numbers when we got them. 2nd dr visit the office staff was willing to wait to see the new card. So...the policy will vary depending on the practice and who handles the payment...

The drug store said pay cash price and bring back insurance card within 1 week and we will redo and after 1 week I would have to submit to my insurance company myself. Its like Russian roulette with which prices will be higher for prescriptions and we often pay the cash price because its less anyway.

 

[Swimalie]

I have the same insurance you do and have since 2001. When we first got it, my husband was in training 800 miles away for 3 months and I was scheduled for emergency (they thought it was cancer) surgery. I was able to get his department's HR department to get me the group and enrollment number. They faxed me all the paperwork I needed and I handed that to the hospital. Everything went through fine. You should be able to do that but your husband will have to be the one to get the initial contact at the HR Department for you and make the initial contact.

If not, they will retroactively cover you and you will just have to pay out of pocket and they will send you a check for the reimbursement. They do this for my son's dental each year.

A warning, dental coverage is horrible! Look in to the supplementals offered. We don't have it yet because our son is only 5 and isn't to the age that he needs a lot but we will be getting it soon. Without it, they only cover about $17 worth of dental cleanings, no root canals and barely any fillings.

Welcome to the Fed!

 

[macsmom09]

Thanks for the advice from everyone! I guess we got spoiled by the police dept. he previously worked for- it was so easy to get the information we needed and insurance was a breeze.

Swimalie, thanks for the advice on the dental. We have been talking about the supplemental plan so it sounds like we will definitely go with that, especially with a 10 year old!

The HR dept. emailed him a copy of our enrollment form, but then told him our two options- pay OOP or wait until next week and contact BCBS for the number. I think the doc would be ok with just a faxed or emailed copy of the group and enrollment number, and that's what we have asked for, but with no luck yet. DH sent me the contact info so I am probably going to call them later today to see if they can give me what I have been asking for.

I think it's hardest because DH is 12 hours away and I feel like I'm the one dealing with all of this by myself. He's been great getting the SAC for their class to help out with his (and my) questions about this, but ultimately I'm the one that has to deal face to face with the doctor and the pharmacy.

 

[Cheshire Figment]

One of the best things with dealing with the BCBS Federal Employees Program is the recurring prescription medications costs which is done through Medco. You can get the prescription from the doctor for up to a 90 day supply with up to three refills, in other words a year at a time. For generics the first four fills per year are free, after the first four they are no more than $10; if the meds are less you will be charged the lower price. For Brand Names it is a maximum of $65 for the first 30 fills and then a maximum of $50 for any additional.

 

[disney_family_1247]

Since you have the extra money, I'd pay and then get reimbursed. Don't want to be short on allergy meds (my kids have allergies/asthma).

I know it's annoying, but as someone who has been paying for private insurance for ten years now, I think you're lucky your husband's job has insurance benefits!

 

[ccgirl]

Since you have the extra money, I'd pay and then get reimbursed. Don't want to be short on allergy meds (my kids have allergies/asthma).

I know it's annoying, but as someone who has been paying for private insurance for ten years now, I think you're lucky your husband's job has insurance benefits!

This is what I would do as well. With some insurances, it is reimbursable only. Meaning, you always pay first and they will reimburse you. I would just pick one of the two choices your DH HR dept gave you. I know, insurance stinks. I am just so grateful I have it. Good luck!

 

[Swimalie]

Thanks for the advice from everyone! I guess we got spoiled by the police dept. he previously worked for- it was so easy to get the information we needed and insurance was a breeze.

Sounds like your husband and my husband went from similar jobs into similar jobs. My husband was a detective when he took a job as a DEA investigator. That's when he had to go to Quantico for 3 months while I was in GA, left to sell our house, recover from surgery, find a place to live across the country, etc. Plus get the insurance taken care of. Oh and his dad passed away 3 weeks before he left so I had to help his mom figure out how to live on her own, too. But I digress.

Medco is good to work with. Very quick on sending out medication. My prescription ran out for my thyroid medicine (I had about 10 pills left but no refills). I contacted them on a Wed. On Friday I got a call that they had contacted my doctor and were filling the prescription. It arrived about 5 days later. They are good!

 

[curlybop]

As of today, his agency STILL has not sent our enrollment forms to the ins. company. They promised us they are being faxed tomorrow, but it will be 4-6 days before we can get a group number.

This makes no sense to me. I enroll new hires at our location. They should have a listing of all group numbers no matter what. If they already know the premium amount, then they know the plan he signed up for and the number it's related to.

I think someone just fell behind in following through. We have eight different insurance plans and if someone chooses one, I can tell them immediately what their group number is along with the premium amounts. I think you should contact the HR department and light a fire under someone.

 

[Swimalie]

This makes no sense to me. I enroll new hires at our location. They should have a listing of all group numbers no matter what. If they already know the premium amount, then they know the plan he signed up for and the number it's related to.

I think someone just fell behind in following through. We have eight different insurance plans and if someone chooses one, I can tell them immediately what their group number is along with the premium amounts. I think you should contact the HR department and light a fire under someone.

It's the Federal Govt. There are thousands of people who deal with the insurance. Not just 1 HR Department. And at times, the HR Dept for a person's particular department is across the country. When my husband was with the DEA and we were in Oregon, we would have to call someone in DC to get answers. It's just not that simple when you are dealing with the govt as in a private company.

 

[cm8]

Y'all I am so mad at DH's new health insurance plan. He was hired by a federal gov't agency and we picked the nationwide BCBS plan. He signed the paperwork on Oct. 27 and the effective date was Nov. 7. As of today, his agency STILL has not sent our enrollment forms to the ins. company. They promised us they are being faxed tomorrow, but it will be 4-6 days before we can get a group number.

Ummm, problem- DS has an allergy appt. on Thursday! Plus, he needs his asthma meds refilled this weekend, and I need my prescription refilled as well. His asthma meds are over $100 without insurance. They wasted no time in taking out the premium on his first check, and then told us that our options are to pay for his visit and scripts out of pocket and then submit a claim for reimbursement, or to reschedule his visit.

I am so far past the point of being mad that I can't even see straight! What's worse is that DH's training is 12 hours away, so I feel like I'm the one who is going to be fighting this battle. We have the money in savings if I do need to pay OOP, but I am having such a hard time agreeing to do that since they have held onto the paperwork for almost 3 weeks now- and our coverage has been in effect for the last week!

Any advice? Do I suck it up and get the meds refilled/dr. visit OOP or hound them until they get our enrollment expedited and in the system???

If you can reschedule, then put it off. If you can not then go, pay OOP and then submit a claim for the visits. I feel your pain.

Some offices however are able to get the information needed for you by calling the 800 number. In your case since he has already made contact with HR, be prepared to do what was stated, as that is what they will go by unless you have proof your coverage started on the 7th of November

 

[Earstou]

I feel your pain!!! My dh was hired by a state agency. First day of employment Oct. 3, wasn't enrolled for insurance until Nov. 1st, and now has a 30 day waiting period.

So I'm still sitting here waiting to fill prescriptions and go to the doctor and dentist!

As a side note, BCBS is slow as molasses!

 

[MissBritt]

It's the Federal Govt. There are thousands of people who deal with the insurance. Not just 1 HR Department. And at times, the HR Dept for a person's particular department is across the country. When my husband was with the DEA and we were in Oregon, we would have to call someone in DC to get answers. It's just not that simple when you are dealing with the govt as in a private company.

Someone in his local HR department should be able to give him a group number. I work for the VA and have never had an issue getting information from any HR person here, even as a new hire or when changing plans. I just enrolled in new dental and vision (FEDVIP) today online, and got the info from HR for next year's coverage.