Health Insurance Question?

Question

My family's health insurance is issued through my husband's employer. They recently changed our insurance from blue cross to united healthcare beginning Nov. 1. We still have no cards. When I try to print the temp. cards from the website I get an error. I called my husband's employer and the human resource director told me to not go to the dr. and don't have any perscriptions filled until we get the cards because the insurance is bad about reimbursing. I called the insurance company and they couldn't give me any info--they said I had to have my card before they could help me! I'm so ticked off right now and I have 2 drs. appts tomorrow that I simply can't cancel. My question is--is this legal? Isn't there some time frame in which they have to give us the cards?

Thanks in advance!

Answer 1

The cards should have been issued by now. If you are enrolled in the plan, UHC can pull up your info without a card. The HR dept is dragging their feet. How would the HR dept know UHC is bad about paying claims if they just switched? If no other option is available, contact you state insurance department and file a formal complaint.

Answer 2

There is no legal time frame in which to get you the cards, however there is a time fram to get you the cert.
Have any of the others employees been getting their cards?
If yes, make sure your address is correct with your husbands employer. UHC will send the cards out to the address the employer supplied.
If not, if could be due to the fact that the switch was a last minute deal (as in BCBS dragged the feet on the renewal, and came back with high rates, so the company set the group out to bid late, and UHC got in the door at the last minute) the cards may not have been created/issued/mailed yet. So it may not necessarily be their (UHC’s) fault.
However, what the UHC customer service person CAN do for you is to print out a copy of your ID card and fax it to you (or your husband), or straight to your doctors office.
Also, the HR rep should have offered to do the same. If he/she hasn’t yet, THEY should attempt to print a copy of the card for you. Perhaps it is just your comp giving you the error. If they can print it out, they can then fax it to your Dr. for you…
If you do end up paying out of pocket, save your itemized receipts from the dr. and pharmacy (with the CPTand ICD-9 codes, and prices per item/service) and photocopy to submit. Reimbursements could take anywhere from 2 weeks to about 2 month.
Once you get your cards, I bet you will find UHC a great company to be insured by.

Hope this helps.

(a former cust. Service rep, for a TPA, now sales agent, representing a major med carrier (won’t say which) while covered by UHC.)
-A

Answer 3

You are insured whether or not you have the cards...so by all means go to the doctor.

And, what you are hearing is right about UnitedHealth. One of their biggest complaints is about accurate and timely payments. They are a very, very large company with a very, very lean staff and so it is easy to understand how a non-standard case claim can get caught up in a system that is hard to negotiate.

Now....if your husband's employer has more than 50 employees, there's a good chance that they are 'self-insured' and just using BCBS or UHS as an administer of the employer paid health plan.

In that case, the employer (not the adminstrator) is paying the claims and it doesn't matter anyway....

So don't worry about the cards.....just make sure you have your policy number and go to the doctor anyway.

Answer 4

Unfortunately, nobody regulates insurance companies, so they can do pretty much whatever they want. I know of plans taking 3 weeks or so to get the cards to the patients.

Have your husband call the plan. As long as he can provide his SSN, they HAVE to give him the info. Especially since he's the one paying for it. If he has to, have him call every day.

Keep your doctor appointments. Explain to the doctor's offices that you have new insurance and are waiting for the cards. You may have to sign a waiver stating you'll bring the cards within a certain time period, but that's okay. Don't pay up front. Doctors have about 45 days to file claims with United Hc. (If they have internet access at the office, they might be able to get the id# and stuff anyway as long as you can provide your husband's SSN

BUT - this sounds a little fishy to me that the HR person at your husband's job told you not to go to the doctor or get prescriptions filled or anything.... I do know of cases where the employer makes the plan effective on the 15th instead of the 1st of the month to prorate the premiums and save money. (In which case, call the Dept. of Labor in your state and report them. ESPECIALLY if you have the pay stubs documenting that you've been paying for the insurance.)

Answer 5

I feel your pain. Every year my insurance get worse and worse. It costs me more yet my coverage keeps shrinking. My wife is a full blown diabetic with a myriad of health problems. We have BCBS. However, in your situation as long as
you have the insurance and you are minus your cards, just call the insurance company back, get the Group ID number and the policy number and just take that to the doctor with you. If you get your prescriptions filled with the same card usually, (I don't, I have a different card for pills), then after your appointment take that to your pharmacy as well. Make them get up off their lazy azzes and do some research. As long as you have that info you should be OK until your cards arrive.

Answer 6

I don't know about the time frame, but they MUST reimburse you if you were covered during that time period. If you do go to the doctor tomorrow I would explain your situation and they might let you not pay this time and then when you get your card then they can submit the bill to the ins company. If it is a doctor you've been to before I'm sure they will help you out. Sorry and I hope you get your cards soon.

Answer 7

Ask the Human resource person for the "Brokers" number call her/him up and get your card. It is the job of the Insurance broker to help you with these issues. I am a health insurance broker who helps my clients obtain cards, especially with a transition from one carrier to another. When employers use brokers, they should make sure the brokerage is available to all employees seven days a week, and any good brokerage is open till 10pm everyday of the year, as mine has been since 1991. If any of my clients have a question on thanksgiving day, (needs to go to a hospital and does not have a card) I am open!
www.HSAInside.com

Answer 8

I don't know where you are located, but if you continue to have problems with your health insurer, you can contact your local Department of Insurance. Any insurance company operating in a US state must be licensed through the state's Department of Insurance. You can find your state's website through www.naic.org

And yes -- insurance companies are regulated. However, whether there are regulations governing the time period in which they must have provided you with a insurance card, I don't know.

Answer 9

Sounds fishy to me!! Can you print the coverage screen from the website as "print screen" instead of printing temporary insurance cards??