LA TIA SECRETOS
1/5
Is not customary for me to do this write ups, but I feel is necessary so that other people know what they are getting into.
I am a Covid survivor and I depend on oxygen since 2020, 24/7.
The insurance was paying rent on a portable inogen/oxygen tank until it broke while I was on vacation in Mexico.
Before I left on the trip, I called blue shield and key Medical group about what to do if I encountered any emergency while I was on vacation in a different country. The answer from both (blue shield and Key medical) were to pay for services then I could request for refund….-they made sound so simple and it has been a nightmare. When the portable oxygen tank broke I called Apria (medical oxygen supply to get a replacement -they said that I shouldn’t take it out of the country that the rental was strictly for in the country😳.
I submitted a claim to the department that their office staff said to do it -they mailed the forms and ask me not to call and check until after 2 months because if I do that would put me further behind. I called after 2 months -they said I submitted the wrong forms to the wrong department, then they sent different forms for out of country claims, then they said it was wrong and finally sent me to the right department -core blue shield. Papers were revised and blue shield denied payment -according to them, it was not an emergency. They said they only pay for emergency services. (It was interesting for me to find out that not being able to breathe on my own is not considered an emergency for the department. I asked if they had a doctors reviewing the documentation and they say that is not happening. Anybody with a little bit of knowledge about medications would know that there are specific medications that are given only on emergency basis.
I bought oxygen cylinders, paid for oxygen refills, went to see a Dr. On emergency basis. I wrote to every department in detail about the town where I was staying, dr’s addresses n phone numbers, explanations about Mexico way of operating on emergency basis (doctors still visit you at home if you can’t move), but blue shield core services were asking me for emergency discharge papers. I spoke to like 10 different people and requested to assign my case to someone that was familiar with the medical services in Mexico or had some training on the subject. I was informed all do.
After approximately 10 months the insurance reimbursed part of it, but not the medical visits medications, or the oxygen refills.
Now my portable oxygen ( that I use on my outings needs service - is not converting oxygen. Is just blowing air. I called blue shield insurance and Key Medical. I was informed that since I bought it, I don’t qualify for any services that my machine needs.
I have services for any medical equipment that I use in my coverage, they refunded me some money- so both of us paid for it, but because I am not renting it I don’t qualify for it to be service, And if I rent a machine I have to be confine to this country only because when you rent a machine you can’t take it out of the country?
I am very confuse and frustrated. No one in this world should go through all this turmoil specially when you are medically sick.
So be carful and inform yourself about any and all details when buying a Heath insurance.
I got to say that I have never had problems with the HMO blue shield of California in over 18 yrs of membership.
I recommend for them to train their staff well in every department (every time I spoke with a representative he/she couldn’t give me correct information except for the last lady that directed me to the right department blue shield core -after4-5 xs I spoke to different departments and staff.
2nd recommendation: get a train nurse to revise medical emergencies.
3: hire or train staff that is familiar with emergencies in other countries- in this case Mexico
