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Unicare of Illinois / denying claims

1 IL, United States Review updated:

My wife is type 1 diabetic. She has been fighting to keep her sugar under control for 5 years.Her doctor gave her a prescription for a insulin pump. Her doctor said this will be the only way to keep her sugar under control and keep her kidneys from failing. My wife was also told she needs to be on the pump if she wants to have a baby. Unicare denied her claim. They said they needed more medical information from her doctor. This was provided to Unicare. They denied the claim again because they claim the insulin pump was not medically necessary. Unicare also denied my claim for a stress test when I went into the hospital with chest pains and they also did not pay the doctor bill on two visits my wife made to the emergancy room because the E.R. doctors were not in network even thou our hospital was.You can't pick your doctor in a E.R. situation. I feel I've been robbed by the insurance company and I don't know what else to do.

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  • Mo
      11th of May, 2009
    0 Votes

    I am going thru the same issue with my ER Visit.

    I just received a Dr. Bill from a Hospital we found in Network, the bill for $700, now, UNICARE informed he is out of Network and therefore only $200 would be taken in consideration towards my annual deductible (I have a HSA Acccount).

    So those $500 dollars out of pocket I need to spend are going nowhere.

    Their Online system give you the option to email inquiries, it took them more than a week to reply and simply to just to tell me that I need to mail a letter!!!

    Don’t even get me started on their customer service, last thing I need is attitude from a phone rep.

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