Pharmacy chain CVS charged about 11,000 customers who have health insurance small copays when they picked up some recent prescriptions. What’s wrong with that? Those prescriptions were for generic contraceptive pills, which should be dispensed with no copay at all under the federal Affordable Care Act. Now those customers are due a refund. [More]
Kim received a solicitation in the mail from Anthem BlueCross BlueShield offering her the opportunity to apply for guaranteed health insurance coverage. This plan offers appealing benefits like no copay for routine screening tests or immunizations. Sounds great! Except it’s not. [More]
Should our health insurers try to nudge us toward the healthiest habits possible, like eating fresh, healthy food and exercising regularly? Or should they just give up, accept Americans’ crappy habits and hope that we do less healthy versions of unhealthy things, like eating giant plates of whole-wheat pasta? Reader Scott wonders whether that’s what his health insurance company, Anthem Blue Cross/Blue Shield, is up to with a package of coupons that they sent recently. [More]
Steven has health insurance through Anthem Blue Cross, a company that deals in direct-pay individual policies, instead of employer-subsidized group health insurance. A recent change to the plan adds a service, maternity coverage. (Yes, many direct-pay plans require you to buy insurance covering pregnancy and delivery separately, and before you get pregnant.) The problem? If he and his wife want to have a baby, he’s going to have to carry and give birth to it. The maternity coverage only applies to the policyholder, not their spouse or dependents. Pretty sweet if you’re a fertile woman with her own policy. Pretty useless if you’re not.
David and his wife had a baby last year, and one item that their health insurance covers is an electric breast pump for putting away milk for later. Their mistake was not calling up Blue Cross/Blue Shield to find out whether this was a covered item with a prescription. Not that their customer service representatives are infallible, but it might have prevented what happened next. Instead, David called up the medical supply company, asked them whether it would be covered, and made the purchase. Months later, they received a bill in the month for the pump, and learned that the item wasn’t covered after all, and they were on the hook for $300. Oh.
As part of the Affordable Care Act, health insurers must spend at least 80% of the money they earn from premiums on actually providing health care, with the remaining cash used to cover all administrative, advertising and payroll costs. Those insurers with plans that don’t follow this ratio are soon supposed to start giving the extra money back in refunds and discounts. But new legislation introduced in the Senate this week could jeopardize this, while giving insurance companies even more money to stick in their dog pillows.
Wellbutrin is an atypical antidepressant used to treat patients with depression, but it’s also effective when used short-term to help people quit smoking. As far as Anthem Blue Cross/Blue Shield is concerned, then, if you’re using Wellbutrin, you’re a smoker. For people whose health insurance comes from their employers, this isn’t as much of a problem. But the individual health insurance market is a cruel, unforgiving place where smokers pay higher premiums. And so reader Elizabeth’s husband, who quit smoking more than four years ago, is slapped with the smoker’s rate because he has a prescription for Wellbutrin, which they consider an “atypical tobacco product.”
Jason has sleep apnea. When he sleeps, if it can be called that, he stops breathing up to twelve times per hour. His body’s reflexive response is that his jaw shoots around wildly, chipping and grinding his teeth, and then he wakes up for a second. A dozen times every hour, every night, he wakes up to his teeth clanging around his mouth. As if that wasn’t fun enough, of the $2,400 the mouth guard his doctor prescribed prescribed him, his insurance plan is only going to cover a max of $94.
Andrea has been a customer with Anthem since 1995, paying her bill all the time and never submitting any claims. So you can see why they canceled her coverage.
Amid criticism for increased rates and cushy executive salaries, the CEO of Blue Shield of California has announced that the company will cap its net income at 2%, returning any extra funds — $180 million this year alone — back to certain policyholders and doctors.
Dentists in Cook County, IL, were more likely to provide emergency treatment to children who had private insurance than to those on Medicaid, even if the dentists were enrolled in the state’s Medicaid program, according to a new study. Medicaid typically pays less than private insurance plans, and experts say there’s “little market motivation” for practitioners to take on those patients, rather than just going with those who have private insurance.
Two rounds of WCIA bloodshed are in the book and the beaten bodies of 24 multi-billion dollar companies are being hauled off to be burned on a pyre. But for those businesses left standing — let’s call them the Elite 8 — the parade of pain marches on.
After eight days and 16 first round battles, the WCIA steel cage is littered with the bones of those companies not crappy enough to continue on in the tournament. But the thrill of victory is fleeting for the remaining combatants, all of whom must square off again if they hope of crowning themselves the Worst Company In America!
For the sixth year in a row, we asked Consumerist readers to send us their nominations for our Worst Company In America tournament. And this year’s response was the greatest by far.
Health insurance is often complicated, with a seemingly endless variety of plans to choose from, all with their own particular loopholes and problems. Over at SmartMoney.com, they have put together a round-up of things your insurance company may not be telling you.
Blue Cross Blue Shield of Illinois, the largest health insurer in the Land of Lincoln, has agreed to pay $25 million to settle allegations that it denied coverage to sick kids who needed nursing care.
If you live in Massachusetts and have Blue Cross Blue Shield health coverage, you may end up paying more if you want to go to certain hospitals.
Crimefighters at the Justice Department put on their antitrust capes today, filing a lawsuit against Blue Cross Blue Shield of Michigan. The DOJ alleges the insurance company violated antitrust laws by asking hospitals to sign contracts that precluded other insurers from offering a better discount.