Re: Insurance & Employer - Kristy

[Guest guest]

Kristy Sokoloski wrote: >>>>>>>>>>The employer has no impact on what the insurance carrier decidesto put in their plan. I know this about the employer issue because with my mom's if I have a complaint about something I have to go to the insurancecompany first and then after so many times I can get theminvolved to help with appealing. Kristy Kristy, the Employer can have a say in what is covered. I'll give you an example. When I was 8 months pregnant with my first son, I found out the hospital I was to deliver at was not in my Network anymore (changed on me during pregnancy)! As you can imagine, one month before delivery...I flipped out...and cried my eyes out. My doc was still in

network...but like it really mattered if I was going to be stuck with a huge hospital bill. My husband spoke with the head of Human Resources at his Employer...she called the Insurance and told them to cover me as if that hospital was still in Network! I also got my epidural paid for by calling and making some 'noise' (determined, but in a polite way)..... *grin* I had another situation as well, we called Human Resources again, and they contacted the Insurance and told them to cover my birth control pills. I was taking them for Endo and not for actual bc reasons....I pointed out that I thought they should be covered when used for a medical condition, and HR worked it out, they were covered! Ladies, if your Insurance denies coverage on Compounded meds or for other reasons, contact the Human Resources Dept. of your Employer and get them involved, that is what they are there

for. It may not work, but it is definitely worth a try. It can potentially save you some money! Kristy, how is your mom doing? Are they giving her a good prognosis about the breast cancer? Take care, ~Chelle