Premium Plan: Massachusetts Blue Cross/Blue Shield tried screwing Dante

[Procrustes Stretched]

Premium Plan: Massachusetts Blue Cross/Blue Shield tried screwing Dante

Worked at a major University. Selected the most expensive health insurance plan they offered. Everyone said it was dumb, go with a mid level plan, but Dante figured better to play safe...take everything offered if employer paid in...catastrophic coverage, a life insurance one that cost more than most, but was the best. Had it all.

Ended up using health insurance for an out of state rehab. Blue Cross/BS claimed they didn't have to pay because it was too far away. I replied they paid for a rehab for other employees with a lesser plan, in New Hampshire. They replied it was within a certain mile radius. I proved they were playing games with out of state versus out of state within a certain mile radius...whatever. Point was I called state regulator and they paid.

Insurers almost always would try to cut costs on individuals who were less educated on rules and laws than Dante. I knew a VP of a major Insurance company with a skyscraper downtown Boston. He was head of the dept where claims got fought. He told me it was his job to try not to spend on claims, legit or not.

I asked my friend "How do you sleep at night?" he replied "On silk sheets, with my wife, and very sound" Dante learned an important and insightful lesson that day. We stayed friends this man and I. He later helped people as an advocate but played both sides by staying an industry spokesperson and such. I do not hate insurance for profit...I just believe basic health insurance should be run out of non profit firms like Switzerland switched to

edit: Forgot to add best part

edit: "Blue Cross/BS claimed since I was on a large employer plan, the employer owned the plan and they merely managed it. The major university claimed my coverage was managed by the insurer and my fight was with them. Can you imagine BU (oops, named them), claimed they only owned the plan and it was out of their hands? It ended up one person arguing the plan payed for coverage under a contract with a few rehabs or something like that. Dante argued 'so the fuck what' I pay for out of state coverage ... Massachusetts had a great Agency that I called and with a very short period of time my contract and word to the out of state rehab was honored.

Interviews - Pascal Couchepin | Sick Around The World | FRONTLINE | PBS

Question: One of the things really striking for Americans is that under LAMal, you now say the insurance companies can't make a profit on basic coverage. What's the thinking there?

Answer: The idea is very simple: If it is a social insurance, and everybody is obliged to be a member of a health insurance system, you can't ask them to pay so that the shareholders get a better revenue. It is a little the same, if I can compare with SBB, our railway system. We are very attached to the railway system; Switzerland is a country of railway. ... I think that the people wouldn't [have] agreed to privatize the railways [as] it is done now in Great Britain. To think that they can [make] a profit on the railway system, it [would] be against equality in this matter.

Naturally, you can question that, ... but till now we were able to afford a good railway system, to improve it and to have a high quality in transportation. ... We want also high quality for everybody in the health system, and after that you can earn more money than your neighbor. ... School, health care, railway system, aging, to have a good place for nursing homes for old people, retired people, we think that we must have equality of that -- not quite complete equality, it is impossible, but to have a great sense of solidarity among the people.

 

[Procrustes Stretched]

explains why Dante is vehement about hitting back at those who would blindly back the insurance industry for mere partisan reasons

 

[TNHarley]

I have bcbs and I hate those fuckers

 

[Procrustes Stretched]

I have bcbs and I hate those fuckers

with the employer plans hard to escape

I forgot to add the best part,,,,,thanks for reminding me....will edit OP

 

[HenryBHough]

"Rehab" said so very, very much.

Makes sense of some of it, too.

 

[Rozman]

Don't worry Dante...Obama Care will take care of your every need!

 

[Dont Taz Me Bro]

I've had Blue Cross Blue Shield for years and have never had a problem.

Of course, I am also a lot more intelligent than Dainty.

 

[Procrustes Stretched]

"Rehab" said so very, very much.

Makes sense of some of it, too.

rehab for what?

 

[Procrustes Stretched]

I've had Blue Cross Blue Shield for years and have never had a problem.

Of course, I am also a lot more intelligent than Dainty.

You're also not going to be affected by Obamacare, so stfu!

 

[Vox]

I have bcbs and I hate those fuckers

tell that to Antares

Dante, did they eventually pay for your treatment?

 

[Procrustes Stretched]

I have bcbs and I hate those fuckers

tell that to Antares

Dante, did they eventually pay for your treatment?

Yes. Call a state regulator and it's amazing the things businesses will do to keep their books from being scrutinized too closely

 

[Meister]

I've had Blue Cross Blue Shield for years and have never had a problem.

Of course, I am also a lot more intelligent than Dainty.

You are understating this.

 

[Procrustes Stretched]

Wee-whittle Tizzie Tazzie understands shit

Happy Holidays

 

[Meister]

Wee-whittle Tizzie Tazzie understands shit

Happy Holidays

If I were your insurance company, I would be screwing you over too....just for general principal, Dante.

 

[Procrustes Stretched]

Wee-whittle Tizzie Tazzie understands shit

Happy Holidays

If I were your insurance company, I would be screwing you over too....just for general principal, Dante.

Why thank you! That's the sweetest thing anyone has said to me all week.

 

[HereWeGoAgain]

I've had Blue Cross Blue Shield for years and have never had a problem.

Of course, I am also a lot more intelligent than Dainty.

I agree. Blue Cross paid thirteen thousand for out of network surgical assistants when I had cancer surgery...they didnt have to. But they did without complaint.

They also paid for my in home rehab when I had my hip replaced.

Nothing but good things to say about Blue Cross.

Perhaps dainty missed a few premium payments?

 

[Sunshine]

Premium Plan: Massachusetts Blue Cross/Blue Shield tried screwing Dante

Worked at a major University. Selected the most expensive health insurance plan they offered. Everyone said it was dumb, go with a mid level plan, but Dante figured better to play safe...take everything offered if employer paid in...catastrophic coverage, a life insurance one that cost more than most, but was the best. Had it all.

Ended up using health insurance for an out of state rehab. Blue Cross/BS claimed they didn't have to pay because it was too far away. I replied they paid for a rehab for other employees with a lesser plan, in New Hampshire. They replied it was within a certain mile radius. I proved they were playing games with out of state versus out of state within a certain mile radius...whatever. Point was I called state regulator and they paid.

Insurers almost always would try to cut costs on individuals who were less educated on rules and laws than Dante. I knew a VP of a major Insurance company with a skyscraper downtown Boston. He was head of the dept where claims got fought. He told me it was his job to try not to spend on claims, legit or not.

I asked my friend "How do you sleep at night?" he replied "On silk sheets, with my wife, and very sound" Dante learned an important and insightful lesson that day. We stayed friends this man and I. He later helped people as an advocate but played both sides by staying an industry spokesperson and such. I do not hate insurance for profit...I just believe basic health insurance should be run out of non profit firms like Switzerland switched to

edit: Forgot to add best part

edit: "Blue Cross/BS claimed since I was on a large employer plan, the employer owned the plan and they merely managed it. The major university claimed my coverage was managed by the insurer and my fight was with them. Can you imagine BU (oops, named them), claimed they only owned the plan and it was out of their hands? It ended up one person arguing the plan payed for coverage under a contract with a few rehabs or something like that. Dante argued 'so the fuck what' I pay for out of state coverage ... Massachusetts had a great Agency that I called and with a very short period of time my contract and word to the out of state rehab was honored.

Interviews - Pascal Couchepin | Sick Around The World | FRONTLINE | PBS

Question: One of the things really striking for Americans is that under LAMal, you now say the insurance companies can't make a profit on basic coverage. What's the thinking there?

Answer: The idea is very simple: If it is a social insurance, and everybody is obliged to be a member of a health insurance system, you can't ask them to pay so that the shareholders get a better revenue. It is a little the same, if I can compare with SBB, our railway system. We are very attached to the railway system; Switzerland is a country of railway. ... I think that the people wouldn't [have] agreed to privatize the railways [as] it is done now in Great Britain. To think that they can [make] a profit on the railway system, it [would] be against equality in this matter.

Naturally, you can question that, ... but till now we were able to afford a good railway system, to improve it and to have a high quality in transportation. ... We want also high quality for everybody in the health system, and after that you can earn more money than your neighbor. ... School, health care, railway system, aging, to have a good place for nursing homes for old people, retired people, we think that we must have equality of that -- not quite complete equality, it is impossible, but to have a great sense of solidarity among the people.

When my son was little, he had some problems which the insurance company handled the same way. But we called the HR department where he worked and it all got fixed. If your employer is large he is likely just paying the claims and BCBS administers the program. That is often the case. If you EVER go out of your local area for treatment of any kind, you should check with your insurance FIRST. You may indeed not be covered. Or the insurance company may be willing to pre approve the treatment.

In the event that insurance does not pay, you still can negotiate the cost of the treatment with the provider. Just don't try to negotiate with a secretary.

I have been in a cache 22 on an echocardiogram. My employer sent me a summary that stated my retirement benefits started on June 1. I had the echo on May 29. Medicare doesn't want to pay because I told them my official retirement date was June 1 and that is what HR told me. That would make Medicare secondary. But HR turned around and reported to BCBS that I was retired as of mid may. So the COB departments are hashing it out. One of them is going to pay. Or they can split it, I don't care. But I paid both BCBS and Medicare premiums for that time period. If they don't pony up, I'll sue them both AND my former employer.

 

[Sunshine]

Wee-whittle Tizzie Tazzie understands shit

Happy Holidays

If I were your insurance company, I would be screwing you over too....just for general principal, Dante.

No doubt he is like a worm in hot ashes! LOL.

 

[Procrustes Stretched]

oy vey!