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Complaint 10 of 12 in "Errors in Claim Payments"

Insurance Carrier: Blue Cross Blue Shield Of Illinois
State: Illinois

Consumer Complaint:

I found out yesterday (when one of my doctor's offices called) that Blue Cross changed my primary insurance (employment provided) to secondary status. I called Member Services who informed me that it was changed 09.11.08 because of a questionnaire that indicated my AARP coverage (self paid) was in effect longer than the Blue Cross plan. This was a rule that they decided to enforce after years of my supplying AARP as my secondary for several years. I was never notified of the change. No consideration was done as to the benefits of the AARP plan. AARP has been getting EOMBs from Blue Cross for years. I faxed the AARP benefit info today but do not expect a quick response. In the meantime I am being billed by healthcare professionals and facilities because they are not getting any reimbursement. My AARP benefits were exhausted early in the year.


Insurance Expert Answer:

This is a new one for us. There are all sorts of rules in effect that govern "coordination of benefits" that aim to stop people from collecting benefits twice or more realistically to keep 2 insurance companies from each paying full benefits. I'd suggest you write a letter to the Blue Cross asking for a detailed explanation, and call AARP and also speak to the Insurance Department in Springfield and discuss it with them as well as.


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