I've been waiting to start a FDX Health Insurance discussion ...

My wife and I have both had catastrophic medical illnesses covered by our FedEx Medical Benefits. I'm happy to report that we've been able to go to the best doctors and hospitals in the country for treatment, seemingly without anybody ever questioning our choices for medical care.

It was nice to open numerous hospital bills for more than $100,000 and know that I would only be responsible for our contractual deductible and copays. I was glad to see that ALPA negotiated a new lifetime cap of $2,000,000/person. I was mildly concerned that should we have future medical problems, that the old limit could become a problem for us.

I have justified the seeming lack of supervision of our really good benefits as "maybe" FedEx is self insured, maybe Anthem just administers the program and really doesn't care about controlling costs?

Something changed in the past 6 months ... a year ago I fell and injured my shoulder (broke my scapula). After a few weeks of Physical Therapy, I received a letter from Anthem saying that they understand that my shoulder hurts but that I have full range of motion now so further Physical Therapy is no longer medically necessary? (That's not what my doctor and MRI say!). My wife received a letter from Anthem this week questioning her need for a pain medication that her doctor recently prescribed?

Interestingly ... there was a CBS 60 Minutes special 2 weeks ago documenting Anthem's blanket denial policies! They interviewed a contract medical consultant (it seems many of Anthem's doctors are consultants and never actually see your medical record, Anthem just signs their names to the denial letters!*?) whose name was signed to denials in their segment.

So ... it seems that something has changed. I'm not sure if Anthem's corporate policies are making their way into our benefits or if Anthem is getting pressure from FedEx to CUT COSTS?

Are other folks experiencing the same issues?

http://www.insurance.ca.gov/0400-new...ease135-14.cfm