Health Insurance Providers

  • Commercial insurance plans
  • Blue Cross and Blue Shield plans
  • Self-insured plans
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One Response to “Health Insurance Providers”

  1. Shirley Pitman Says:

    I have Medicare Part A,B and D and Supplemental Policies from AARP for Part B and D (the RX program). Understand that Federal Law requires Medicare Providers who accept Assignment mush file for Part A and B if Medicare Manual 2010 on pages 25, 35 and 47 states that Medicare will pay for Inhalants that go into nebulizers..Problem:::I have called Medicare..they say they will pay 80% and my supplement will pay 20 % for Xopenex which I need, medically necessary by physician and will get prior authorization..Problem..no provider will order it for me and file uner Part B, even though they accept assignment..big circle around the tree here…I cann’t substitute albuterol..interferes with my heart condition and totally ineffective for my bronchial asthma..Prescription Solutions, Apria Pharmacy, and a local pharmacy , Ford’s Pharmacy in Spartanburg, S.C. have denied even ordering it for me..will not even try or file the claim..is this not in violation of Federal Law!!!They say “No:” I think they should lose their creditation to provide all Medicare products if they cannot take the Medicare payment on Xopenex (even though they say it costs them money to get it for me) Can’t someone negotiate with the company who sells this drug, Sepracor, to get it for one patient like me, senior citizen with heart by-pass surgery and chronic asthma/bronchitis?????? I need help, and will contact a local television station who likes to help senior citizens and get local publicity on this if I do not get results from people who should be helping me. My doctor’s office has been trying also to solve this problem..but no results. My Part D medications are expensive enough..and I will not pay for this under Part D when it’s to be fully paid by insurance I pay for under Part B. Please Help!!! Simple problem..no solution…I cannot accept this. Shirley Pitman

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