Re: How do I appeal BCBS Application Denial
I'm going through an appeal with BCBS over denying my application. I started my appeal on 5/9 and am still waiting to hear a response.
My rejection was over incomplete or inaccurate medical records, too. I physically brought them the "full" medical chart from my doctor, and my husband's doctor has amended one of his office notes that was made in error -- which I physically picked up and brought to BCBS.
I've talked to a broker about this. This has basically forced my hubby and I to use his employer's plan which is eating up most of DH's paycheck, because we don't want a lapse in coverage. Here in FL, it's 30 days, not 60 or 90. The broker says all the big insurance companies are notorious for doing this on individual policies. She said it helps the insurance industry as a whole to reject when possible. I've reached the point in time where it's going to be necessary to file a complaint with my state's insurance regulation office over this. BCBS assured me I'd have an answer within 21 business days -- from May 9th. It's June, what, 22nd now?
And COBRA here is a fortune! Here were our options:
COBRA at $872 a month for covering DH & I with a kick-butt good PPO plan from BCBS (we're mid-30s and a clean bill of health). Mind you, the employer that had this insurance paid most of it. It cost us $150 per month at the time DH was employed with this company before being laid off.
DH's new employer's BCBS HMO at $700 and change for the two of us. Really bad plan, IMO. I need a referral for everything, everyone needs to be in the "network," and anything medical needs to be preapproved by an adjuster. Scary;
Finally, the individual plan for DH & I through BCBS at $404 per month, PPO, decent plan, but nothing preexisting would be covered, no matter about a lapse in coverage or not. Preexisting is simply not covered for a two-year time period. After the two years are up and IF DH & I had not been treated for "the" condition, then we could reapply for a whole new policy to cover those things. We were rejected for this policy because of the paperwork screwup. Now I just want the appeal to go through and the rejection off our record.
Good luck with this. I wish I'd never called BCBS for a quote.
Last edited by StenoLady1; 06-22-2007 at 06:09 AM.