Hello, Quick question for the group. We live in Florida and are considering changing our Health insurance from Aetna to Blue Cross. Does anyone have experience with IVIG and or home health visits with Florida Blue? (We are looking at a Platinum Plan) Thanks in advance for the help
Hi, I wanted to let you know that we changed insurances at the beginning of the year, from Aetna to Anthem Blue Cross Blue Shield. I get IVIG and Home health visits as well. I get a nurse and an aide. In the beginning nothing changed. CSI delivered my medication and my home health came but then I received a letter from Anthem (Blue Cross blue Shield). The company whom was billing for my services were either billing incorrectly or BC/BC had different coding for billing. My letters stated that I needed to send in a whole medical file to receive a crown on my tooth (What?!). After another letter came stating the same thing, I called the company billing and they stated they would look into it. After that the problem was resolved because I had to call bc/bs myself. They fixed the problem on their end because they were making a mistake. Another issue I noticed that was different with bc/bs was getting admitted to the hospital I had to have authorization first while I never had the problem with Aetna. My medication was also a problem. The co-pays on certain medications went up. My cymbalta, I use for nerve pain, for 1 month, was a co-pay of 500. We couldn't afford that. Every item has to have an authorization, I feel like, while Aetna was just easy for us. Please read up on all the items your family needs prior to deciding on an insurance. If we had a choice we would have stayed with Aetna but company changed and that means we change too. Good Luck to you!
Rick, I mistakenly posted this reply in the wrong discussion section of this website.
FYI, I have had an employee-sponsored BlueCross/Blue Shield insurance plan for more than 30 years. It is the most expensive plan offered by my employer, so it may be similar to a platinum plan. For more than 15 years, the plan has been covering my IVIG infusions, which I receive at home in New Jersey. Initially, I was reimbursed by New Jersey BlueCross/BlueShield. However, about five years ago, my reimbursements began coming from Florida Blue Cross Blue Shield (the provider of the medicine was located in Florida). One thing that I've noticed is that Florida Blue Cross/Blue Shield was prompter in processing my insurance claims and created less red tape than New Jersey Blue Cross/Blue Shield. However, this year my insurance plan made it economically impossible to continue using the Florida provider (which I used for about 15 years). This year, I need to use the "Specialty Pharmacy Program" contractor, which is CVS Caremark. This costs me $40 for each 30 day supply of IVIG, regardless of how much I use in a 30 day period.
While this information may not be entirely relevant to the platinum plan you are considering, it may give you some ideas to consider.