Insurance Cancellation Hor BC/BS NJ

NancyNJ

Has anyone had a problem with threatened policy cancellation from Horizon BC/BS NJ?  After submitted bills for two mastectomy's, a DIEP Flap that failed, Hospital infection, nurses at home for months etc..etc...etc.....we were"randomly" audited and they've asked for one piece of documentation after another and nothing - nothing seems to satisfy them. Has anyone dealt with anything like this that can offer any support or guidance?

Soccermom4force

Nancy,

Contact these folks ...



http://www.disabilityrightslegalcenter.org/about/cancerlegalresource.cfm



They've helped me navigate the insurance minefields!



Marcia

cp418

http://law.freeadvice.com/insurance_law/health_insurance/healt_insurance_cancel_policy.htm

http://www.legalmatch.com/law-library/article/cancellation-of-health-insurance-policies.html

NancyNJ

Thank you so much!

NancyNJ

Thank you!!

cp418

Nancy - when I read your post my blood boiled!!  These insurance companies are EVIL in how they treat patients!  BTW - BCBS NJ is my insurer too ---- the bleeps.

chrissilini

That just stinks. Hope things work out for you. I'm waiting for something like that to happen to me. Open enrollment is coming up and you just never know when they are going to jerk you around. When I had my bmx with te's in Dec, the office manager told me a week before surgery that my insurance company didn't approve it yet. They needed more info. What the heck more did they need than the fact I had breast cancer. Really?



I had my exchange to implants in March and although I don't know if I'll need fat grafting, ins won't cover it. They used to but have changed their policy. WTH? My insurance is Cigna.



Good luck to you.

NancyNJ

They are evil people - the status so far is basically they're cancelling us and if we don't like it we can spend even dime of money we've put away to pay legal fees to make them do the right thing.....I guess they bank on the fact that with a cancer patient there's an expiration date.

I'm disgusted and frustrated.  Got no help from anyone.

Lowrider54

Well, I sure am glad I don't live in New Jersey anymore - my suggestion is get together and write letters to the Attorney General - lots of letters - the Attorney General in Minnesota is very proactive and given enough complaints, they are bound to at least investigate the matter. 

All you NJ gals, get out your pens, computer, crayons if you have to - bombard them with letters and maybe you can get some action on your behalf!  Power in numbers...I would look for English Major on here and send her a PM - she is AMAZING when it comes to advocacy and may have some great suggestions for you!

Luck to you all...LowRider

Galsal

WOW, what an anger building scenario they create with such demands that are ludicrous!  Feeling SO thankful now that UHC and Fla have not questioned one claim.  For that matter, the only two not paid are from when I went for a second opinion and the deductible hadn't yet been met.

cp418

http://www.nj.com/corruption/

Is there a way to contact NJ News television and website to publicize this situation? Get the attention of NJ Health officals and Governor Christie?

http://www.news12.com/index.jsp

Mardibra

Insurance companies are evil.  Although I have not had any issues with coverage to date, they did call the other day saying "they wanted to reach out and let me know the resources they can provide for support".  Ya, BS....they were asking tons of questions about my BC experience to date and questions about my doctors, etc.  I am just so distrustful of them...gave them the absolute bare minimimum of information.

Good luck to you...you should not have to deal with this.  Disgusting. 

lago

Here are some more links for you:

http://www.patientadvocate.org/

http://www.cancer.org/Treatment/FindingandPayingforTreatment/ManagingInsuranceIssues/HealthInsuranceandFinancialAssistancefortheCancerPatient/index 

http://www.cancer.org/Treatment/TreatmentsandSideEffects/ClinicalTrials/StateLawsRegardingInsuranceCoverage/index  

http://www.cancer.org/Search/index?QueryText=insurance&x=0&y=0  

glostagirl

Hi Nancy,

Just wondering how things are going.  I was researching a simmilar issue for a friend here in MA and came across "Small Group Insurance Laws"  which I was sure you'd also have in NJ.  So I did a quick Google search.

Here's the link:

  http://www.state.nj.us/dobi/division_insurance/ihcseh/sehguide/introduction.html#overview

The bottom line is:

Under 25 hours a week is considered part time and ineligible for coverage

They may be in violation of HIPAA by denying you coverage based on your medical information

They can only cancel you on your anniversary of coverage (renewal) date. 

They may have to provide COBRA coverage (would be more costly)