How do you get Insurance to Pay!?

[fallingrock26]

So I got Crohns. Hello all, I'm 26 got it when I was 19, been wonderfull as many of you know:ybatty: . I finally have insurance and a secure job, but Blue Shield Blue Cross of Nebraska HMO says they take six months waiting period to pay for pre-existing condition. Which 6 months is ok, but when I received my paperwork, the date on it to cover pre-existing conditions is acually set 9 months ahead, and thats already after my 3 months of working with the job to get the insurance, which is done.

I remember reading on this stuff awhile back and hearing of people able to get insurance to actually step up to the Crohns fees, but they had to hire attorneys, get doctors letters or something. Was wondering if anyone on here has experience on how to pry these companies to do they're job, and whats involved in doing so. I did a search on the web, and this forum just before signing up to this forum, but didn't come up with much. I'm not to sure what the best keyword would be for that though...

 

[CD68]

Contact your state department of insurance.

You file complaint with them at no cost and if the company is violating the law (federal law that defines this is HIPAA ) , in general the rule is that they can exclude your preexisting condition for one month, your state may have other rules that are more strict) the state will represent you at no cost and massively fine the insurance company to boot for the violation.

A lot of people are unaware of this free resource and head to the $$$lawyers$$$ first. Attorneys don't mind this at all.

 

[fallingrock26]

I've heard of Hippa but didn't know they could get involved. I'm going to look into this before my next appointment in Feb. Hopefully they'll put a fire under Blue Cross and I won't be spending most of my extra cash on medical bills. I swear if wasn't for Crohns I would have been a multi-thousand-air by now! Sometimes I think Doctors are in the same bracket as Lawyers:tongue: , but they're necessary...

 

[Kittee]

I have BCBS and I had to FIGHT to get them to cover me. I had to prove that I did not have this as a pre-existing. They had me fax stuff that was from employers 3 years back.

It was NUTS. It held up my Remicade treatments by 3 months or so.

 

[ErinDF]

Hi,

Here is the link to a Nebraska Department of Insurance brochure on HIPAA and pre-existing conditions. http://www.doi.ne.gov/brochure/out99112.pdf There is lots of other information on their website too that I don't really have time to sift through.

Hope this helps,
Erin

 

[fallingrock26]

hmmm, looks like Nebraska law doesn't require insurance to cover pre-existing conditions until 1 year later. Now... My physical address is in California, my work is in Nebraska, and my actuall address is here in Tennessee... haha, who knows which state laws applies to my insurance, but I'm assuming its Nebraska since thats where the insurance is provided. In any case, it sounds like Blue Cross Blue Shield is doing pretty good with giving me insurance after 9 months since legally they can wait 1 year according to HIPPA Nebraska law. Guess I'll just keep paying the full doctor bills until 9 months. After that I'm keeping insurance indefinately... Not worth lapsing insurance and paying some major bucks to get treatment...