Tues 1/3/2018
For the past month we could not get medication for William; when we came to the pharmacy, their system shows Williams has active coverage with Anthem BlueCross thus they cannot use Medi-cal. The billing lady at the doctor office told us the same thing.
I was so surprised because we requested to remove William out of Tim’s policy few months back when we got Medi-cal. So I had Tim to talk to his HR again. Not sure if they did not do it that time or it just took that long to be effective. Finally it shows up as in-active at Anthem web site on Dec, with the Ended Date is 11/1/2017.
I thought the Medi-cal system would update automatically so I gave it 2 weeks to come to the pharmacy again; and guess what? The status is still active!
So I called Cal-Optima, they said I have to send in the Termination Letter from Anthem before they can TEMPORARILY REMOVE William’s insurance so that I can get medication for William; but this is just temporary. To PERMANENTLY remove insurance, we need to contact Social Service.
So I called Ms. Juliana from Medi-Cal office; she was our Medi-cal case manager. She said that we no longer have a specific case worker, we need call the Medi-cal number.
So I called the Medi-Cal number Ms. Juliana provided (waiting time was 1 hour, I left the phone number and they called back). The lady temporarily remove William’s insurance so that we can get medication for William but she said that we still need to send in the termination letter from Anthem so that it can be permanently removed. She said the system gets updated by the State so she has no control over it. She removed it temporarily but the state will put it back unless it’s permanently updated by the state.
Later in the evening, I asked the pharmacy, and they said the system is still not updated!
Thursday 1/4/2018
8:10 AM We called Anthem requesting the termination letter. It took about 20 minutes, finally I got the letter sent to me via email. It’s a 2 step authentication process to open the pdf file: From the email, clicking on the link to register (name, email, password, etc. ) then it’d load the pdf file after account is created. When opening the file it’d ask for password, which is given to me by the Anthem rep. It’s Anthem1234.
12:00 PM I came to Staples to fax the termination letter to Cal Optima and Medical. I tried both fax numbers given to me by the lady at the Medi-cal but they all failed. So I went to Medi-cal website to get a fax number and faxed to that. I also faxed to CalOptima.
Friday 1/5/2018
10 AM I called CalOptima, it took 15 minutes for the rep to find our fax; then she said she temporarily update the system so that William can get his medication.
12:00 PM I came to the Social Security office because no-one from Medi-cal office returned my call. The front desk said for this I need to see a case worker; so I waited for 1 hour and 10 minutes to see one. His name is Alex. He checked the system and said that the system was still not updated! I was so disappointed because I just talked to CalOptima 2 hours ago, and she assured me that it was temporarily updated. At this point, I really felt that I can’t trust what people say anymore.
Alex said he would email Sacramento and once they receive the email, they’d process it within 24 hours, which means by Tuesday the system should be updated. He also said he’d try to see if he can temporarily remove the insurance; he’d call me in 30 minutes to let me know.
So I went back to work; Half hour later Alex called and said that he was able to remove BlueCross insurance temporarily.
Monday 1/8/2018
A case worker returned my call! She confirmed that BlueCross doesn’t show up in the state system anymore. I called CalOptima to confirm, Molly said the same thing.
Tues 1/9/2018
So I asked our pharmacist to check, he still could not bill Medi-cal!
5:00 PM. I called CalOptima, talked to Molly again; and she still said the same thing. William’s record only shows United Care Group which is the group that I selected from Cal-Optima.
So at this point I really don’t know what else to do. Everyone from Medi-cal and CalOptima said there’s no private insurance in William record but the pharmacist still cannot bill Medi-cal; which means I still cannot get medication for my son. Unbelievable!
The pharmacist suggested that we call United Care Group.
Fri 2/2/2018
I called Cal-Optima, they confirmed that the BlueCross Health Insurance is no longer listed in the system. I’m so happy that this is finally taken care of.