CLEVELAND, OHIO -- We also have had a terrible time with Anthem Senior Advantage failing to cover my husband's doctor visits and labs dating back to 09/07/07. After multiple phone conversations and being told of different requirements, we finally phoned the broker through which we signed up for the coverage. He has contacted Anthem but as of 03/12/08, the claims have not yet been paid. My husband had health coverage with a different company through my employer for a short time, but that coverage was canceled on 06/30/07 when I became eligible for Medicare.
Anthem's Coordination of Benefits Department has not responded to its Customer Service Department's requests to eradicate duplicate coverage and until it does so, our claims will be refused. My husband also is paying for his Anthem Medicare premiums through deductions from his social security for Part B, so Anthem is receiving its payment, plus my husband has paid all his co-pays, but we are still struggling with the company to get the claims paid. I understand that providers need to be paid timely, but the fact is that the providers all agreed to accept Anthem's payments, so I feel we are being harassed by providers phoning and sending bills requesting that we deal with Anthem and clear up this matter.
Dealing with this situation has taken literally HOURS of phone calls, all of which are documented in Anthem's computer system, but which so far have yielded zero results. Today we went to pick up prescriptions, and one that my husband paid $30 for last month jumped to $221.00, so now I must phone Anthem yet again and ask what is the reason for the sudden increase; in essence, Anthem is not covering any part of the cost of that particular prescription. The prescription coverage limit has not been met, but we believe Anthem is unhappy with our complaints and is refusing to cover the aforementioned medication.
Thank you for letting me vent!
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Posted by Long Sam on 09/11/2009
In going to the pharmacy today I was shocked to see that Librax cost has jumped to $200.00. I take it because I was diagnosed with Lymphocytic Colitis. This is what the doctor has prescribed for me and it does work. How do you expect seniors to pay for their meds if they are going to charge that amount for a prescription. It is absolutely absurd. I have always been very happy with my coverage but this is really a terrible blow. Can't even get the meds you require. It is a sad day.