Health Care Options
- Thread starter 1980
- Start date
wornoutupser
Well-Known Member
1980,
The BCBS PPO plan stinks, especially if you have a family member with a major illness that will require ongoing care.
My hospital kept sending me bills after the payment went in. I called to ask why, with my EOB's in hand.
Their explanation:"You have the lowest paying plan and we want more money."
I called Cental States to complain and they would not touch this even though the providers are under contract to accept that payment amount for that service. I wanted Central to go after the hospital for breach of contract and they refused to. My state insurance board refused to go after Central States because they are a health and welfare plan, not an insurance company. They are exempt from all laws,rules and regulations in the state of Florida. It seems as though our glorious union can hide all they want when it comes to this matter.
The net result is that I ended up paying over $37 K that I did not owe to stay out of court in my state.
Another problem here is that I live in a small town yet the BCBS book lists 307 doctors that practice in our limited medical center. I called to ask about this and I was told that I did not know enough to call and complain.
I REALLY loved this one, because I delivered the 17 doctors in my town that truly exist here. I am the only driver that delivers the doctor office area of town. I still can't find the other 290 doctors out here that are hiding. Some are actually as far away as 70 miles, yet we are required to use the because they are affiliated with a group that is within a 25 mile radius, yet they never come into our area. This really sucks when you have to have a specialist and have to drive that far to stay in plan.
In summary, I do not know what you have but be careful about wanting to go into this one. We have a driver in our building. His wife has a lump in her breast and a bad family history of breast cancer. She has to have a mammagram every 3 months to monitor this.
As she went to her second one this year, she was informed that she would have to pay in full. When she asked why (it was always covered before) she was told that there is a 1 a year limit regardless of diagnosis. The doctor was correct, and she nows has to pay for 3 out of 4 mammograms out of pocket each year.
The BCBS PPO plan stinks, especially if you have a family member with a major illness that will require ongoing care.
My hospital kept sending me bills after the payment went in. I called to ask why, with my EOB's in hand.
Their explanation:"You have the lowest paying plan and we want more money."
I called Cental States to complain and they would not touch this even though the providers are under contract to accept that payment amount for that service. I wanted Central to go after the hospital for breach of contract and they refused to. My state insurance board refused to go after Central States because they are a health and welfare plan, not an insurance company. They are exempt from all laws,rules and regulations in the state of Florida. It seems as though our glorious union can hide all they want when it comes to this matter.
The net result is that I ended up paying over $37 K that I did not owe to stay out of court in my state.
Another problem here is that I live in a small town yet the BCBS book lists 307 doctors that practice in our limited medical center. I called to ask about this and I was told that I did not know enough to call and complain.
I REALLY loved this one, because I delivered the 17 doctors in my town that truly exist here. I am the only driver that delivers the doctor office area of town. I still can't find the other 290 doctors out here that are hiding. Some are actually as far away as 70 miles, yet we are required to use the because they are affiliated with a group that is within a 25 mile radius, yet they never come into our area. This really sucks when you have to have a specialist and have to drive that far to stay in plan.
In summary, I do not know what you have but be careful about wanting to go into this one. We have a driver in our building. His wife has a lump in her breast and a bad family history of breast cancer. She has to have a mammagram every 3 months to monitor this.
As she went to her second one this year, she was informed that she would have to pay in full. When she asked why (it was always covered before) she was told that there is a 1 a year limit regardless of diagnosis. The doctor was correct, and she nows has to pay for 3 out of 4 mammograms out of pocket each year.
Wornoutupser is right. It sounds like he is in Central States and has the same lousy Blue Cross/ Blue Shield Plan I am on. Its the worse health insurance I have ever been on, and I have just finished my thirty-first year with the company. I would steer as far away from them as possible, my mailbox is full of Doctor bills I have to pay because of what they don't cover. I try not to go to the doctor unless it is absolutely an emergency, I know I will wind up paying for at least half the charges. I don't know how people without Health Insurance at all survive.
wannabeups
Well-Known Member
You guys are right the insurance plan admininstered by the Central States plan is the drizzlin smile**
C
C. S. Sux
Guest
Yes it does suck,but you still don't have to pay for coverage like most companies charge their employees.Wait,I'm sure it's coming though.Wornoutupser is right. It sounds like he is in Central States and has the same lousy Blue Cross/ Blue Shield Plan I am on. Its the worse health insurance I have ever been on, and I have just finished my thirty-first year with the company. I would steer as far away from them as possible, my mailbox is full of Doctor bills I have to pay because of what they don't cover. I try not to go to the doctor unless it is absolutely an emergency, I know I will wind up paying for at least half the charges. I don't know how people without Health Insurance at all survive.
1980
Well-Known Member
Did you guys ever belong to the traditional plan because that also has its downside.Yeah Ive got freedom of choice but they NEVER pay well care(shots,mammogram,yearly gyno) and you could also be on the hook for anything above what they consider reasonable and customary.If you post ,please give me as much detail as possible because I dont want to friend this up. THANKS!!!!!!
wannabeups
Well-Known Member
Central States Insurance is so bad they should be paying people wages just to use it
C
C. S. Sux
Guest
I went to the Dr's yesterday and they said I have a balance of $80 from an appt. in July. They had submited twice and never got paid. So I call C.S. and they said we just cut a check to them last week. Took them from July until Oct. to pay my Dr. $80 bucks. That is B.S..
