private duty nurse

[TPNki]

What is the name of your state?ok
I have BCBS federal employee health insurance. They wording in the summary of benifits in plan book says that I only have 25 nursing visits at only 2 hours at a time. I need private duty nursing, but they refuse to pay for private duty nursing. I have found no wording that says the don't pay for private duty nursing. It does say that they will not pay for nursing if its used for comfort of family.

I am on IVs 24 hours a day.

Thank you,
JAW

 

[JETX]

From your post, it appears that your 24 hour nurse is not included in your policy.
What did the insurance benefits agent say when you asked them??

 

[TPNki]

I was told that 24 hour nursing wasn't provided, but they wont tell me exactly where it states that private duty nursing is not covered. It says nothing about private duty nursing not being provided, or PDN not being provided. I have a federal insurance, so states insurance dont apply to my situation.

Thanks,
JAW

 

[JETX]

A policy doesn't have to describe everything that is NOT covered, only those services that ARE covered. And if the services you are looking for are not listed, don't assume that they are included.