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Misinformed by emp. of BC/BS, BC/BS says written contract trumps employee advice

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georgiarob

Junior Member
What is the name of your state?What is the name of your state? Georgia

Please help. My wife is pregnant and the baby was lying transverse, which would have meant a definite c-section, which we wanted to avoid. We found out about an acupuncture procedure called moxibustion which has an 80% success rate. We both called up Blue Cross Blue Shield separately and we were each told that we were covered for 75% of out of plan expenses provided we went to an MD acupuncturist. We did just that and submitted the bills. Turns out that the bills were subject to our $500 deductible. I called up to complain and ask for payment, but was told that even though (after reviewing the phone calls) we were not told about the deductible, our written plan says that using outside providers subjects those bills to the deductible and the written plan trumps the employees advice. Ughhhhh!!! Is there anything we can do? Do we have any recourse to a state or federal agency? Please help. I desperately need advice ASAP. Thank you.
 


purple2

Member
You don't have any recourse, sorry. Your insurance policy is a contract. It's legal for the insurer to follow the contract.
 

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