Blue Cross of CA Fined Over Transgender Coverage Delays

[Carolyn Marie]

https://news.bloomberglaw.com/health-law-and-business/blue-cross-of-california-fined-over-transgender-coverage-delay

 

 

The text of this article is only partially visible due to Bloomberg's pay wall.  But its enough to get the gist.

 

Carolyn Marie

[tracy_j]

I know this is specific but just at the moment insurance companies seem to be making a point of dragging their heels over paying in general quite a lot of the time.

 

I have not looked into it but I wonder which is to be favoured - coverage via health insurance which is iffy at times over payout through company (and location?) or coverage via health (NHS here) which is limited by resources.

 

Tracy

[KayC]

I am wondering if this was a conscious plan by Blue Cross to delay coverage/services or if they're just not competent.  My assumption is the former.
Same as @tracy_j I believe a lot of insurance providers might be dragging their feet for these (and other) types of coverage, just waiting to see if Obamacare is overturned by SCOTUS .. and who wins next week. 

[VickySGV]

Here in CA, there could be one other issue that has not been mentioned yet, and that is the BC / BS group is overwhelmed by the COVID-19 situation.  They are a major provider of insurance for the "essential" workers most likely to become COVID victims.  The State and County retirement systems that administer health plans for public employees all offer the BC / BS plans as well as the Public Utilities companies.  At one time I had the Blue Cross medical insurance and although this was 50 years ago, they were slow back then in processing claims which is why I opted for different coverage.  In California, by matter of state law, they must provide for Trans health care, so it is not a matter of SCOTUS or national health care issues.  I have seen our State Insurance commission stats on Trans health care and it is a negligible amount compared to their overall payouts. 

[Jackie C.]

Once upon a time, I worked in insurance. The golden rule is, and always has been, "Insurance companies are in the business of collecting premiums, not mailing payouts." In an insurance company you are always pressured to pay out the minimum possible amount or, preferably, nothing at all. I think we're just noticing it more because the system is overtaxed by COVID right now.

 

Hugs!

[VickySGV]

3 hours ago, Jackie C. said:

The golden rule is, and always has been

 

That should be "Rule of The Gold" there. 

[Jackie C.]

3 hours ago, VickySGV said:

 

That should be "Rule of The Gold" there. 

 

Yeah, that's fair.

 

Hugs!

[KayC]

23 hours ago, VickySGV said:

that is the BC / BS group is overwhelmed by the COVID-19 situation. 

 

23 hours ago, VickySGV said:

In California, by matter of state law, they must provide for Trans health care, so it is not a matter of SCOTUS or national health care issues.

That's a good perspective Vicky.  Thanks for sharing that!  YEAH for California❣️