GT400SC
PM for Decals
I know most of you are military and get your medical from Uncle Sam on base or on the ship but as a civilian government employee, I and my wife have an HMO and for the last 15+ years, it's been Pacificare. http://www.pacificare.com/
Or maybe I should call it Pacific-SCARE!
As some of you already know, I had my 2nd total knee replacement about a month ago at Grossmont Hospital in La Mesa. All this paid for by the government because the blown out knees are from a job-related injury. But soon after leaving the hospital, I developed an infection (gee, I wonder where THAT came from) and I decided to go see my HMO primary physician, which is one who participates in my Pacificare HMO and get treated.
Are you with me so far?
I make the appointment and when I arrive at my doctor's office, they tell me my (and my wife's) Pacificare coverage was TERMINATED in April of this year. They wouldn't even treat me until I signed a waiver saying I would pay the thousands of dollars for lab work if Pacificare didn't cover it. So I signed it because I needed to be treated (antibiotics).
Are you STILL with me?
So, when I get home from the Doc, I call Pacificare and basically ask..WTF?
They told me that my employer told them to cancel me. I knew that wasn't true. When a federal employee is on disability, (have you ever heard the phrase "I'm out on disability"?) your employer is NOT paying your wages anymore, the Department of Labor is paying them. They are also paying the premiums to your health care provider to insure your coverage is uninterupted.
When you go back to work, and get back on the regular payroll, those premiums start to come out of your check again.
You're still with me, right?
I have been out on disability since April when I had my FIRST knee replacement. The Department of Labor pays my wages through Direct Deposit and the premiums for my HMO (Pacificare) by electronically transferring funds to them to keep me and my wife coverd. The Dept. of Labor (DOL) sends me a financial statement every month showing me what the deposit was in my checking account. They ALSO show me the payments that went to PacifiSCARE.
So when I called PacifiSCARE today and asked them where all that money went, they had no answer. Since they had told me my employer asked that my coverage be terminated, I quizzed them how that came about. Was there a letter on official letterhead? Was it SIGNED by someone, what was the name at the bottom of the letter? They had no answer. When I pushed harder about the thousands of dollars for premiums that had been sent to them since April, and where that money is now, they could only say "We sent it back to your employer".
I about lost it. I'm dealing with idiots here. I just had to keep asking more questions like, "I'm on disability, the DOL is sending you this much money every month and you're sending it to my employer? Why would you do that? The DOL is NOT my employer. If I have no coverage, and the DOL sends you money, send it back to the DOL, not my gov't employing agency! They had no answer for that either.
Tell me you're still with me here!
I told PacifiSCARE..."Look, you have made a major blunder through some stupid clerical error and accidentally terminated my wifes and my coverage MONTHS ago. And you didn't even tell us! And we go to the doctor or get prescriptions using our HMO card IN GOOD FAITH because we KNOW we have coverage only to find out we don't. Some of those doctors and pharmacies who will be submitting the bills to Pacificare for payment are going to be rejected and then my wife and I are going to get slammed with medical bills we never should be getting in the first place".
They're looking into it (they say) and of course, the people from Pacifi-SCARE who promised me they'd call me today with information didn't. I suppose they didn't want to deal with it and ruin their weekend. I have all the receipts showing they always got the premiums paid by DOL. I have a letter from the DOL that was sent TWICE to PacifiSCARE telling them NOT to interupt my coverage and that they (DOL) was taking over paying the premiums until I returned to work.
Yet these braindead uneducated middle school dropouts can't follow directions because they apparently are illiterate and can't read. My phone calls to these people were so maddening, you wonder how they manage the brain power to walk upright and breathe at the same time. Uh, step, breathe, step, breathe, breath, no wait, step, breath....oh I forgot, keep heart beating, step breath...Synapse gaps wider than my rear tires!
These people are so stupid, it's scary! And don't think for a minute I'm not emailing their website a link to THIS thread! Cuz I am! Next stop, TV, Newspaper, my dad's radio program in L.A. and my Congressman, Duncan Hunter. Think about it...Just what am I and my wife supposed to do in an emergency while these uneducated baboons figure out how they screwed up? I'm kinda in a jam here!
They will wish they'd never screwed with me! Gee, can I make MILLIONS off of this? Go to Google and type in "Pacificare horror" and see just how many times they've been sued and paid out 100s of millions of dollars for false claims, denial of service and government fines. Amazing they're still in business.
Well, it's my turn I guess!
Or maybe I should call it Pacific-SCARE!
As some of you already know, I had my 2nd total knee replacement about a month ago at Grossmont Hospital in La Mesa. All this paid for by the government because the blown out knees are from a job-related injury. But soon after leaving the hospital, I developed an infection (gee, I wonder where THAT came from) and I decided to go see my HMO primary physician, which is one who participates in my Pacificare HMO and get treated.
Are you with me so far?
I make the appointment and when I arrive at my doctor's office, they tell me my (and my wife's) Pacificare coverage was TERMINATED in April of this year. They wouldn't even treat me until I signed a waiver saying I would pay the thousands of dollars for lab work if Pacificare didn't cover it. So I signed it because I needed to be treated (antibiotics).
Are you STILL with me?
So, when I get home from the Doc, I call Pacificare and basically ask..WTF?
They told me that my employer told them to cancel me. I knew that wasn't true. When a federal employee is on disability, (have you ever heard the phrase "I'm out on disability"?) your employer is NOT paying your wages anymore, the Department of Labor is paying them. They are also paying the premiums to your health care provider to insure your coverage is uninterupted.
When you go back to work, and get back on the regular payroll, those premiums start to come out of your check again.
You're still with me, right?
I have been out on disability since April when I had my FIRST knee replacement. The Department of Labor pays my wages through Direct Deposit and the premiums for my HMO (Pacificare) by electronically transferring funds to them to keep me and my wife coverd. The Dept. of Labor (DOL) sends me a financial statement every month showing me what the deposit was in my checking account. They ALSO show me the payments that went to PacifiSCARE.
So when I called PacifiSCARE today and asked them where all that money went, they had no answer. Since they had told me my employer asked that my coverage be terminated, I quizzed them how that came about. Was there a letter on official letterhead? Was it SIGNED by someone, what was the name at the bottom of the letter? They had no answer. When I pushed harder about the thousands of dollars for premiums that had been sent to them since April, and where that money is now, they could only say "We sent it back to your employer".
I about lost it. I'm dealing with idiots here. I just had to keep asking more questions like, "I'm on disability, the DOL is sending you this much money every month and you're sending it to my employer? Why would you do that? The DOL is NOT my employer. If I have no coverage, and the DOL sends you money, send it back to the DOL, not my gov't employing agency! They had no answer for that either.
Tell me you're still with me here!
I told PacifiSCARE..."Look, you have made a major blunder through some stupid clerical error and accidentally terminated my wifes and my coverage MONTHS ago. And you didn't even tell us! And we go to the doctor or get prescriptions using our HMO card IN GOOD FAITH because we KNOW we have coverage only to find out we don't. Some of those doctors and pharmacies who will be submitting the bills to Pacificare for payment are going to be rejected and then my wife and I are going to get slammed with medical bills we never should be getting in the first place".
They're looking into it (they say) and of course, the people from Pacifi-SCARE who promised me they'd call me today with information didn't. I suppose they didn't want to deal with it and ruin their weekend. I have all the receipts showing they always got the premiums paid by DOL. I have a letter from the DOL that was sent TWICE to PacifiSCARE telling them NOT to interupt my coverage and that they (DOL) was taking over paying the premiums until I returned to work.
Yet these braindead uneducated middle school dropouts can't follow directions because they apparently are illiterate and can't read. My phone calls to these people were so maddening, you wonder how they manage the brain power to walk upright and breathe at the same time. Uh, step, breathe, step, breathe, breath, no wait, step, breath....oh I forgot, keep heart beating, step breath...Synapse gaps wider than my rear tires!
These people are so stupid, it's scary! And don't think for a minute I'm not emailing their website a link to THIS thread! Cuz I am! Next stop, TV, Newspaper, my dad's radio program in L.A. and my Congressman, Duncan Hunter. Think about it...Just what am I and my wife supposed to do in an emergency while these uneducated baboons figure out how they screwed up? I'm kinda in a jam here!
They will wish they'd never screwed with me! Gee, can I make MILLIONS off of this? Go to Google and type in "Pacificare horror" and see just how many times they've been sued and paid out 100s of millions of dollars for false claims, denial of service and government fines. Amazing they're still in business.
Well, it's my turn I guess!
Man that is just terrible...Call Turko files..Keep us posted..
