Question about Insurance Coverage

Discussion in 'UPS Discussions' started by jedispork, Jan 3, 2009.

  1. jedispork

    jedispork New Member

    Hello everyone this is my first registered post here. I've been with ups for 9.5 years. I work a full time combo job at the Rockford IL building.

    I've just been to the doctor because I have some tightness and pain around my ear. I thought it was just a ear infection but they couldn't find anything wrong. It feels like all the muscles around my ear are tensed up. They want me to have a ct scan just to be safe.

    I have a blue cross and aetna card. Which one is usually used for this sort of thing? I haven't had to use insurance for this sort of testing before. The blue cross says for hospital services only. Someone just told me about another clinic in town that is much better to deal with than the hospitals and they absorb all costs after insurance.

    If I call the insurance company(not sure which card to use yet) can they tell me exactly if that clinic is covered?


  2. dannyboy

    dannyboy From the promised LAND

    Insurance will vary greatly from one area of UPS to another. Depending on your job, the insurance carrier, the issuer of the insurance etc.

    I would call both monday. I bet you will find only one of them is active, unless you have another job that provides insurance.

    That way, you will get the best information for not only your area, but also to what and how much they will cover where ever it is you are going.

    One thing too.

    Co pays.

    Say your bill is 600 bucks.

    Your insurance gets a discount so it is now 212.

    They pay 187 of it. You only pay the difference between 187 and 212, not the 600 bucks.

    If you are double insured, you should not have to pay anything for visits.

    If you are uninsured, you are stuck with paying 600. Not fair, but it is what it is.

  3. JohnnyPension

    JohnnyPension Member

    Hi Jed

    I wish you the best. My experience is Blue Cross is hospital only. The insurance company would be the one to tell you if you are covered at the clinic. Beware because I just had an experience where I asked a specialist's (joint doctor) billing department if they took my coverage and they said yes. I should have gotten that in writing because they lied to me and I am getting bills from them for the full amount. The union does have major medical for doctors that are not in network but I had not reached my deductible for the year. Still fighting with them over it.

    Also make sure the doctors check for plaque in your arteries (carotid?) around your ear. I seem to remember an old friend who had similar symptoms and they found blockage. Saved him from a possible stroke.

    Good luck.

  4. UpstateNYUPSer

    UpstateNYUPSer Very proud grandfather.

    Danny, excellent example and advice. The only point that I disagree on is the uninsured having to pay the full 600. I would think (hope) that most, if not all, providers would work with the uninsured to try to do what they can to help lower their bill.
  5. dannyboy

    dannyboy From the promised LAND

    Nope, and that is why people that can not get insurance are getting screwed and many refuse to pay, making it more $$ for the rest of us to get care.

    Ours is blue cross. They cover everything from hospital, drs and things like therapy and after care supplies. You need to have a heart to heart with the billing department, and then the doctor if they still refuse to take insurance. They can not just say no.

    Your co pay might be more if they are not in network, but you still have coverage.

    As for the deductible, that is something that no one can explain. Some times they take your whole bill and put it to the deductible, other times just a part or none at all. I think it has something to do with full moon, level of the oceans, and the creek has to be at a certain level cause nothing else makes any sense.

  6. dilligaf

    dilligaf IN VINO VERITAS

    I have Cigna with Aetna Dental. I use Cigna for everything medical. Speaking of ins. I got Cigna because my doctor accepted it and I didn't want to find a new doc. So know my doc has retired and I have to find a new doc. Don't like the one he sold his practice to and they quit Cigna. So what are your experiences with Cigna verses BCBS? Since I have to find a new doc, I'm wondering if I should switch to BCBS.
  7. dilligaf

    dilligaf IN VINO VERITAS

    Jedi, you will also, probably have to get pre-approved to have extra procedures done, which your doctor should be doing.

    I believe Aetna is dental only.
  8. smf0605

    smf0605 Member

    The BC card is for hospital only. The Aetna card is for doctors (including doctors you have when you are in the hospital).
  9. dilligaf

    dilligaf IN VINO VERITAS

    Hmmm, I didn't know this. But I don't have BC.
  10. dannyboy

    dannyboy From the promised LAND

    And see, with us having blue cross alone for everything, it varries a lot!

    And that is why you need to check with your teamsters office. You should have been given a book to read [evil]I know, most throw it in the trash[/evil] that will have a lot of detail in it.

    But teamsters would be the first call.

  11. barnyard

    barnyard KTM rider Staff Member

    Call the H&W office and ask for your packet of insurance info. Read it. When you are done, put it in a safe place so that next time you need it, you can check through it again.

    That is the best way for anyone to know what is covered and what is not.

  12. jedispork

    jedispork New Member

    My Aetna covered the test for 80% as expected. They had everything figured out right there and I paid the bill.

    It was nothing serious. They basically just told me I have sinus problems and need to follow up with my primary care physician.

    thank you everyone