Tuesday, June 23, 2015

Generous Carrier Tricks

Our on-going Stupid Carrier Tricks series is generally over-represented, so it's nice to be able to add one on the positive side. Medblogger Lisa Emrich daily chronicles her thoughts and strategies as she battles MS; she also reports significant events on Facebook, where she recently posted this:

"Some readers doubted my description of an insurance company who pays much more than hospital charges for an infusion. See details from the EOB."

Turns out, her Grandfathered health insurance plan (from Carefirst BCBS) allows for very generous benefits, especially when it comes to treating her MS.

How generous, you ask?

This generous:

That's right, they actually allow a greater amount than what her provider ended up charging her, and this was in turn reflected in her balance due. And, of course, the amount she pays in co-insurance helps reduce the balance for the rest of the year.

Reason I mentioned her Grandfathered status is that this plays a role in the overall scheme of things. Lisa tells me that "I absolutely appreciate the 10% coinsurance which is why I've kept this grandfathered plan. After Carefirst processes the 2nd infusion (in June), I will have fulfilled my max OOP (for medical) for the year." Nice.

Bottom line: it's nice to know that some carriers really do try to help out their insureds whenever possible. Chalk one up for the good guys.
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