I was 11 weeks pregnant when I found out that the baby had died. This was and is extremely traumatic for me. I went to get a second opinion and watched in vain as the technician searched for a heart beat on the ultrasound. My doctor prescribed me to come in for a procedure to have the baby removed. My family has a history of complications with bleeding and the baby was large enough that she did not want to risk me having serious complications if I were to "wait it out" at home. So, they called MHBP to get pre-approval. MHBP denied the claim, saying they do not cover abortions.
I called MHBP and explained the situation, that this was a medically necessary procedure and it was not an abortion, but that my baby was already dead. This is really traumatizing to have to say that over and over again. They then told me they would cover the procedure. I called the nurse and asked her to work it out with them and just before the procedure, told the Doctor to please write a letter explaining why the procedure was prescribed, that my baby was dead and this was not an abortion. She did so.
Just now (one week into recovery, which was much easier physically than mentally and emotionally), I called them to ask if they have processed the claim. They told me it has been denied because they do not cover that procedure. I told them I understand they do not cover elective abortion and this was not an abortion. The unfriendly, completely unsympathetic woman on the phone told me that she knows more about insurance than I do and they do not cover that procedure.
I asked what she meant since it was medically necessary. She said, it is billed through internal medicine and "we do not cover that procedure for internal medicine." "Well, do you cover it under some other type of medicine?" She answered that she cannot provide advice.
So, basically, you have an insurance company (I have the Standard option, not a low cost option!) that wants to distance themselves from necessary female health services, especially if it might be ever considered anything related to abortion.
If you have a uterus and are thinking of getting pregnant, think of a different health insurance option, as these people will do everything in their power to get out of covering an assisted miscarriage when you have a dead baby in your womb. Further, I wish this experience on no one. It is incredibly traumatic and immeasurably sad and they are in the business of making money, without one iota of sympathy. Now we have to consider whether we want to even try to get pregnant again, knowing that if we lose the baby, we will be in this fight again. As if there is not enough to worry about.
I concur with the other review concerning routine mammogram insurance coverage. I had a similar experience. They refused to pay in 2013, although it is clearly identified in the plan as being covered. They told me that it needed to have a certain code sent in by the doctor. I pointed out that it did indeed have that particular code. Although it was obvious they had clearly made a mistake, they said they wouldn't pay because too much time had passed. After that, the code changed on the claim to match their story. To be fair, the code did change back again, although it was something they said they had no control over.
NEW LONDON, KENTUCKY -- MHBP has refused to pay benefits for a November 2011 MRI for my son. We went to an "in-network" provider and obtained pre authorization from MHBP prior to the procedure. After the procedure, MHBP denied the claim and indicated that the MRI was not medically necessary. I appealed the decision and submitted 27 pages of charts notes and letters from two of my son's doctors supporting medical necessity for the procedure. MHBP has denied the appeal. They also failed to respond to our appeal within 30 days and failed to provide copies of documents relevant to the denial (the timeline and copies of docs requirements are outlined in the "Plan Brochure").
Almost 60 days after filing the appeal, we have heard absolutely nothing from MHBP. We learned of the appeal denial by obtaining a copy of the denial from our son's provider. This is most egregious of several MHBP claims denials for routine medical procedures or doctor visits. Thankfully, we have switched to another plan (GEHA) and are having no problems with denied claims.
We continue to struggle to get MHBP to pay for 2011 claims involving covered services within-network providers. We would advise anyone purchasing health insurance to avoid this company. Dealing with them is an incredibly frustrating combination. They refuse to follow their own contract (The Plan Brochure) and are incompetent at the same time.
P.O.BOX 8402, KENTUCKY -- After moving to a new town I consulted the website for the Mail Handlers Benefit Plan, Coventry network, to find an in-network physician. I went to see this family physician in October and all was covered. Now, 6 months later, I went back. I consulted the website before making the appointment to make sure he was still covered in-network. Coventry now says that despite this doctor being listed on their approved website, and despite having covered this doctor as in network previously, this doctor is not now, nor ever has been, in-network. They insist that you must call to confirm any information on the website, because it could be outdated.
I'm not sure what the point of having the website is if you cannot actually count on the information being true. I took my daughter to see a different physician listed on their website as in-network. They covered the doctor's visit as in-network, however the blood test they performed and assessed on-site, within their office, was not covered as in-network. Apparently, Coventry says the doctor is okay, but the labs performed and assessed within the same room we saw the doctor, is not in-network.
These people have given me nothing but trouble and it is expensive insurance!!! I suppose $700 per month isn't enough to buy us 3 simple doctor's visits per year for sinus infections.
I just finally canceled Mail Handlers Health Insurance, and then changed my health insurance. I tried repeatedly to advocate for my necessary medical needs, only to be blown off from the Mail Handlers' customer service. Two MHBP providers have turned me over to collection agencies. Mail Handlers refused an MRI on my ruptured disc and then refused to cover a routine mammogram. Both physicians involved told me this should have been covered. I sent in doctor notes, orders, etc, REPEATEDLY. I am very unhappy and am now struggling to pay $750 to the collection agency. This is a crime.