My complaint:
My 92 year old homebound mother fractured her shoulder and has Empire Blue Cross Blue Shield’s Medi Blue Plus Coverage. Her policy states she is entitled to up to 8 hours a day 35 hours a week for Home Heath Care Benefits. I ed this early on with Empire BCBS. My mom was just released from the hospital 2 days ago after being in the hospital 3 times and rehab for about 2 weeks. Until her fracture heals, she needs help getting dressed, walking, bathroom, PT etc as you can imagine at 92. Well- BCBS and all their in Network providers will not perform up to 8 hours a day35 hours a week. I called every one. So Blue CrossBlue Shield is saying you are covered for something you will never find an in network provider to cover. All their listed providers will say they can provide help 2X a week. Hmmm- so you need help getting dressed etc on a Monday, but then on Tuesday you miraculously can help yourself but Wednesday we will provide services again. No one will bother to help the seniors navigate this process. One BCBS employee will tell you one thing and the other something else. Brandi from Empire told me today(June 30th) that no one really receives up to 8 hours a day and I was the first one to ever ask her. So you are paying a premium for something they will never cover you for!!! That’s illegal, immoral and sad that you would treat Seniors this way. Oh- and they are saying the process takes 14 days. Wow- a long time to wait.
Suggested solution:
They need to provide my mother with an in Network Home Health Care Provider that will be able to provide up to 8 hours of Home Health Care benefit up to 35 hours a week. We will provide documentation of Medical necessity. If they can not provide someone- they should allow us to secure a provider that would perform the services and either reimburse us or pay them directly. We can not wait 2 weeks for an answer. PT, Home health aide services are needed immediately.
