Troubleshooters: Insurer holding back on woman’s reimbursement

It’s not uncommon to have hassles getting health care reimbursements from an insurance company., But 90-year-old Elda Hearn has been waiting two years for a check from Blue Cross/Blue Shield. The company owes the Hampstead woman almost $2,000. She got so fed up with the run around, she called Troubleshooters.

“I have felt in my mind there was no use in going any farther,” Hearn said. “I wrote to some of the government people, senators and representatives. I didn’t even get an answer from them.”

Hearn just celebrated her 90th birthday, and she doesn’t hear as well as she used to. Two years ago, she bought some top-of-the-line hearing aids from a local miracle ear vendor, and paid almost $5,000 for them up front.

She has insurance through Blue Cross/Blue Shield of Michigan, where she worked for years as a school bus driver. The insurance company authorized a $1,700 reimbursement for Hearn back in 2008, but she’s yet to see the check.

“It shouldn’t take two years to get,” she said. “You don’t have two years to pay them. If you don’t pay your premium, why, you’re not insured.”

Hearn said she’s called Blue Cross/Blue Shield about 20 times over the years, trying to get her money. She says Blue Cross/Blue Shield of Michigan told her the problem was with Blue Cross/Blue Shield of North Carolina. Blue Cross/Blue Shield of North Carolina gave her a different story.

Bottom line, she never got her check. Hearn’s elderly sister had a similar problem a few years back, and they feel they’re being taken advantage of because of their age.

We made some calls on Hearn’s behalf. Blue Cross/Blue Shield of North Carolina said it had no record of her in their system. We had better luck with Blue Cross/Blue Shield of Michigan. It apologized for the delay getting Hearn her money, and said it looks like she got hung up in the claims department and never made it to the grievance and appeals department as she should have.

The company assured us she would have her money within the month, and we’ll stay on top of this to make sure that happens.

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