Switching from Commercial to Medicaid is causing glitches in treatment and coverage. How can we navigate this?
We’re facing a frustrating situation with my girlfriend’s insurance. She qualified for Medicaid (Horizon NJ Family Care) as of June 1st. We received a letter from her commercial insurance, BCBS, saying they would remove her from her father's plan since it’s not eligible to have two insurances. This worried us, but we decided to stick with Medicaid as her primary coverage. We even confirmed with BCBS that her policy would be canceled by July 31st.
With that in mind, we scheduled all her doctor’s appointments for August, using her Medicaid NJ Family Care card for visits and prescriptions.
However, yesterday we got a call from her physical therapy office saying they tried to bill Medicaid, but were told to bill BCBS instead because it’s still listed as the primary insurance. They mentioned a $400 copay, which shocked us since we thought BCBS coverage had ended.
Now, we’ve begun the process to cancel BCBS, with the coverage ending officially on August 31st. We’re also working with Get Covered NJ to retroactively remove BCBS coverage starting from July 1st. But the problem is, as of now, BCBS is still listed as her primary insurance in the system, and we’re worried about complications from using her Medicaid card for previous appointments and prescriptions where BCBS might still be billed.
We’re concerned about potential billing headaches and the possibility that BCBS could deny the retroactive cancellation, especially since we tried to use the Medicaid card, and its entirely possible that doctors just skipped over it and billed BCBS without informing us, because they were instructed to do that by NJ Family Care.
We even had to push back a crucial IV saline infusion scheduled for tomorrow as well as this PT visit to avoid any administrative issues, delaying much-needed treatment by two weeks.
Did we do the right thing? Should we not have worried this much? My head is about to explode because I've spent 8+ Hours on the phone between multiple providers, get covered nj, BCBS, and Horizon NJ Family Care the last two days and it's mind numbing. I do not have faith that things will work out, because there is a track record of things not working out for us…
submitted by /u/Chrisgpresents
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