Basic health insurance and Cancer insurance

pangtidor
pangtidor Member Posts: 127
edited October 2014 in Employment, Insurance, and Other Financial Issues

Anybody here has to file the claim from the cancer insurance? I just wonder how they reimburse your chemo treatment with your basic health insurance coverage and the deductibles.

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited August 2014

    Sorry I don't have personal experience with this particular scenario but hope your clinic or hospital has financial counselors whose job is to guide you. There is the concept of coordination of benefits where one company takes primary responsibility and the other picks up what the first may not cover. Don't be surprised at long time frames in processing claims or denials (which can be appealed). Be sure to get pre-authorization ahead of time whenever something expensive comes up to prevent providers trying to collect directly from you. There may be cheaper alternatives that are just as good.

    If you think you're not getting the best service, your state government insurance commissioner's office might be able to obtain prompt action. I will bump the thread with my story in case it will help. It can all be very frustrating and confusing. Hang in there: make yourself & your health top priority. Keep your premium payments up to date so they have no reason to cancel your policies.

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  • pangtidor
    pangtidor Member Posts: 127
    edited August 2014

    thank you vlnrph for your reply. I know it will be a long road . We have been dealing with the insurance for our daughter's medical issues prior to this.My husband warns me not to handle any of the insurance issues at this time and just focus to get better.

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  • angelia50
    angelia50 Member Posts: 381
    edited October 2014

    pangtidor, did you ever get your insurance resolved? I have Colonial Life Cancer Supp and began submitting bills in August. I think they are doing the typical insurance thing of jerking me around, asking me to jump hoops,to avoid paying. I have been paid for parts of the coverage but not all. I think companies avoid paying in lots of instances just because people just give up but they better get ready, I'm not giving up.

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  • pangtidor
    pangtidor Member Posts: 127
    edited October 2014

    angelia50, they already gave me a check for the first claim (cancer diagnosis). They sent me the cancer policy benefits. They will pay the mileage to the oncologist (more than 50 miles from home). First claim was processed within 2 weeks. The reimbursement of the benefit will take 30 days. Hubby keeps on calling them whenever we fax the bill copies. Squeaky wheel gets the grease. Keep calling them!!! The primary health insurance gave me the benefits' copy and everything was explained well by my HR employees benefit representative. I do understand its deductibles, out of pocket and pre certification. My cancer policy is Humana.by Bay Bridge.

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  • angelia50
    angelia50 Member Posts: 381
    edited October 2014

    Mine is with Colonial. They have paid some, 3 different payments but each time, seems they don't pay until I message them. They had requested operative report and itemized things etc, so I put that all in a big envelope and mailed it. Other things, I had been sending by FAX. So, naturally, they say they never got that so now, I have to get that all again from the hospital. Dumb me should have kept copies.  They may think I'll give up but they are WRONG.  Mine is also supposed to pay mileage and even for a companion, which they have paid some on, but now, they say well, appointments aren't going to work, they want doctors notes. Hoops to jump, I know their game.

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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited October 2014

    Angelina, normally insurance companies are in the habit of receiving the records directly from the physician.  Have you tried just sending the forms to your doc?

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  • Beatmon
    Beatmon Member Posts: 1,562
    edited October 2014

    I have Aflac. They processed and mailed claimed within the  4 days as advertised on their commercials. Thank you, Duck!

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  • angelia50
    angelia50 Member Posts: 381
    edited October 2014

    Brookside VT. No, there really aren't any forms, that adds to the issue.  Orig. I had to submit a form and a copy of my pathology to verify I had cancer but now, they have not actual form to list what you are sending or anything.  You just send proof of bills. I had been sending them the info off the bills I was getting or things I could get online form the hospital and I do understand, for the surgery, they need special codes and all that but I think they are trying to make it dififcult to hope to not pay much.  They got off easy, they would have had to pay $100 for each day of chemo or radiation and I didn't have to have either of those.  They actully send $3,000, which was for prostetic items, and I don't really have my final implant yet, so apparenlty they called the TE prost. 

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  • pangtidor
    pangtidor Member Posts: 127
    edited October 2014

    I have to get the statements from my oncologist and surgeon states that I don't have the oncologist&surgeon services locally in my town. They want the copy of itemized bills too. They also want the bills with the date of service of each appointment. I haven't got any bills from my chemo yet. They sent me the copy of the benefits I will have. We usually call them every time we fax anything just to make sure they have received them.

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