Can you believe this crap????

[WalkingZombie]

So, my DME finally called me Friday to let me know they have received the RX from my sleep doctor, and they proceed to tell me that they can't get my insurance pulled up. Then as she has me on the phone, she says I'm coming up under Blue Cross Blue Shield. I tell her, "I don't have BCBS I have Pharmacy Trust insurance. She says the computer tells her that I have BCBS as of Oct. 1st. To top it all off, my $1,000 deductible nor my $1,000 out of pocket expense has been met. I almost had a heart attack! I had surgery this past August and had met all of my deductibles! As it turns out, Pharmacy Trust has gone out of business and BCBS has taken over their policies. I'm hoping and praying that BCBS will recognize that I've met my deductibles, if not, then I am screwed. This has just torn me up!! So, now I have to jump through hoops, and it's near impossible to get talk to a warm body from BCBS.
This is just my luck. I've waited over 2 weeks for the sleep doc to finally write my rx and now it's gonna be delayed even longer.

[RandyJ]

You should call BCBS. If they take over a policy everything SHOULD remain in place (original effective date of insurance, plan renewal date, copays, deductible, amount paid toward deductible, etc.)

[Lew56]

Call BCBS and explain that you have already met your deductible. If you are not happy with their response, escalate it to management. If you receive your health insurance through your employer, I would suggest contacting your employer's benefits coordinator first, since they can usually straighten things out a lot quicker. Good luck.

[GumbyCT]

Sorry to hear that. You just might be better off to buy on your own too.

Read this - viewtopic/t69536/2nd-sleep-studyneed-he ... meone.html

[chunkyfrog]

You might also want to contact you state insurance licensing board.
Your existing contract should not reset mid-year because of a corporate buy-out.

[FeelingBetter]

You know I have a decent insurance and my copays for 3months would have bought my intellipap auto. My insurance company was willing to reimburse me 100% to buy one online as they can't due to contracts because the online price was far less than they would have to pay (plus the 25% I would I have to pay as my portion). Anyway, now I own mine free and clear. They'll buy me one every 5 years. Maybe you should ask to speak to a case manager, they can usually authorize such things.

[WalkingZombie]

Thank you all for your responses! I am hoping and praying that this will all work out. Surely they will give me credit for meeting my deductible! I just hope it doesn't delay getting my cpap for very long. I will definately consider ordering from cpap.com if I need to.

[JohnBFisher]

I would be VERY surprised if BCBS does not properly honor the deductibles of the previous insurance company. If they do not, contact insurance oversight agency in your state. If they start to get notes from that agency, they WILL act. But as I noted, it should NOT be a problem. Though they can be sticklers for the paperwork, I've been generally very pleased with working with BCBS in the past.

[.mike]

I almost never meet my deductible. So I buy my masks online and get my machines from http://www.Craigslist.org . I have bought a couple machines for about $100 each. If I would have got it thru my insurance, I would have to buy new and would have cost me way over 100.

[idamtnboy]

So, my DME finally called me Friday to let me know they have received the RX from my sleep doctor, and they proceed to tell me that they can't get my insurance pulled up. Then as she has me on the phone, she says I'm coming up under Blue Cross Blue Shield. I tell her, "I don't have BCBS I have Pharmacy Trust insurance. She says the computer tells her that I have BCBS as of Oct. 1st. To top it all off, my $1,000 deductible nor my $1,000 out of pocket expense has been met. I almost had a heart attack! I had surgery this past August and had met all of my deductibles! As it turns out, Pharmacy Trust has gone out of business and BCBS has taken over their policies.

What is the actual name of your former insurer? A Google search on "Pharmacy Trust" insurance only pulls up a "Pharmacy Trust" in Canada. Pharmacy Trust Insurance, as an American company name, seems not to exist!

[pap4life]

I feel realitively certain that BC/BS will completely take over the all of the info from the previous insurer. Since they show up on the DME's computer, give BC a call for verification. No problems..

[Carl LaFong]

I feel realitively certain that BC/BS will completely take over the all of the info from the previous insurer.

I'm more than relatively certain. They will. They have to. Might want to give them a call just in case so they know you're watching.