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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: 1046
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
_________________________
Recovery is possible. Hang in there, brothers.

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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: 3513
Loc: somewhere in Africa
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
_________________________
As my life goes on I believe somehow something's changed
Something deep inside...
I've been searchin so long to find an answer
Now I know my life has meaning
Now I see myself as I am, feeling very free...
When my tears have come to an end I will understand
What I left behind: a part of me. Chicago


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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: 1046
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
_________________________
Recovery is possible. Hang in there, brothers.

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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: 1552
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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