Insurance Expert Talks
Don't get your shingles vaccination before your 60th birthday.
I have 2 regular appointments a year. I went to the doctor on June 18 and because several friends of mine had had shingles recently the vaccine was on my mind. Since my 60th birthday was in 3 weeks (July 6), I figured it would be okay to get it while I was at the doctor's office. Highmark has denied the charge even after I appealed because I wasn't 60 yet. Also you would have thought the doctor would know this. The original charge on the claim was $285. After the appeal, they are now saying I am responsible for $385. It's a shame they can't be bothered to take special circumstances into account.
Reason of review
Problems with payment
Worst possible experience from day one!
It all started at healthcare.gov. I submitted the application for health insurance coverage for myself my wife and my two children. That went fairly smooth I discovered that I would receive a descent tax break and selected the insurance for my family. Two weeks later I recieved my insurance cards in the mail. They were labeled highmark Delaware. One problem I live in Pennsylvania. So I called and asked about the cards and was told they were not valid and that I would receive the correct cards in a few days. One week later I received my new cards and this time they were labeled highmark dental. I didn't think to much of it at the time. But I should have called about it because it came back to *** me at the worst possible time. Meanwhile I received an invoice from highmark on 1/13/14 stating that a payment was due no later than 1/14/14 or there will be an interruption in my insurance. So I submitted an electronic payment with my bank card knowing that it takes at least three days for the payment to clear. Two days later I came down with pneumonia after having the flu. And sure enough there was an interruption in my service. I found this out when highmark refused payment for antibiotics at my pharmacy. After seven different phone calls and four hours of phone time they realized the payment was recieved and that I also received the wrong cards again. So I was told I could print cards off the website. Wrong!!! The website still hasn't recognized that I made a payment so I could not access my cards. Once again I called highmark and another hour later the majority of this time on hold and being transferred just to repeat basic information name number address which is really annoying when you have to do this three times in one phone call. Just to be told the system hasn't updated try again tomorrow. I did and sure enough I got access to my cards only to be surprised that only my wife and I have cards and my kids don't. *** with it I'm sick I'll go to the pharmacy get my meds and deal with it later. Oh, and my copays on my correct cards are $0 on the junk cards they sent me the last time they were $20 and up. So now I have to try to sort this mess out with the doctor and hospital and try to get my money back. Anyway I went to my pharmacy feeling fairly confident that this mess with my coverage will be straightened out. Nope. Once again another kick in the balls. The pharmacy said it still will not go through so they called highmark and an hour later highmark realized they had my birth date wrong and was finally given my meds and was told they would make the correction in their system. So back to my kids not having coverage. I called highmark and explained tbe situation and was to someone from healthcare.gov who told me my kids have their insurance through chip even though I specifically applied for coverage for highmark and did not fill out an application for chip. Which I am still having issues with. And tonight my wife couldn't get her prescription filled! !!! So I called highmark to find out they also had my wifes birthday wrong and they still didn't correct mine. All I can say is *** highmark and pull your heads out of your ***!
Princeton, New Jersey
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