Anthem BC/BS thinks nothing of changing the terms and conditions of a contract in the middle of a plan year.in late October, 2015 we were sent a form letter telling us that the company has "partnered" with OrthoNet to "help get you the therapy services you need." Although it was a form letter, signed by a Regional Vice President of Sales (instead of by someone who actually has responsibility for existing contracts/plans), I held onto it. Shortly thereafter, our daughter started experiencing knee problems from a past injury. I dug out the letter, which states "it is probably a good idea to first visit your doctor or specialist to get a treatment plan." Those words concerned me so I called customer (dis) service, as suggested later in the letter. As I had surmised, pre-authorization is now absolutely necessary to get physical therapy visits covered. When I told the representative that "it is probably a good idea to first visit your doctor or specialist" is a misleading way to communicate that pre-authorization is required, he allowed that might be the case. However, he had nothing to say about the fact that Anthem is changing the terms and conditions of the contract in the middle of the plan year. Since our family and my husband's employer are paying for a contract that specifies 20 PT visits per year (without a pre-authorization requirement), this type of change should be illegal. I have complained to the Ohio Department of Insurance and I hope that other plan participants who find themselves in our situation will do the same. Anthem is not to be trusted and as consumers, we have to do our part to make sure they don't get away with mid-plan contract changes and misleading communication.

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