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Michael's complaint:
March 08, 2012

Insurance Company: Horizon Blue Cross Blue Shield
Coverage Type: Health Insurance

  • PolicyHolder Service - Inadequate Service
  • General - I feel abused by this company

I had health insurance with Horizon Blue Cross Blue Shield of New Jersey (Horizon). In network outpatient lab work was provided by Laboratory Corporation of America Holdings (Labcorp). Due to the limitations of the policy, there was a limit of $500.00 per year for this benefit. During October 2010, I visited my primary doctor. Blood was drawn and sent to Labcorp. Horizon was billed for four (4) tests - two (2) were paid in full, one was paid partially and the last was not paid. The explanation of benefits sent to me did not show the remaining balance for outpatient testing. For the partially paid test, Horizon was billed at $104.00, allowed amount $20.21, and paid $1.85. The last test was billed at $66.00, allowed amount $11.68, not paid.

When this first started, I offered to pay the unpaid contract amounts of $30.04. It was not accepted. I see no reason why I should pay more than five times the contract amount for a test. Also, I have not worked since January 2008 and can't afford to pay $66.00. If you have Horizon for health insurance or any other health insurance that uses Labcorp as the exclusive outpatient testing service, then you should look for new insurance.

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Ann says:
September 5, 2012 at 5:34 PM

I'm sorry you had to deal with this. However this has nothing to do with your insurance company, this has to do with the lab. If your EOB states that the price is $30.04 and that you are not responsible for the rest according to your insurance company, you do not have to pay the full $66.00. However, if the EOB from your insurance company says you are responsible for the balance, you do have to pay it. Send them $10.00 per month until it is paid.

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