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Blue Cross Blue Shield to Leave USVI Owing Local Health Providers Massive Sums  

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Alana33
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May 11, 2016 9:03 am  

Blue Cross Blue Shield to Leave USVI Owing Local Health Providers Massive Sums

http://stthomassource.com/content/news/local-news/2016/05/11/blue-cross-blue-shield-leave-usvi-owing-local-health-providers-ma


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ms411
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May 11, 2016 9:52 am  

Really distressing to read what the health providers and the patients have had to go through. Now those private employers will have to find a new insurer if they can. So sad.


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OldTart
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May 11, 2016 10:12 am  

Hopefully the Lieutenant Governor's upcoming participation in the meeting of the National Association of Insurance Commissioners will help resolve the problem, as well as address the issue of individual coverage.


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quirion
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May 11, 2016 10:39 am  

Hmmm page not found...


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quirion
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OldTart
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speee1dy
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May 11, 2016 10:54 am  

What happens to those people who are insured by bcbs


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OldTart
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May 11, 2016 10:57 am  

They won't be covered once their contracted term runs out.


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Alana33
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May 11, 2016 11:16 am  

The lack of health insurance of any kind for those not working for the government or private companies that offer it is something those wishing to relocate here should keep in mind.


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caribstx
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May 11, 2016 12:00 pm  

Strange business. If I were a doctor and the claims weren't getting paid, I would have cut off BCBS long ago.

And why hadn't the GVI stepped in much earlier in the game? Another total failure of oversight by the AG's office, who purports to be "regulating" the business.

There is no one to blame here but the government.


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Daval
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May 11, 2016 1:12 pm  

I wonder what that means to those of us coming with stateside BCBS insurance? I have been planning an extended PMV that would extend well past August 1st. We were able to use it there last year no problem and the claim was paid according to my EOB. I wonder if providers will still take a stateside BCBS network?


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Alana33
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May 11, 2016 1:20 pm  

Best check with your doctor that you use here.
The article relates to BCBS out of PR, so you might get lucky if claims paid from stateside BCBS?


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OldTart
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May 11, 2016 1:30 pm  

You'll likely have to pay for medical services rendered and then claim directly through your BCBS stateside carrier.


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watruw8ing4
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May 11, 2016 2:06 pm  

You'll have to check with your Dr. If his/her only contractual participation is/was with BCBS of PR, which I believe is the case, you may have to submit a claim, and be possibly responsible for the entire unpaid portion, above your BCBS company's allowed amount. The providers' beef is with the PR company, not BCBS in general. So they may submit for you. Regardless, since it appears your stateside coverage extends to the VI, you should still be covered after this. Although, you might have to pay more.

I honestly have not been able to figure out why the BCBS Association has not revoked the PR company's right to call themselves a BCBS member and use the trademark, as they have apparently broken so many licensing agreements for so long now.


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quirion
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May 11, 2016 4:10 pm  

Would this be a different thing than BlueCross BlueShield of the U.S. Virgin Islands?

Seems to be the case.
http://www.bcbs.com/about-the-companies/?referrer=https://www.google.com/

Lists
Puerto Rico, BlueCross BlueShield of Puerto Rico

and then under international it lists

U.S. Virgin Islands, BlueCross BlueShield of the U.S. Virgin Islands


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Spartygrad95
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May 11, 2016 4:29 pm  

If they do not figure this out or come up with alternative, we will be moving back stateside.


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speee1dy
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May 11, 2016 4:32 pm  

sparty, i know what you mean.


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IslandHops
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May 11, 2016 5:11 pm  

The funny (not) thing is, BCBS was touted as the insurance provider rumored to be bringing back Individual policies?

Now they are pulling out all together - just great.

The VI Government opted for increased medicaid under the ACA instead of setting up an exchange. That, and high provider costs is why we have no individual insurance options here, and now diminishing group coverage options.

There is a solution (involving government coverage) but having lived here for long enough I doubt the willingness or ability of our government to implement it.


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Gator's Mom
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May 11, 2016 5:48 pm  

Would this be a different thing than BlueCross BlueShield of the U.S. Virgin Islands?

Seems to be the case.
http://www.bcbs.com/about-the-companies/?referrer=https://www.google.com/

Lists
Puerto Rico, BlueCross BlueShield of Puerto Rico

and then under international it lists

U.S. Virgin Islands, BlueCross BlueShield of the U.S. Virgin Islands

From websites, BCBS of the USVI and BCBS of Puerto Rico are different companies.

Both have contact addresses in San Juan but different email and telephone.

BCBS USVI has a Miami telephone extension and is part of ELAM BENEFITS per website. The BCBS that was referenced as potentially selling individual health plans is this one.

The one closing shop it BCBS of Puerto Rico.

This shouldn't interfere with policies that are not underwritten by BCBS of Puerto Rico, which is having financial problems as a result of Puerto Rico's government not paying bills.

Nonetheless, the article in the Source left far more questions unanswered than answered. I am waiting the Daily News for better information.


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speee1dy
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May 11, 2016 5:50 pm  

i believe all of the bcbs policies written here are the ones out of puerto rico??


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ms411
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May 11, 2016 6:15 pm  

Gator's Mom is correct - they are 2 different companies. I remember when BCBS came to VI and the guy who brought it here, Omar, was on the radio regularly promoting his provider network.

The territories are not eligible to join the exchanges and even if they were there has to be some insurance companies willing to provide coverage. The territories are too small a risk pool for most insurance companies.

Even with health insurance many people can't afford the deductibles and co pays. The system is totally rigged against most workers, imo.


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Gator's Mom
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May 11, 2016 6:32 pm  

If the hospitals were sold and privatized, proceeds from this sale could be used to fund a risk pool for health insurance.

There is plenty of value in those hospitals if they were owned and managed differently.


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OldTart
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May 11, 2016 6:44 pm  

This is a very comprehensive breakdown of the situation concerning "Obamacare" and the US territories:

http://www.yourhealthcaresimplified.org/news/u-s-territories-obamacare/


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Spartygrad95
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May 11, 2016 7:10 pm  

Both my wife's policy and mine are BCBS Puerto Rico. My lease ends at the same time as BCBS withdraws. Maybe the writing is on the wall. I don't want to leave, but I will not stay without healthcare insurance for my family. My current copays are very manageable. A drastic increase from another company will push us out of here as well.


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IslandHops
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May 11, 2016 7:54 pm  

Looks like BCBSVI is probably also Triple-S Salud, Inc. (BCBS PR) - so yes they would be stopping coverage...

Mailing is PR...
BlueCross BlueShield of the U.S. Virgin Islands
PO Box 11865
San Juan PR, 00922-1865

BCBSVI Website...
This site is owned and controlled by Triple-S Salud, Inc., d/b/a/ Blue Cross and Blue Shield of the US Virgin Islands, a corporation organized and created under the laws of the Commonwealth of Puerto Rico. ...

(edited to add...)
And Triple-S Salud has owned both since 2009...

Triple-S Management Corporation, the Blue Shield licensee in Puerto Rico, has signed a Definitive Agreement to acquire managed care assets of Blue Cross of Puerto Rico (La Cruz Azul de Puerto Rico, Inc.). Both the Blue Cross brand in Puerto Rico and the Blue Cross and Blue Shield brands in U.S. Virgin Islands are scheduled to transition to Triple-S on July 1, 2009.


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