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Individual deductible is 16% of my annual income and combined family deductible is 32%. No benefits are realized until annual deductible is met, which amounts to having to pay provider's full rate (minus insurance "discount"), so the stated $50 office call runs anywhere from $75-$100, until deductible is met, which at the rate set, it won't. Further, premiums don't count toward deductible (contrary to my experience with other legitimate insurance). Further yet, the so-called prescription drug benefit is non-existent.
According to the carrier's own literature, prescriptions are supposed to be covered at $10/45/60. Yet my FORMULARY asthma medication costs me over $200 retail. When asked why my prescription isn't $10 per fill, I'm told that coverage doesn't go into effect until I meet my individual deductible. So, in effect, I pay around $780/month for a discount plan. Run as far as you can from this plan. You're probably better off going to an exchange under the UN-affordable Care Act (Obamacare). Looking to start/join a class-action lawsuit against BC/BS CareFirst for insurance fraud and file criminal complaint with my state's insurance regulator.
We paid thousands of dollars for nothing until we got smart. They don't even offer dental or vision. They keep changing their plans and keep raising the premiums for less coverage. They even are trying to rip off my mother after she has died. They owe us a refund and I am waiting for them to figure that one out.
VERY SHADY business practices. After 6 months of good coverage, CareFirst decided to change how they processed my kids' necessary specialty asthma medications, without ANY notice. We went from having a monthly $30 copay to owing around $7000 in the last 6 months. After months of calls, where I did got a different answer every time as to what was happening, I was finally informed that these prescription medicines were no longer processed under our drug benefits, but were now considered medical equipment claims.
The medicine still showed up in our drug benefits as a covered prescription with a $30 copay, but only if it was filled at a regular pharmacy. It was always and continues to be a specialty medication that has to be shipped directly to our doctor. Picking it up at a pharmacy was NEVER an option. They claim that our benefits coverage didn't change, just how they define this product, which makes little difference to me. After months of appeals, they did not make any changes and we are out a ridiculous amount of money. This is exactly why people despise insurance companies!
I have been in contact with CareFirst since December of 2017 trying to get claims paid. Every time I call I get a different answer as to why they are not processing. They say call back in 14 days - I do and then they tell me to do something differently. I have over 10,000 dollars in claims pending that are covered underneath my plan. I have been reimbursed a total of 600.00 totals YTD. I am disgusted with everyone I have spoken to at CareFirst. They are not helpful. It is a covered expense which they tell me on every call but then say it isn't processing correctly. I can't do anything about that. The services I am receiving are medically required - again acknowledged by CareFirst. However, they will not pay me back in a timely manner. I have submitted and resubmitted paperwork a total of 10x to them the local plan and the appeals.
So I’m going on vacation for two months and I got authorizations for all of my prescriptions but I have two pain medicines that are very fragile. I guess you would put it these days because they are **. So that means I’m a drug addict because the government says I am LOL. So anyways I go to get my vacation fill on all of my medicine but since I am leaving out of town actually out of the country for two months the day after tomorrow I am filling my medication two days too soon. So they won’t!!! Idiots!
I cancelled the application process on 3/2/18 and received a cancellation statement in my email and was told I would not be charged for the insurance. Yet YESTERDAY they charged me $186.24 for insurance I don't have!!! Not once, but 3 times!!! That's over $550.00!!! I want my money back!!
It takes them 1 week to reply to an email. And when they reply to the email, they make silly mistakes, or don’t do proper homework. It’s been 4 weeks since I sent a basic inquiry, but the people on the other side of the system don’t seem to have any common sense.
After many years with Aetna, which kept dropping previously covered medications and cut my migraine medication to a ridiculous low amount per month, we decided to switch to CareFirst and are very happy; a much better value and service! I'm now also covered for acupuncture.
For the second time in as many invoice periods, I NEVER received my DENTAL invoice by mail or email, but did get a dunning notice (no it didn't go to my spam folder). And yes I went online to pay them. I spent 1/2 hour of my dwindling life trying to get someone to hear me. If this affects my credit in any way, lawyers will be involved! It's open enrollment and there is no chance I use them again. Oh, I do get my MEDICAL invoices from them just fine! CareFirst, just doesn't care...
Do not pay anything if you are Medical Medicare patients. It is to be written off. If you are paying for this insurance get off. Go to another insurance you want and have them get you away from these crooks. Do not allow to pay then be taken for your monies. It defeats the purpose of having coverage here in USA. You need a better insurance if they are billing you and not submitting the proper Authorization form to be seen by a true network provider. Read your manuals. Contact your insurance provider within network dr's.
Do not go to any facility they send you to. I took my mom to a facility thinking they were contracted with her CareFirst and they were not. They only seen SeaSide Adult patients. Go figure. I never heard of this one and I have my experience with billing. These Dr's break off cause of poor monies being funded by the state/government. Dr's are greedy and want, want, want monies daily. IPA's are not good. Find one facility/group that pays well and dr's are there for the patient not your money. Pay for a Dr that truly diagnosis you and truly cares. Pay what you can afford not what dr's are overcharging and billing depts are falsely lying to you about what you are resp for.
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