It took Anthem Blue Cross over one month to approve an MRI exam that my knee doctor requested. Apparently, Anthem relies on a 3rd party contractor "AIM" to do the approval job.
Unless you call Anthem and harass them several times, they won't do anything.
In this era of health insurance woes, everyone wants a
dependable insurer that will also continue to underwrite policies for the
foreseeable future to avoid finding a new one.
There are 12 companies that comprise 50% of the market that generate roughly $550 Billion in premiums. Depending upon whether they insure in your state is important factor for what is available. So according to one summary, Anthem.com ranks #3 with a market share of 6.3%. So on that basis, they have the resources to deliver. However, in the context of the Health Insurance Swamp, my experience has been somewhat murky when it comes to speaking to their Claims and Benefits Customer Service which is your lifeline regarding your policy with them.
Like all industries, depending upon who you speak with, it's a coin toss as to whether you're getting correct info. It's just as daunting to get Anthem to be accountable if they advise you incorrectly and you make a decision that ends up costing you more than you bargained for. You might want to get that procedure done that's in your best interest and they tell you it's just a small co-pay only for it to mushroom into a $1000 chunk of your deductible. So, you have to be hyper-vigilant, read some of the boring coverage details and either get things in writing or get a reference number. Beware, though, that if they want to go into denial, things have a tendency to get lost. It's all about their bottom line and if you don't cover your butt, you might feel all jammed up.
So a few pointers, if you have to escalate things or appeal anything, use your cell phone where you will have a record of making a phone call. Anthem is not above lying about whether you actually called them.
Don't depend entirely on your state Insurance Commission to bail you out. They have all they can do to make sure that residents have insurance companies with deep enough pockets to sustain the trauma of dealing with most people that have pre-existing conditions that is the centerpiece of the ACA.
In my opinion, the ACA is positive and helps society. It just needs to be tinkered with and things will get better. While some people might disagree, the Individual Mandate is important in lowering overall costs as they get spread over a higher base of people.
Should you have a sudden unexpected illness, you will be supremely grateful that you're properly insured.
So, keep detailed notes on conversations, who you spoke with, a reference number and anything to back up your version of what was said should you find Anthem crossing the line.
As far as pharmacy benefits, most of that very well defined so Anthem will generally follow through. There are plenty of sites that rank health insurance companies so get reviews about insurance companies, their reviewers, etc.
I've had health insurance with Anthem for a number of years. My impression is that all of their articles about maintaining good health, which is of course important, isn't because they care about the members, but they like all insurance companies, want to pay out as little as possible. Their 'managed health' has the same intent; what can we deny or label medically unnecessary? Sure they have med staff to weigh in on it, but they're just in the role of paper pushers. They have the goal of minimizing what the co will cover. Med staff certainly not making decisions/recommendations because they care about patients' health. I've worked in other insurance cos before and I understand very well the intents of how companies like this restrict their prescription formulary and how they use underwriting. Really, health insurance was a lot more effective before all the ins cos went public. They don't care about the patient; they first care about the Investor.
It keeps telling me to call a person M-F. It is now Saturday. Enough said. Their app is even worse garbage. How can these people make SO MUCH MONEY and yet fail to create a basic functioning website?
This is the worst insurance i ever had..and it cost so much yet it covers hardly anything ..i got this insurance threw my ex job and when the company closed permanently i was still in the states system as active ..so therefore i could not apply for obama care ..until they take me off the system ..which has tooken me weeks to try to talk to someone .and havent had any luck ..
This is the worst insurance my wife and I have ever had !!! It's
over priced and we had to go to the lowest insurance plan to keep insurance at work. The plan we had the last two years was not as good as we had before "hussein care" was forced on the "Real Americans" of this great country by the traitor muslomer in the White House and the Leftist in DC.
They are all about their bottom line. They do not care about their buyers. They owe me one month's premium for not giving me the services I was suppose to get with that premium. This is a failing of most insurance companies, but Anthem is the worst.
I got my Anthem card in the mail with a sticker on it that only says, "Access your online services by registering at anthem.com/register anytime after your coverage begins". Well, I went there, I filled in every page of a multi-page form only to have it give me this error:
Internal Server Error - Read
The server encountered an internal error or misconfiguration and was unable to complete your request.
This was the only thing I saw on the screen after filling in the form. I tried this a whole bunch of times. Then, I looked at the site for ways to contact someone to report this and under Contact / Email, I got a page that said that I couldn't email them. Although it was the weekend, I went to Contact / Phone in case they had a 24/7 number. They had a number, though it didn't say what hours anyone was available. So, I thought "what the heck" and called it.
The phone robot asked me for all the usual information. When I got to my birthdate, it told me to enter the a two digit month, two digit day and four digit year. I did this and it said, "sorry, I didn't catch that," and repeated these instructions. So, I tried several more times. Finally, I just told it my birthdate as name of month, day, year. It accepted that. After going through a bunch of menus and submenus in the phone system, I finally got it to "find an associate to help," and was told that none were available and to call back M-F during business hours.
They could have saved me the time calling by putting these hours next to the phone number on the website.
So, after all's said and done, I've wrangled with this for probably about half an hour and still haven't registered with no way of even reporting the problem.
I can't believe Anthem was so careless with their patients data. Hacked accounts are being hit by phishing attacks. That alone would have me looking for other choices for health care and health insurance.
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