Illegal???!?

NakedZergling

I just went to get my prescriptions filled. I was denied. The pharmacist said blue cross denied my claim. I called another manager to see if he had heard anything weird. Today (friday) he tried to go to the dentist and his insurance was denied as well. When he called blue cross, the lady from blue cross called our company benefits department and was kept on the line for their convo. Our company didn't know an employee heard our benefits department admit to blue cross that our company didn't pay blue cross this week, even though they deducted money from our paychecks for medical this week. She went on to say it would be "fixed on monday"

Our company is going to announce massive store closings and maybe chapter 11 on monday, and it's looking to me like they took our money for medical, and didn't pay the insurance company, which has quote "put a stop to all benefit claims until monday" unquote.

This in my mind can not be legal. It sounds like the exact definition of embezzlement to me.
I am on meds for high blood pressure and anxiety because i have a diagnosed panic disorder. I can either wait to see what happens because corporate is closed weekends or choose to pay $179.99 for pills that normally cost me $11.

My district manager even said that if they took money out for medical but didn't pay the insurance company, it "seems like that would be illegal"

What do i do?

ascannerlightly

NakedZergling wrote: »

What do i do?

tonight, peruse this and this section of the rhode island labor laws. in the morning, contact a lawyer.

AyeJaye

Well this really depends on how serious your panic disorder is and what you're planning for your weekend, but I'd say let it wait until Monday. Just chill out, stay inside and have a nice low-key relaxing weekend without worrying about this until you can find out more on Monday. Calling a lawyer can't hurt, as well.

Wiley

Ask the pharmacy to give you enough of your blood pressure medicine to last until monday as that is one that you should try not to miss. I'm not sure if all of them will do it, but my pharmacy has given me a few pills to last until a refill comes through on several occasions.

TL DR

Wiley wrote: »

Ask the pharmacy to give you enough of your blood pressure medicine to last until monday as that is one that you should try not to miss. I'm not sure if all of them will do it, but my pharmacy has given me a few pills to last until a refill comes through on several occasions.

This. If you run out and can't get a few to tide you over, buy the script and expect the insurance company or your work to reimburse you.

Everywhereasign

Had the same problem with my employer. As soon as they found out about the error they made it very clear that they would reimburse any out of pocket expenses incurred as a result. Personally I was able to wait the 2 days until they sorted it out, I know others just paid cash and sent the receipt in to the insurance company.

I assume my employer paid up, and the insurer had record to allow claims that were made on those two days.

YMMV, I'm unionized and I trust my employer not to fuck this sort of thing up due to the fallout that would result.

You should be able to contact someone at your company and say I've filled my Rx with the understanding that I'll be reimbursed as per my contract.

Although you can go through a lawyer, unless you're spending a shit tonne on drugs, you don't have to. If they refuse to reimburse you, take them to small claims court (no lawyer needed), bring your contract that says you get benefits, bring your pay stub that shows you were deducted for the benefits. My guess is they'll take care of you before it gets that far though.