Anthem

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Susan of Santa Monica, CA November 11, 2009

The Anthem Blue Cross 2500 PPO Life health insurance policy is being sold deceptively. The overview information that is used to lure in customers states "Office visits are not covered UNTIL...." which infers that office visits would at least be applied to the deductible. In fact, they are not. The plan offers an annual mammogram and Pap, yet does not cover any office visit of any kind, UNTIL you have spent 2500 in what they do cover: emergency only. That should be spelled out in PLAIN ENGLISH.

Insurance companies should be forced to describe exactly what it is that they are offering and what it does not include, on every piece of material that it uses to market to consumers. This plan is bogus and a joke. It should be called an EMERGENCY ONLY plan, because that is what it is. I will be writing extensively on this, complaining to Anthem, the BBB, my congressman and the media. If we are ever going to have effective health reform, it has to start with honesty. Anthem should be made to cover office visits under this policy, as it deceptively infers it will.

Dwayne of Louisville, KY September 3, 2009

I recently took my mother, who has Anthem Health Insurance, to the hospital for a test that a vascular doctor explained was basically checking her blood pressure in her legs. He explained that it was a non invasive procedure that was no big deal. When we were in admitting, the attendant told us that the procedure cost over 300 and that her insurance would not cover any of the cost. Why do "insurance companies" take your money when you pay your premiums then refuse to pay for medically necessary exams. Once again it goes to show that health care in this nation is only concerned with the almighty dollar. Needless to say, we refused the test and are filing a complaint with the "insurance company" as well as the local and state health agencies.

rene of SPENCERVILLE, IN May 20, 2009

I am the mother of a special needs child, and imagine my frustration after waiting approximately six weeks to get an answer from Anthem Blue Cross/Blue Shield about a letter of medical necessity in regards to testing for a mutated form of “Charcot Marie Tooth disease that my eleven year old son may have.

Imagine now, if you will, my despair at learning Anthem has denied our request for testing as not medically necessary. The reason given was lack of information on my son's case. This is more than a little puzzling to me, as the nurse who works with my son's neurologist stated she had faxed all requested documentation more than THREE times to them. Conveniently Anthem has either misplaced or lost this documentation, which would be my guess. My son, Matthew, fits the criteria for this form of CMT. We were seeking confirmation through blood work that can detect this mutation. Matthew was born post term; at birth his diagnosis was macroephaly, a very large head but not hydrocephalic. When Matthew was a year old we were told after one of many scans that he had mild cerebral palsy. He had missed his milestones. He couldn't sit up or crawl like other babies. We were unsure if he would even walk, but after intensive physical therapy started at age six months, he walked at age two. Matthew used a small walker to start with and that was later discontinued. Shortly after Matthew gave up his walker, he would wake up unable to stand, walk or even feel his legs. These episodes happened periodically and lasted for hours at a time. Eventually sensation and ability to stand would return. Matthew's neurologist was as puzzled as we were, and at the time she referred to it a periodic paralysis. Repeated testing indicates Matthew has peripheral poly neuropathy; all his extremities are affected. He has nerve damage in his eyes and suffers from carpal tunnel in both hands. Recent studies in Germany were brought to our attention by his neurologist. Matthew fits the criteria and has many of the symptoms of CMT. A typical morning for Matthew starts like this: First I scoop his legs up over the side of his bed, and then with my hands under his neck, I help him stand. We stand there a few minutes until he feels steady enough to walk to the bathroom. Once in the bathroom, I run a tub of hot water. He says the hot water helps his hands, feet and legs to wake up. This has been our morning ritual for the last nine years. Matthew has foot drop, his foot or feet can drop and catch causing unexpected falls. The numbness or as he puts it sleepy legs used to go up knee high; it now extends to his groin. Matthew has trouble with temperature extremes as a result of neuropathy. When it is cold, you and I would be uncomfortable. Matthew is miserable. No amounts of layered clothing seem to help. Gloves come out of storage in October as his hands are like ice. Summertime is also a challenge as Matthew overheats easily. God blessed me with this special needs child. I just wish I knew why the insurance industry makes it so hard for me to care for him. I wish they could understand the medical need for confirmation of his neurologist diagnosis, which she has based on all of his symptoms. This test cost 800-900, which I cannot afford out of pocket, or will have to borrow. I just want to give my son the best possible care, and the insurance company is denying me the right to do so.

Howard of Cincinnati, OH April 30, 2009

A friend of mine is scheduled to have his kidney removed on May 12, at Christ Hospital in Cincinnati. His surgeon wants to freeze the small, slowly-growing tumor and save the kidney, but the decision-makers at Anthem Insurance, which, in addition to Medicare, provides Bill's medical coverage, refuse to pay for that procedure, which classifies as an out-patient treatment and costs 10,000. However, they will pay for the complete removal of his kidney, which costs them 20,000.

So, despite his surgeon's many pleas to Anthem to finance the freezing procedure, Bill finds himself being left with no choice. He is also essentially broke ... has no savings ... pushes carts for Wal-Mart on the third shift ... and will be off work for several months. He has no one to go to bat for him, and all I can do is send an email to an important organization like yours and ask, Is there no one out there who can make a corporate bully like Anthem change its mind?

Tyler of La, CA April 8, 2009

Tyler of La CA (04/08/09)
my monthly rate will be going up 50 % called customer service they said everyone across the board is getting a large rate increace.the rate was due to the escalating cost of health care.but a 50% jump same very large.how can there be no recourse for the customer,beside droping health coverage

David of Long Beach, CA March 15, 2009

David of Long Beach CA (03/15/09)
I am a resident physician. I was hospitalized emergently for medical care at a Veteran's administration hospital that I work at. I am a non-veteran and the emergency occurred after work hours. I sought care at the VA hospital because I was an employee there and it was the closest hospital to where I was at when the emergency occurred (a heart arrythmia). The hospital erroneously billed Blue Cross which apparently they are not allowed to do because I am not a veteran. Instead I was told that Blue Cross is supposed to reimburse me and then I am to pay the hospital bill.

I have now been engaged in a claim with Blue Cross for many months in an effort to recuperate the money from the bill. I have placed no less than 20 phone calls and 20-30 emails to Blue Cross totalling hours of my time. I was told by them in January that my claim was approved and then checks would be issued. Although I have received a small percentage (i.e. 10%) of the total reimbursement, I have yet to receive the majority of the payment from them. Each time I have called them over the past 2 months I have been told it is in process.

I went into collections status with the VA hospital as a result of non-payment by Blue Cross. My federal tax refund was garnished last year because of the unpaid reimbursement and I received penalty fees. I have wasted countless hours on the phone and via email with Blue Cross.

Zav of Pasadena, CA February 23, 2009

Zav of Pasadena CA (02/23/09)
I'm on hold trying to get through to Blue Cross, so I have lots of time to rant about their horrible service. They charged me 2.00 to send me a bill. The bill said to call a number to sign up for automatic pay. Then the message on the phone said it would cost me 15. I pay outrageous insurance premiums and they charge me extra for everything they do. What a RIP OFF! Can't any regulatory group get off the lobbyist teat long enough to control this monster!

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