http://www.ketv.com/news/blue-cross-blue-shield-insurance-carriers-face-questions-come-midnight/27816944
Blue Cross Blue Shield of Nebraska and CHI Health, formerly Alegent Health, were unable to come to an agreement about pricing last week, so all CHI affiliated hospitals (about 15) and over 1000 providers just became “out of network” for Blue Cross members. That means costs just went way up for those patients because insurance policies usually have patients owing about double when they go out-of-network. Nebraska is pretty rural outside of Omaha and Lincoln, and there aren’t a ton of hospital choices without traveling large distances. If your doctor is part of this mess then do you decide to change docs (a very personal decision) and possibly drive a lot more or pay more for services?
As a member of Samaritan Ministries I am again reminded how happy I am to have no worries about provider networks. Samaritan lets me see any licensed doctor I want with no hassle about whether they’re in or out of network. That is a great relief when traveling, and now also when these kinds of negotiations fail.
I have such sympathy for Blue Cross members and hope these companies are able to get things straightened out soon, for the sake of their customers. Blue Cross is a huge provider in this area, this problem affects a lot of people I know.
Thank you so very much for your explanation 🙂
I am thinking about cancelling my insurance under covered california very soon and I LOVE how samaritan works. Especially my husband and I are currently dealing with the disappointment from our insurance policy.
I saw one of your comments mentioned SMI even allows members submit the medical bill (which is before the membership) to Special prayer needs, is that correct?
….cos I go look into the guidelines and I do not find any info about this. Hope you can tell me some examples. Thanks so much!
Yes, for bills that are a burden to the family finances, I have seen some special prayer needs listed on my share slips that said they were for an issue that took place prior to membership, in fact there’s one for an appendix removal surgery (pre-membership) on there right now and I remember one for a gallbladder removal from a couple months ago that took place a couple months before the lady became a member (she’s in my area). I think the bill has to be less than a year old (possibly a little less than that, but a year is sticking in my head right now). Obviously it has to be for a need that would otherwise meet the guidelines (plus dental, pre-existing), but I don’t know if they have any other qualifications (like a minimum or max dollar amount). I look forward to welcoming you as a member soon! I love how Samaritan works, too, it’s so simple and honest in this crazy world we live in.
Hi Heather,
hope you are doing well!
I have a question about the Special Prayer Needs. Let say we have a medical need that is not publishable and cost $500 as I pay cash. If Samaritan approved my special prayer need, how much will it be helped out by members’ additional help? Thanks very much!
I am doing well, thank you. 🙂
Since SPNs are voluntary giving, there’s really no way to know. It’s pretty likely you’d get something, but it could be $5, or all $500. A need of that size wouldn’t be shown to a lot of members on their share slips, because it doesn’t take a lot of them to cover it. (SPNs can be listed again if needed) The SPN area is there for unpublishable needs that are burdensome to members. It’s a way to try to help ease the burden purely from the generosity of member hearts, but not everyone is able to give, and others give quite generously. In the end, there’s no way to guarantee anything. Mathematically it seems that bigger SPNs have more likelihood of receiving gifts simply because more eyes will need to see it. If you’re worried about that, you could wait on submitting the $500 SPN to see if other non-publishable needs appear that year and then submit them together.