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Old 11-14-2005, 09:25 AM   #1
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sickandconfused HB User
need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

My husband and I are changing health insurances and I need to know ASAP anyone's experience with the two options available to us:

United Health Care PPO (through definity)
Blue Cross Blue Shield PPO

Other than my current HMO (which is horrible), those are the only plans available to us. I need to know this info ASAP about people's experience with their treatment of lyme, i.e. meds, etc etc.... My husband just dropped a bomb on me and told me the change needs to be done by this wednessday morning.

(((( --- removed --- )))))

Thanks so much,
Nancy

Last edited by moderator2; 11-14-2005 at 03:06 PM. Reason: please follow the posting rules

 
Old 11-14-2005, 11:19 AM   #2
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Re: need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

Hi Nancy.

I have Horizon Blue Cross Blue Shield of New Jersey. It's the HMO type of insurance. I pay close to $400 per month for single coverage. In my opinion - they stink!

My LLMD is not in their "plan" so I pay out of pocket for office visits. My prescriptions are 50% covered.

My tests (MRI's, blood tests, etc) are covered, but its like pulling teeth to get the money out of them. I still get bills from tests I had last year. Yikes!

Good luck with the decision!
Mickie

 
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Old 11-14-2005, 01:08 PM   #3
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Re: need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

Hi Nancy,

I wish I could give you advice but I don't have any insurance except for Medicare as I am on disability.

Maybe if you look up both companies on the net you can find the differences?

Let us know what happens as I know these medications, doctor fees, etc. are so expensive.

Denise

 
Old 11-14-2005, 03:26 PM   #4
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Re: need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

I had United Health Care PPO when I got ill with Lyme. Fought with them for payment for almost everything. First year I stayed in network and still spent $4ooo. over what they would pay. I didn't start treatment until second year and stopped counting by then. I wanted to change plans but my husband missed the deadline by two days. We didn't miss it the next year, I made sure of that. I now have a HMO and believe it or not I think it's better.

 
Old 11-14-2005, 03:57 PM   #5
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Re: need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

dIANNE....

WOW!!! Is the united health care though definity??? I am so upset to hear they didn't cover anything!!! Can I ask..... 1) where do you live (insurance plans differ very muchin different areas) and 2) what is your new hmo??

I now have oxford but I am having trouble w/ them w/ covering certain meds and the whole HMO "gate keeper" thing is preventing me from seeing the drs I need!!!

 
Old 11-14-2005, 04:33 PM   #6
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Re: need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

I don't know who the United Health Care was though. When I called them I was calling New Mexico. I have Amerihealth now. Have had no problem with payment for meds. But I do pay for my dr. if I go out of network. I live in Delaware.

 
Old 11-14-2005, 04:37 PM   #7
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Re: need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

thanks Dianne. I am in NY..... hopefully united health care is better plan here. My HMO stinks! Also, I am seeing a therapist to help deal with this horrible disease and mental health coverage with my plan is the worst ever! (even my therapist says so! ;-( My only other options are Oxford (which I have now) and Blue Cross/Blue Shield, which are notably the worst insurances when it comes to lyme! Lucky me, they are 2 of my husband's companies three choices, united health being the 3rd! ;-(

 
Old 11-15-2005, 06:02 AM   #8
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Re: need advice ASAP re: lyme treatment and united health care & blue cross/bshield PPO!!

Just wanted to add that I have United Health Care too (from Wisconsin) and so far have had to fight them tooth and nail for my treatments as well. They put a stop to my IV treatments after only covering two rounds for me, saying that there was no medical evidence showing that more than 4 weeks of IV treatment is effective!! Also as far as labs, doctors visits and specialty visits go, they charge you an arm and a leg if you go out of the "network". And the network size for me in this area is very very small! It was almost impossible to track down a neurologist anywhere close to where I lived in WI that was covered. So it was always very nerve wracking for me to have to worry aout who I was seeing and double checking to make sure they were in network, or having the right labs run my tests...cuz if they didn't then I got stuck with a huge bill. Plus they over charged me a time or two and caused me tons of headaches and time trying to get them all straightened up. Some of the mess took over 5 months to straighten out. And don't even get me started on their customer service, many times I would call up, get one answer from someone, then get a bill, call them back, and have someone else tell me that the first person was wrong and that that dotor wasn't in my network afterall, wasn't approved, or whatever and now I was stuck with the huge bill. All in all, if I had another choice for insurance I would grab it, but since I'm so sick I know that I can't qualify or afford to switch right now. So if I were you I would be very careful about taking up United Health Care with Lymes. Good luck.
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Last edited by Roman77; 11-15-2005 at 06:04 AM.

 
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