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Old 09-03-2014, 04:15 PM   #41
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Cobra from Megacorp was $1,058 for two of us and bronze was $735 a month. If you are healthy and not on any long term drug therapies - it makes sense. YMMV
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Old 09-03-2014, 05:09 PM   #42
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Currently in limbo. Retired 8/1 (employer group plan covered us until 8/31), Cobra paperwork generated 8/5, on 8/19 initiated Cobra coverage to be effective 9/1 and was advised bill would come in "about" 1 week. Confirmation of Cobra enrollment paperwork generated 8/20, it also included reference to bill that would be coming and requirements for timely payment.



DW was scheduled for surgery on 9/2. On the afternoon of 8/29 doctor's office advises BCBS IL was not approving procedure. Contacted BCBS IL and was told there was no record of prior non-surgical alternatives so they would not approve. Total BS, as BCBS had been paying for those very non-surgical alternative methods the entire calendar year. Customer rep, and their supervisor both said "there is nothing we can do". To me, that was a red flag indicating something else was amiss. On morning of 9/2 DW contacted doctor's office and insurance situation still not improving. I also contacted ex-employer's benefits department, requested expedited handling of billing, no sorry, can't do that either. Only option to go ahead with surgery was to sign off accepting full responsibility for payment, and then "if" and "when" Cobra insurance payments were acknowledged try to get the insurance company to credit/retroactively reimburse us.

But, I have not even yet received the stinking bill, which I fully intend to pay in a timely manner. Oh, but BCBS did manage to send us cancellation notices received on 9/2. So yes, Cobra provides legal rights to continuation of coverage, but it is obvious to me that the insurance company, in this case BCBS IL has so little concern for patient wellbeing that even though they know Cobra coverage has been elected they will deny approvals for procedures and stonewall the consumer. While I understand there would be legal protection, it hinges on premium payments being made, credited, and acknowledged it a timely manner. Do I trust that process would be as efficient as the mailing of cancellation notices? Absolutely not.

So the net result was to postpone the procedure and wait until things are "sorted out", as Rodi indicated above.

<rant>Thankfully, it is not a life threatening condition, but most certainly does affect quality of life, and what probably frustrates me the most about this is that I did the ER thing to get away from the bureaucratic quagmire. And here I am, still up to my armpits in that same nonsense, just from a different source. </rant>
Interesting that it was BCBS IL. Even though I have Kaiser Permanente - the corporate preferred plans are through BCBS IL - and cobra is handled by HCSC, which is partners/owner/subsidiary of BCBS IL (and BCBS TX and a few others.) So my COBRA paperwork is generated by HCSC, but half of the documenation states BCBS IL. I am not, unfortunately, surprised that they denied the surgery.

As far as my son's prescription. I signed paperwork for the doctors appt saying I would be responsible if the COBRA didn't come through. The pharmacy didn't offer the same thing - after talking to a supervisor I was advised to pay in full, then submit a claim for reimbursement. I did that - and am still waiting for the check. It's been a few weeks, so I should probably follow up. I was not offered the opportunity to sign a form promising payment if cobra didn't come through. The business offices are about 15 miles from the satellite office & pharmacy I was at so there was no one onsite to go talk to.
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Old 09-03-2014, 06:43 PM   #43
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True, but one advantage of being retired is that you have all the time in the world to pester, hound and harass them until they do right by you. Ask me how I know...
I think that's the case for pretty much anyone who wants to elect COBRA, retired or not.

But it's not right for the insurers to act the way they do. They know you probably aren't going to complain to your former employer HR, so you lose a lot of the leverage of being in a group when you go on COBRA.
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Old 09-03-2014, 06:47 PM   #44
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DW was scheduled for surgery on 9/2. On the afternoon of 8/29 doctor's office advises BCBS IL was not approving procedure. Contacted BCBS IL and was told there was no record of prior non-surgical alternatives so they would not approve. Total BS, as BCBS had been paying for those very non-surgical alternative methods the entire calendar year. Customer rep, and their supervisor both said "there is nothing we can do". To me, that was a red flag indicating something else was amiss. On morning of 9/2 DW contacted doctor's office and insurance situation still not improving. I also contacted ex-employer's benefits department, requested expedited handling of billing, no sorry, can't do that either. Only option to go ahead with surgery was to sign off accepting full responsibility for payment, and then "if" and "when" Cobra insurance payments were acknowledged try to get the insurance company to credit/retroactively reimburse us.
Sorry to hear about your ordeal.

Are you saying that the insurance company is requiring you to sign off accepting responsibility for payment, and also requiring payment in full upfront ? That is wrong and illegal.

But IMO, if they are merely requiring signing off and accepting responsibility, but not requiring immediate payment prior to the surgery, that should be fine, and you should proceed. They can bill you and then credit you once you receive the bill for the COBRA premium from your employer, and pay it.
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Old 09-03-2014, 06:51 PM   #45
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As far as my son's prescription. I signed paperwork for the doctors appt saying I would be responsible if the COBRA didn't come through. The pharmacy didn't offer the same thing - after talking to a supervisor I was advised to pay in full, then submit a claim for reimbursement. I did that - and am still waiting for the check. It's been a few weeks, so I should probably follow up. I was not offered the opportunity to sign a form promising payment if cobra didn't come through. The business offices are about 15 miles from the satellite office & pharmacy I was at so there was no one onsite to go talk to.
I hope it wasn't too large of an amount for the prescription.
The meds for myself and my husband add up to about $5,000 per month. I would never pay upfront if on COBRA. Fortunately, Kaiser gives me 100 day supply with one copay, so last time I went on COBRA, I didn't need refills until after the COBRA situation was sorted out.
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Old 09-04-2014, 12:05 AM   #46
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DH was hospitalized with several pulmonary emboli when we were in the 30 day grace period after I left Federal employment and before COBRA began. 3 years later all the bills aren't completely straightened out.


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Old 09-04-2014, 08:40 AM   #47
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......snip......

But it's not right for the insurers to act the way they do. They know you probably aren't going to complain to your former employer HR, so you lose a lot of the leverage of being in a group when you go on COBRA.
My experience was very different. I never contacted benefits department about insurance until I was on COBRA. Megacorp didn't act any different to me as an ex employee. My experience may be the 1 in 1000000.

My COBRA got jacked up, suddenly didn't have coverage, one call to Mega and its fixed. My DW's Medicare refused to pay as they thought she was covered by my expired company benefits. One call to Megacorp benefits and that was fixed. The list goes on. Highly recommend involving your ex employer for issues.
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Old 09-04-2014, 09:35 AM   #48
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<rant>Thankfully, it is not a life threatening condition, but most certainly does affect quality of life, and what probably frustrates me the most about this is that I did the ER thing to get away from the bureaucratic quagmire. And here I am, still up to my armpits in that same nonsense, just from a different source. </rant>
I hear ya. I left on May 9 and was scheduled for a sprint triathlon on May 17. When I didn't get anything on COBRA after a few days I called my previous employer and they told me that it would be handled by a third party company. That company didn't even have the material from them yet. They gave me the same song and dance others got here: just tell them you don't have any coverage but you WILL sign up for COBRA when you get the paperwork and they'll treat you. Don't worry, be happy.

I was paranoid as heck that I'd crash into another bicyclist and end up in the ER and have to hand over every credit card in my wallet to get treated. All went well, I got the paperwork after the triathlon and then we bought a private policy for me and got DH on Medicare. This whole insurance coverage process has been the most stressful part of retiring and I'm a retired actuary so I know the jargon better than the average consumer.

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My DW's Medicare refused to pay as they thought she was covered by my expired company benefits.
Yeah, that happened to us with DH, too. I guess it's nice that Medicare is tracking the existence of other coverage since any other coverage is primary (so they're saving taxpayer dollars) but it would be even nicer if they also got prompt info when that coverage ended.
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Old 09-04-2014, 09:39 AM   #49
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Are you saying that the insurance company is requiring you to sign off accepting responsibility for payment, and also requiring payment in full upfront ? That is wrong and illegal.
Insurance company is saying coverage has expired. Which would technically be correct.

Cobra payment is to be made to 3rd party benefits department of ex-employer, but I have not yet received a bill with remittance instructions so that I can pay it (Cobra coverage was elected 8/19, paperwork confirming that was prepared 8/20). Meanwhile, the clock is ticking on deadlines for payment.
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Old 09-04-2014, 09:48 AM   #50
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I hope it wasn't too large of an amount for the prescription.
The meds for myself and my husband add up to about $5,000 per month. I would never pay upfront if on COBRA. Fortunately, Kaiser gives me 100 day supply with one copay, so last time I went on COBRA, I didn't need refills until after the COBRA situation was sorted out.
Not budget breaking - but still significant. The antibiotics were $168, instead of a $20 copay. I can aborb that - but shouldn't have to.

As far as contacting former employer - that was one of the places I called. And they referred me to the COBRA company they outsource with - HCSC... who are the folks that jacked it up in the first place.

I *think* it's straightened out now. Kaiser sent me new cards (that are exactly like the old cards - same id's.) But I still don't know where my premiums went if they weren't being sent to Kaiser. Health Care Services Corporation was pretty prompt in cashing the payment checks.
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