I have had Anthem for just over a year. I paid $1,200 a year for the first year, my premiums just raised to $1,500 a year. My deductible is $750 for things that are not covered, they will cover these items after the deductible is met. I first used my insurance to schedule an annual (female) exam. This was listed as a covered expense. My first explanation of benefits came, and showed I should owe $0.
I received a few back-and-forth that they were requesting additional information from the provider, but that things were still covered. A couple months later the doctor called asking if I could call my insurance, that they had sent all the information the insurance requested, but that the insurance was no longer giving them any information. They would call and get no more information than "it's under review."
The doctor informed me my insurance was trying to deny the claim for "pre-existing condition." To what, was my pre-existing condition?? Being a female and thus, having an annual exam every year? Is just being human then, a "pre-existing condition" to having anything a doctors office could charge for? Long story short, after much battle, the office charged me the full amount of the bill, over $500.
Additionally, the lab they went through also charged $250 since my insurance denied that too. How on earth can they say an annual female exam is covered? Best part, since they drug their feet into the next year, I asked Anthem if it would go towards my 2012 deductible since I was just NOW being billed the amount. No, they said, because the visit occured in 2011. Had I had no insurance and paid in cash, I would have spared myself the grief (and gotten a cash discount) and saved $1200 for a year.
Now, I am being charged for six chiropractic visits from last year and this year. My insurance says they cover three per year, then all visits afterwards would apply to the deductible before being covered. Had I instead paid in cash for these six visits, it would have been $65 each, or I also had the choice if I wanted to pay to go towards my deductible - $75 each.
I paid my $35 co-pay each time - opting to have my insurance pay for their "three covered visits" per year. I now owe $618.00 for those "covered visits." The irony being, had I not tried to use my insurance, the bill at the most would have been $450, and in reality I would owe only $240 of that for the subtraction of each deductible I paid. How wonderful to be penalized for having such crap insurance.
So in summary, I am paying for fraud insurance. I have paid $1200 for a year, have had probably less than 1% of "covered" expenses paid, and now I have had over $1300 in surprise bills I have to pay all at once. (Which I can't and the first of these has already gone to collections.) I'm in tears and so tired of calling Anthem and getting the run-around. Nothing is ever resolved, or ever answered with them. The only thing is, I have to pay exorbitant amounts for things that were at first "covered."
All my different doctors had the EXACT same complaint about Anthem - they all even got to the point of asking me to call my health insurance to try to get answers for them, because Anthem was being so difficult in giving them any information on what else they need for the claims. Finally they all one by one gave up, and billed me instead for the entire claim. I am so afraid to use my insurance, and am instead trying to save up cash to go to the doctor next. Not an easy task on a fixed income, with now $1300 in surprise bills and other things like home and auto repairs adding up.
I despise Anthem Insurance, and I feel like they are the shining example of what is so wrong with our country and economy. People can't fight the big giants, promising to "insure" our health or lives, when instead they charge us for providing a card with a false sense of security. Not to mention having to pay twice as much or more at offices for denied insurance claims than paying cash at the office. And when everyone's required to have insurance, I'm sure even more people are going to be ripped off by Anthem and in tears and left with no choice like I am.