His colleagues and family spoke on his behalf, asking the board that approved the Blue Shield insurance to intervene.<\/p>\n
“Today I’m forced to stand here and beg because an insurance company decided that profits matter more than the life of a man who spent his career protecting this city,” said Rachel Jones, daughter of Ken Jones.<\/p>\n
One of the board commissioners and San Francisco Supervisor Matt Dorsey promised to question Blue Shield.<\/p>\n
“We want to get answers on whether this practice that we are seeing represents a change or something new that is a diminution of service from Blue Shield of California, because that is not what we signed up for,” Dorsey said. “I don’t think that’s what this board signed up for when we made the decision on the basis of the RFP process. I lost my own mother to lung cancer, and she raised a son who was going to fight, to make sure that people get this care that they’re entitled to.”<\/p>\n
MORE: Bay Area college students rescue tiny gopher, but get huge ER bill<\/a><\/p>\n A year ago, Blue Shield took over from UnitedHealthcare, insuring many San Francisco city retirees, including firefighters. Now, many firefighters are asking for the city to intervene as a number of them have reported problems with Blue Shield’s coverage.<\/p>\n “Most of the people are retired — 60, 80, 90 years old — when they get a denial, they say, ‘Oh, I guess that is, and they give up,” said Fred Sanchez with the Protect our Benefits, watchdog for San Francisco City and County retiree benefits Protect our Benefits.<\/p>\n In statement Blue Shield said in part: “Blue Shield values our relationship with the City and County of San Francisco and we are committed to working closely with the Health Service Board to address any issues that are raised by members.”<\/p>\n Former San Francisco Fire Chief Jeanine Nicholson is hoping this fight helps other firefighters and her friend, Ken Jones.<\/p>\n “This is a fight, not just for Ken Jones, but for all firefighters in the future who may need lifesaving treatment,” Nicholson said. “They are killing him.”<\/p>\n MORE: A 15-min, $100K trip to ER left Antioch family with burned infant in billing mess: ‘Unbelievable!’<\/a><\/p>\n Full Blue Shield statement:<\/p>\n “Due to privacy laws, we are not able to comment or provide information about our members. We do encourage members to reach out to Blue Shield of California by calling the number on the back of their member card for any questions or concerns they may have about their coverage.<\/p>\n It’s important to note that for Medicare members, all prior authorization decisions are governed by criteria established by the Centers for Medicare and Medicaid Services (CMS), not by Blue Shield of California. <\/p>\n Appeals can be filed directly with health plans or with independent organizations known as Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIOs). <\/p>\n Blue Shield values our relationship with the City and County of San Francisco and we are committed to working closely with the Health Service Board to address any issues that are raised by members.”<\/p>\n A GoFundMe has been started to help Jones pay for health care costs. You can view it here<\/a>.<\/p>\n
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