F
fair is fair
Guest
I am in NC, but my Corporate office is in Va. The insurance offered by the company is great for the Va. employees, but it's Optima, which no one in NC has even heard of. For instance, there is only 1 OBGYN office in our directory of preferred providers! There is NO hospital. It's called Surgicare, and when I dial the phone number listed, I get a recording telling me to call 911 if I need assistance. Not very reassuring.
If I were in Va. I would have my choice of hospitals and many doctors to choose from. No deductible. I would have no % co-pay and a $15 payment for a doctor's visit.
For me to go to my doctor I had a $300 deductible and 80/20 copay. I did not know this, as I never got a schedule of benefits until AFTER I went to the doctor. My insurance card says "out of area plan" and $15 doctor visit co-pay on it. My doctor's office charged me $15, but now the insurance has refused the claim. Corporate has told me that they do not feel responsible for my not knowing the benefits even though I never got a booklet until after 7 months of coverage! They do not feel the need to reimburse my deductible because they say my doctor's office should have told me.
When I complained about the insurance to Corporate, I was told that they would take the monthly amount they spend toward each employee's insurance and apply it to the insurance of our choice. Great, except that small group plans (there areonly 4 of us in this NC office) cost a minimum of $270 per month, putting me out of pocket about $100 more a month for insurance, which I can't afford.
Is it legal for them to have insurance that is so good for some employees and so poor for others? What options do I have here?
All I want is comparable coverage for ALL of us regardless of what state we live in. It isn't fair for Va. employees to have better insurance than we do. It's like they make more money just to live in Va. Someone help? I like my job but this is starting to be a real problem.
If I were in Va. I would have my choice of hospitals and many doctors to choose from. No deductible. I would have no % co-pay and a $15 payment for a doctor's visit.
For me to go to my doctor I had a $300 deductible and 80/20 copay. I did not know this, as I never got a schedule of benefits until AFTER I went to the doctor. My insurance card says "out of area plan" and $15 doctor visit co-pay on it. My doctor's office charged me $15, but now the insurance has refused the claim. Corporate has told me that they do not feel responsible for my not knowing the benefits even though I never got a booklet until after 7 months of coverage! They do not feel the need to reimburse my deductible because they say my doctor's office should have told me.
When I complained about the insurance to Corporate, I was told that they would take the monthly amount they spend toward each employee's insurance and apply it to the insurance of our choice. Great, except that small group plans (there areonly 4 of us in this NC office) cost a minimum of $270 per month, putting me out of pocket about $100 more a month for insurance, which I can't afford.
Is it legal for them to have insurance that is so good for some employees and so poor for others? What options do I have here?
All I want is comparable coverage for ALL of us regardless of what state we live in. It isn't fair for Va. employees to have better insurance than we do. It's like they make more money just to live in Va. Someone help? I like my job but this is starting to be a real problem.