Obamacare/Trumpcare Horror Stories

[Jay]

Maybe the breach occurred before you were a customer?

[Tank]

Maybe the breach occurred before you were a customer?

 

no way. look at the steady stream of bad luck, frustrations, and foul ups fan_since has had since signing up.

[fan_since79]

Maybe the breach occurred before you were a customer?

I've been with them since 2004. The breach occurred just a few months ago.

[Jay]

Oh, I thought you recently signed up through Obamacare.

[fan_since79]

Oh, I thought you recently signed up through Obamacare.

 

Well, I did, in late 2013, but I was with Anthem long before that. They have had my personal information since 2004, and the breach occurred in January, 2015. I had a conventional policy with them starting in 2004, and then an Obamacare policy with them starting in 2014. I still have that policy.

 

By the way, all current AND former Anthem Blue Cross customers' data was stolen. That's about 80 million people.

[mp170.6]

You guys will enjoy this...

 

A relative of mine died recently.   His (secondary) BCBS insurance won't tell us if they pay Medicare deductibles because they consider it "Protected Health Information" under HIPAA even though the deductible question was not patient specific; it applies to tens of thousands of people retired from Boeing.  I asked if they were kidding and they said no.  A manager took the same stance.  Some clown in their Legal Department suggested we look all over his house for the completed forms (they aren't there).  He then suggested we hire a lawyer to call BCBS on the phone and ask the question on our behalf.  Ridiculous.

 

His final suggestion couldn't have been any more stupid.  He asked if there were any Boeing retiree clubs nearby.  I said, what???  "Yeah, maybe you could find another retiree with the same group number on their insurance card.  Have them call us and ask about the deductible.  They could pass the information on to you."

[Tank]

i will not be surprised if we get to heaven and find out there aren't any people there from insurance companies.

 

 

 

 

*apologies to nate

[nate]

You guys will enjoy this...

 

A relative of mine died recently.   His (secondary) BCBS insurance won't tell us if they pay Medicare deductibles because they consider it "Protected Health Information" under HIPAA even though the deductible question was not patient specific; it applies to tens of thousands of people retired from Boeing.  I asked if they were kidding and they said no.  A manager took the same stance.  Some clown in their Legal Department suggested we look all over his house for the completed forms (they aren't there).  He then suggested we hire a lawyer to call BCBS on the phone and ask the question on our behalf.  Ridiculous.

 

His final suggestion couldn't have been any more stupid.  He asked if there were any Boeing retiree clubs nearby.  I said, what???  "Yeah, maybe you could find another retiree with the same group number on their insurance card.  Have them call us and ask about the deductible.  They could pass the information on to you."

 

It is policy specific and depends on a ton of variables.  They cannot give that information out without validating that you are the member or someone authorized on the plan (which is required at the point of sign up).  That is why they suggested the lawyer do it.  The insurance company isn't to blame, they are just following HIPAA.

[mp170.6]

HIPAA doesn't prohibit the release of billing information to a family member, or even a friend, to pay final bills for a deceased person. 

 

Nobody has been able to articulate why deductible amounts common to thousands and thousands of people is protected health information.  For all they know, I could be a person looking to change health insurance and wanting to know what is covered under the plan.

[nate]

It doesn't matter, they have to look up that person's plan in their system using PHI and they cannot do that unless they speak to someone authorized to do so.  So yes, HIPAA does protect that.  Not to mention they will send bills and EOBs to the address they have on file.

 

And no, deductible amounts are not common, all plans are different and the amount of claims already paid to the deductible count toward it.  You honestly have no idea what you are talking about.

[mp170.6]

It doesn't matter, they have to look up that person's plan in their system using PHI and they cannot do that unless they speak to someone authorized to do so.  So yes, HIPAA does protect that.  Not to mention they will send bills and EOBs to the address they have on file.

 

And no, deductible amounts are not common, all plans are different and the amount of claims already paid to the deductible count toward it.  You honestly have no idea what you are talking about.

 

Why aren't you familiar with HIPAA laws, Nate?  I thought you worked for an insurance company.  You really have no excuse...

 

45 CFR 164.510

 

( a) Standard: Uses and disclosures for involvement in the individual's care and notification purposes—(1) Permitted uses and disclosures. (i) A covered entity may, in accordance with paragraphs ( b(2), ( b(3), or ( b(5) of this section, disclose to a family member, other relative, or a close personal friend of the individual, or any other person identified by the individual, the protected health information directly relevant to such person's involvement with the individual's health care or payment related to the individual's health care.

 

 

This is paragraph ( b(5) cited above:

 

(5) Uses and disclosures when the individual is deceased. If the individual is deceased, a covered entity may disclose to a family member, or other persons identified in paragraph ( b(1) of this section who were involved in the individual's care or payment for health care prior to the individual's death, protected health information of the individual that is relevant to such person's involvement, unless doing so is inconsistent with any prior expressed preference of the individual that is known to the covered entity.

Edited May 7, 2015 by mp170.6

[Lou]

were you involved in the care or payment for health care prior to your relative's death?

Edited May 7, 2015 by Lou

[mp170.6]

were you involved in the care or payment for health care prior to your relative's death?

 

Yes.  I had been for the past 15 years.

[HaloMagic]

So you're saying that when nate said "they cannot do that unless they speak to someone authorized to do so" you could have simply responded with "I am authorized to do so as I've been involved with the care or payment prior to my relatives death" instead of being a dickface about it?

[nate]

They can only do it if the family member is listed on their insurance forms as an alternate contact.  You still can't just call in say you are their relative and get authorized.  You still have to be in their system.

[mp170.6]

They can only do it if the family member is listed on their insurance forms as an alternate contact.  You still can't just call in say you are their relative and get authorized.  You still have to be in their system.

 

They told me he needed to have completed the forms before he died, even though the HIPAA law doesn't require it. 

 

Kind of beside the point anyway because the question about whether the plan pays Medicare Part A deductibles is not a PHI question.  Boeing agrees with me and is trying to find out. 

[Vegas Halo Fan]

A relative of mine died recently.   His (secondary) BCBS insurance won't tell us if they pay Medicare deductibles because they consider it "Protected Health Information" under HIPAA even though the deductible question was not patient specific; it applies to tens of thousands of people retired from Boeing.  I asked if they were kidding and they said no.  A manager took the same stance.  Some clown in their Legal Department suggested we look all over his house for the completed forms (they aren't there).  He then suggested we hire a lawyer to call BCBS on the phone and ask the question on our behalf.  Ridiculous.

 

A lot of companies try to hide behind HIPAA to prevent having to give out information, even when you ask general policy questions. Working in health care I am intimately familiar with HIPAA and what it does and does not permit. My disdain for health insurance companies is pretty widely known, and this is just another example of why I detest them.

[fan_since79]

Blue Cross and Blue Shield of New Mexico are seeking premium hikes averaging 51.6% for 2016.

 

'Affordable' Care Act. Hah!

 

http://www.abqjournal.com/591023/abqnewsseeker/blue-cross-seeking-51-percent-premium-hike.html

[fan_since79]

Blue Cross and Blue Shield in North Carolina want premium hikes of 26%, and Illinois and Florida insurers are requesting 20% or more.

 

http://hosted.ap.org/dynamic/stories/U/US_HEALTH_INSURANCE_2016_PRICES?SITE=MYPSP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2015-06-01-22-53-02

[Adam]

I thought all of this free universal health was gonna put Nate out of job. 

[gotbeer]

My Wife's Losing Her Obamacare Coverage Because The Insurer Lost $400 Million

[nate]

She didn't lose her coverage overall, she just lost her coverage with BCBS.

[fan_since79]

Just got my renewal notice from Anthem on Friday. Premium will go up 10% and the deductible was raised. Some co-pays are higher too.

 

All in all, it could have been worse. At least the premium quoted is good for a whole year.

[HaloFan85]

Thanks Obama!

 

http://www.zerohedge.com/news/2015-09-29/stunning-explanation-insurance-company-just-used-boost-health-premiums-60

 

 

 

 

[nate]

That is fake or old.  Under Obamacare/Health Care Reform premiums can only increase once a year on Jan 1st.