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I have not been able to sleep in my bed for over a month, I use a cane to walk & I trip & fall with the numbness. I have pack pain, leg pain & hip pain. I have had 3 spinal surgeries & degenerative disc disease. My last x-ray showed that the disc is completely gone & the other are almost gone. I have been to the emergency room & Blue Cross still says that my MRI is not medically necessary. I only get 2-4 hours of sleep a night because the pain wakes me up. I think I have to sue Blue Cross when I fall & break my hip next.
Have returned to Highmark again, as their customer service is wonderful. Paying $13 a month is reasonable for a Medicare supplement. Doctor choices are excellent; as are pharmacy options. Convenient local office.
I've always had good experience with Highmark. Customer service is friendly and knowledgeable. Health coaching outreach was appreciated. Wide selection of consumer tools to support informed decisions.
My father had a stroke and we are supposed to have 100 days of coverage in a skilled nursing facility. They stopped payment on both the skilled nursing facility AND his physical therapy after only 20 some days. Heartless.
We have a recurring policy with them and my wife had two hand surgeries. One in Oct 2018 which was mostly covered. In November I removed one dependent from the policy and it send them into a tailspin. They charged $200 more than the monthly premium and the after numerous calls reduced the premium to 4 times the original premium. Before I made the change I called and asked if her upcoming second hand surgery would be covered. They said yes, however every time you call this place you get a new rep and have start all over again. Well the Dec 2018 was not covered and applied to a new deductible and not out pocket similar to the surgery in October.
Seven calls were made when it was finally escalated to an investigative unit who finally told me they would not cover it and I am responsible for the entire bill. They will not connect me to this department as they claim they do not have extensions. Stay away from these people if you possibly can as they don't give a damn about their policyholders and can't explain reasoning as to why the second surgery was not covered.
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My husband is required to get insurance for his job, and my job mandates Highmark. Since we have to have two insurances, we just buy the catastrophic plan for my husband's which is the cheapest. They rarely cover anything, but since his birthday is earlier in the year, they are supposed to be primary and Highmark is secondary. Long story short, I have spent countless hours trying to get Highmark to provide maintenance of benefits. Many, many phone calls. Eventually, I learned that the most effective way is to go through their message center and send the EOB from the other company. This is ridiculous because the other insurance is also affiliated with Blue Cross. Even when I do this, sometimes it takes several attempts to get the maintenance of benefits to be provided.
My husband and I have excellent credit, and I am terrified that our credit rating will be harmed because we are not paying bills that we should not have to pay for. I don't understand why they will not just put a note on our account to provide the maintenance of benefits. There are also services which are surprisingly not covered, such as newborn care when my son was born in the hospital -- ordinary birth expenses. If I could go with another company, I would.
I've tried phone calls, chats and working with my internal Admin of our account. I never received my reimbursements.The first request was in mid September. I was then told that I would receive a check on 9/25. They have sent me numerous false statements showing that I was reimbursed. I have called the 1-800 number on four different occasions. They keep hanging up on me with no solution. I tried chat and they disconnect my chat line. I was told they would finally reimburse me via direct deposit this week. Still nothing. The first excuse was the person in the office that works on that is gone. The second excuse was their computers are broken. Still no detail provided to me on my dollars owed. No money reimbursement provided. The last person Susan ** told me to call Lindsay and have a Happy Thanksgiving. Gee thanks.
I have been suffering from pain and numbness since Feb 3. I have had an X-ray and nerve tests, still no diagnosis. My Dr wrote a referral for an MRI. They denied it stating I needed proof of pt or chiropractor for last 6 weeks. Highmark has been paying for both since February so why do they need to prolong my pain and suffering while I get a letter from my chiro that what they have been getting paid for since February really happened. What a bunch of jerks! Wish I had UPMC!
I sprained my ankle almost 3 months ago. Had several x-ray which came back normal. I have been in extreme pain with my foot. Tried several different braces with no relief. With severe swelling and ankle and foot pain how can an insurance company do this for insurance that I pay for? I have exhausted all avenue on my own. My attorney with be contacting you regarding this matter. This is going to turn into much more than a rejection of a MRI. Because you have a bunch of idiots working in your authorization department. I do authorizations at my job. I work with NaviNet. I know.
Having had shingles already at 53 I spoke with my doctor and he wants me to have the vaccine as once you have shingles you are at higher risk to get again. I had no idea you could get again and that is not something I ever want again. My immunity was for a few years so now I need to get the vaccine. I cannot get it covered since I am not 60. Even with my doctor's orders, NO... Our contract says 60 and we make the rules. No way to argue the point, ask for a variance, nothing... So where do you complain? I asked what options I had to try and get this covered. The options given by Susan at the Highmark - supervisor - was have the vaccine and pay for it. That is an option that you have. When you are denied coverage you can appeal, however the contract says 60 so it will not be covered. No way to formally request any variances in insurance. Does not seem like the way it has always been.
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