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#422077 - 01/14/13 03:41 PM Screwed by my insurance co.
cant_remember Offline
Member
MaleSurvivor

Registered: 02/26/05
Posts: 1063
So, in addition to my recent breakdown, I was also informed that my health care provider (Anthem) has denied payment for nine visits to my therapist in 2012.

The reason? This is great.

Although Anthem says that the policy (which I buy as an individual on the open market) covers the co-pay for 10 mental health visits, they denied payment to 9 of those sessions because they considered them to be "therapy" which they do not consider to be an "office visit."

My anger level is off the charts right now. I can feel it inside me, and need a healthy outlet.

Therapy tomorrow (which I'll be paying for out-of-pocket).

Cant
_________________________
But he grew old, this knight so bold / And upon his heart a shadow / Fell as he found no spot on the ground / That looked like El Dorado.

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#422080 - 01/14/13 06:35 PM Re: Screwed by my insurance co. [Re: cant_remember]
traveler Offline
Member
MaleSurvivor

Registered: 02/07/06
Posts: 3968
Loc: settling in the USA again
can't -

i feel for you in this wretched situation.

something similar once happened to me. very frustrating to know that there are millions ripping off the medical and insurance industries and getting away with it - while legit issues like ours go untreated or uncovered.

probly won't make it hurt less - but whatever it costs to make you "better" - you are totally worth it!!!

Lee
_________________________
"My experience has shown me that I all too often tend to deny that which lies behind, but as I still believe, that which is denied cannot be healed." Brennan Manning, "All is Grace - A Ragamuffin Memoir"

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#422081 - 01/14/13 06:36 PM Re: Screwed by my insurance co. [Re: cant_remember]
Candu Offline


Registered: 06/30/12
Posts: 312
Loc: Canada
Quote:
they denied payment to 9 of those sessions because they considered them to be "therapy" which they do not consider to be an "office visit."

So you had home delivery? confused

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#422086 - 01/14/13 07:05 PM Re: Screwed by my insurance co. [Re: cant_remember]
cant_remember Offline
Member
MaleSurvivor

Registered: 02/26/05
Posts: 1063
I've put together a complaint with my state's dept. of insurance. I talked to the state's insurance ombudsman on the phone, and he says that they will have access to all the phone calls that I've placed with Anthem, so they will be able to go back and listen to everything that was said... so that sounds good.

Next, I get to cancel my insurance policy.

Then, I get to be uninsured because I'll be uninsurable because other insurance companies will now consider me a "pre-existing condition." Obamacare's pre-existing condition protections don't kick in until 2014.

Cant
_________________________
But he grew old, this knight so bold / And upon his heart a shadow / Fell as he found no spot on the ground / That looked like El Dorado.

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#422090 - 01/14/13 08:07 PM . [Re: cant_remember]
Life's A Dream Offline


Registered: 08/25/11
Posts: 886
Loc: Bouvet Island
.


Edited by Life's A Dream (01/15/13 10:49 AM)

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#422092 - 01/14/13 08:24 PM * [Re: cant_remember]
Smalltown80sBoy Offline
Member
MaleSurvivor

Registered: 03/25/12
Posts: 2217
*


Edited by Smalltown80sBoy (04/29/13 02:04 PM)

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#422116 - 01/15/13 02:50 AM Re: Screwed by my insurance co. [Re: cant_remember]
onlyakid Offline
Member
MaleSurvivor

Registered: 03/31/04
Posts: 1556
Loc: New Jersey
Cant are you sure that is the law in your state?? In NJ, pre-existing condition clause doesn't apply if you have been uninsured for less than 61 days. Besides why do you have to cancel your insurance, if you get the ombudsman to convince Anthem to pay for your therapy why cancel your insurance. Then you'll have none and nothing gets paid for you including anything serious. If the law in your state is that you will not get coverage with a new insurance company that's even more reason not to cancel. Check it out and if the state does give you 60 days remember to get a letter of coverage detailing the dates you had coverage with them.
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"Being with people that understand you...Priceless"

"and i don't want the world to see me, cause i don't think that they'd understand"

"You don't know what love is...you just do as your told"

"My life has changed. What you take as a simple thing, is not so simple for me anymore"


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