Does Anyone Have Experience With Blue Cross Perscription Drug Benefit in Texas?
Question by karen star: Does anyone have experience with Blue Cross perscription drug benefit in Texas?
The high deductible plan seems to have an annual limit of $ 3000 on prescription drugs. My question is that if disaster should strike and someone winds up needing chemotherapy, is chemo considered a prescription drug, or does it fall under some other category of treatment or therapy?
I looked at the plan details, and chemo was ONLY mentioned one time, and that was “excluded if it is to be administered at home.”
My thinking is that the “catch” on the policy will be that I pay the deductible, get a $ 3000 benefit, and STILL have to pay the $ 40000 per round, even though the insurance itself will cost me more than $ 3000 per year.
Does anyone have any experience with Texas Blue Cross? Thanks
Thank you for your concern, Moe. None of us are ill, but that’s what insurance is for – help with things we can’t otherwise predict.
I posted the question in “cancer” because I thought those here might be more likely to have experience with insurance coverage – or the pitfalls inherent in insurance companies’ gambling I’ll stay healthy while I gamble that they will help me if I don’t.
Best answer:
Answer by moe s
I personally don’t but I have heard bad things about them. I have heard good things about scot and white chemo plans. If you or anyone close to you has cancer I am deeply sorry and hope it all works out for the best.
Answer by Panda
I’m not familiar with Texas Blue Cross, but that does not sound like a good policy. We have Anthem Blue Cross/Blue Shield and though they were a pain in the neck sometimes . . especially with ‘experimental’ drugs or procedures . . they did pay for the entire cost of cancer treatment, surgery, perscriptions, experimentals, clinical trials, home nursing, and hospice . . so our insurance did exactly as it was intended . . and since my son also qualified for children with special needs we never had to pay any of the deductibles either. So, even though I complain about the insurance and the forced appeals . . they did end up paying for over a million dollars worth of treatments.
A word of caution though . . make sure that your insurance does not have a life time limit of a million dollars on it . . that will be worthless if you ever need it for cancer . . you will run out of coverage in about two years if not faster. Your coverage should be ‘unlimited’ . . the last thing you want to worry about with a cancer diagnosis is if your insurance is going to cover you or not!! Too, be aware that with the majority of cancers (there are over 200) that insurance has no problem with ‘first line treatment’ . . because there is documented evidence to back up using certain drugs, surgery, or radiation . . but if your cancer fails to respond to that first line treatment . . the insurance company likes to start denying benefits based on the treatment being ‘medically unnecessary’ . . so you end up fighting that . . cancer treatment is not neat, easy, clean, or obvious . .sometimes you need to experiment or try some other treatment and insurance doesn’t like to cover it. They will if you can locate research on it . . but this too is hard to take that time when you are fighting for your life or the precious life of your child.
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