miyooper2b
Full Member
Posts: 329
Location: Central Indiana
Jun 27, 2014 15:38:05 GMT
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Post by miyooper2b on Jan 19, 2018 18:27:02 GMT
OMG! I am pea livid over my health insurance. DH and I are self-pay and make too much money for subsidies but go through the Healthcare Marketplace to find insurance. We got a notice late last fall that our 2017 policy was no longer available and the next closest policy was going to be almost $500 more per month. So within the first week of the open enrollment period I was on the Marketplace website looking at new plans. Found a different policy (different company) that would cover what we needed and signed up. This was in mid-November. Got an email shortly after that we needed to pay the premium. Cool! I used the link and paid the premium, no problem. Reconciled my bank account at the end of November and the premium had been deducted, even better. In early December got a welcome packet, insurance cards, etc. Got a statement dated December 4 from the new insurance company showing a credit for my premium that would be applied to January. I went online through the customer portal in late December to set up automated premium deductions. Got an error message the plan was not ready yet. I waited until after January 1 thinking that was what I had to do. On January 5 I still could not set up the online account. Called and got a young lady who, after looking at my information, said that the company hadn't been able to connect my policy with my payment but she could see where I paid the first premium. She said she was going to send all the information to a different dept. and they would get it all corrected. She even gave me a reference number in case I needed to called back. She said it would take about a week for this to happen. I get back online today to try again. Same error message. Hmmmm . . . call them again. Talked to a nice young man. Come to find out because I paid the premium before December 1 they didn't know what to do with my payment so they CANCELLED our policy on January 2 and are sending us a refund check. He tells me we have no insurance right now!! WHAT!!!  I was so angry! The young man was trying to help me but he couldn't really do anything (yes, I was nice but he could tell I was really upset!). He said that I'd have to go through the Marketplace and reapply. He could see the policy, he could see the payment, yadda, yadda, yadda but no go on the insurance. I told him that the young lady I talked to a couple of weeks ago never mention the policy was cancelled. He could see that it had been when she spoke to me but failed to tell me this important piece of information! If I had known that I would have done something about it then and there! The young man wrote everything up to have it reviewed and then transferred me to a Marketplace rep. She also was very nice and got us set up with another policy. But it won't take affect until March 1st. She did escalate it to try to have the coverage retroactive to January 1 but could not guarantee it would be accepted. We'll know within two weeks if it is. I could just spit nails right now.  DH and I have been unknowingly walking around for two weeks without any healthcare coverage and may not have any for the next six weeks. Before I called I went for blood work this morning for a doctor's appt. next week and I can't miss it. Neither are now going to be covered. I don't still don't understand how two different service reps could see my policy and my payment but someone (or some computer) somewhere else couldn't manage to put 1 + 1 together and avoid this mess. ARRRGGGGH!!! I'm still angry about it. The kicker is that within about 10 minutes of signing up a second time I got an email with the same message that I needed to pay my premium. Luckily the Marketplace rep told me not to pay the premium until a week before March 1. Otherwise I would have paid too far ahead of time again! So freakin' frustrating! |
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Post by jenjie on Jan 19, 2018 18:29:56 GMT
That makes no sense! I’m so sorry that happened and I hope it gets straightened out. I can’t believe they’re just like, too bad so sad.
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freebird
Drama Llama
'cause I'm free as a bird now
Posts: 6,927 
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Post by freebird on Jan 19, 2018 18:40:50 GMT
Heads would roll if it were me. Best of luck to you!
I was without any insurance for YEARS and it was ok, and you'll probably be fine, but I would still be livid like you are.
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Post by underwatermama on Jan 19, 2018 18:42:54 GMT
I'd be livid too. Well, actually I am a little since our insurance went up a lot (and we were already paying a lot).
I'll bet your dr appt and blood work cost will be less than the cost of your premium for the month, but I'd be really uncomfortable too not having insurance for 3 months. Yikes!
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Post by Darcy Collins on Jan 19, 2018 18:43:54 GMT
That's ridiculous - hopefully they can straighten it out. Good luck
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The Birdhouse Lady
Drama Llama
Moose. It's what's for dinner.
Posts: 7,159
Location: Alaska -The Last Frontier
Jun 30, 2014 17:15:19 GMT
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Post by The Birdhouse Lady on Jan 19, 2018 18:45:41 GMT
You are pissed and rightfully so. Did you ask to speak to a manager? I think that someone somewhere should be able to correct the error. I don't think that you should have to take this one in the pants. You did everything right and paid the premium when you were asked.
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quiltedbrain
Full Member
Posts: 429
Jun 26, 2014 3:34:53 GMT
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Post by quiltedbrain on Jan 19, 2018 19:05:24 GMT
I am really sorry you are having to deal with this OP!
My mom had to fight with her doctor's office today because someone with either the health insurance exchange or the insurance company made a typo when entering her DOB and the doctor's office says they won't get paid if they bill for it, so they were demanding payment up front. I don't really have a problem with the doctor's office over them wanting to be paid, but to throw this at my mother while she's got the flu?? And, if the DOB issue gets fixed, will this visit ever get credited to her deductible?
It's continued BS like this that solidifies my support for single payer healthcare/insurance. So many problems caused by administrative goof ups could be solved if we were all covered universally. Ongoing care gets interrupted by stuff like this (what if you were in the middle of a healthcare crisis or had chronic healthcare issues?). Health insurance should not get in the way of health care!!!
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Post by mrssmith on Jan 19, 2018 19:10:01 GMT
If he can see the policy and the payment (I'm hoping with the appropriate date, but you also have that from your bank statement), then the escalation should hopefully be able to resolve that.
Do you have the mid-November email stating that you need to pay the premium?
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scrappinmama
Pearl Clutcher
Posts: 4,864
Member is Online
Jun 26, 2014 12:54:09 GMT
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Post by scrappinmama on Jan 19, 2018 19:37:01 GMT
That is ridiculous! I can't believe they can just cancel like that. Keep all paperwork, e-mails and names of people that you talk to. I hope they can insure you retroactive to January 1st.
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Post by Lexica on Jan 19, 2018 19:50:18 GMT
I would be as angry as you are! I also have insurance through the Marketplace. I wonder if it would do any good to go onto the Marketplace site and make a complaint. They do have live help there at times.
I get so stressed when it is time to re-up for the insurance. I fear that it won't be affordable, like what just happened to you.
This year, I got a letter telling me that it would increase about $400 a month for me. I was so stressed! I did like you and went back to the Marketplace and discovered that the insurance I had had wasn't more expensive at all. In fact, it went down a few bucks for me. I just signed up for the same thing again. I hate having that unknown regarding my health insurance because I need daily pain medication.
And I'm not looking forward to having to sign up with someone else after I leave this state. I have Kaiser now, and it has been so incredibly convenient. I'm spoiled. I don't want to go back to having different facilities for different things again. I am hoping that I can get with Kaiser after the move.
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iowgirl
Pearl Clutcher
Posts: 4,123
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Post by iowgirl on Jan 19, 2018 20:17:31 GMT
It's just nuts.
I am happy to now only be paying a little under 11K per year now, with a 6K deductable before anything, even prescription is covered.
Took two kids off our insurance after they graduated from college and got great jobs with awesome insurance - hallelujah!
Cripes - it is just nuts.
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Post by revirdsuba99 on Jan 19, 2018 20:31:53 GMT
I hope you got their names. I would have asked, no, demanded to speak to a supervisor. There is absolutely no reason for you to be without insurance you PAID for! Hope it all works out for you soon!
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GiantsFan
Prolific Pea
Posts: 8,287
Site Supporter
Jun 27, 2014 14:44:56 GMT
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Post by GiantsFan on Jan 19, 2018 21:21:51 GMT
I'm so sorry. I feel your anger. We have been going round and round with our insurance since Jan 2nd. The new insurance company had the wrong medical clinic and doctors listed even though we have documents with the correct clinic and doctors. It took calling every day until finally on Jan 8th (after I called them a bunch of clowns!) that we got it straightened out and I had them email a letter to us stating we were covered at our normal clinic. DH went to his appointment with the letter in hand. Wednesday we finally received our correct medical coverage cards. Now we're having problems with the medical clinic. Since we were not on the "original insurance list" they're not processing our referrals. I just got off the phone with clinic and hopefully it will be corrected by close of day today. I will call Monday morning to check. DH is injured and needs specialist care and I need CPAP supplies.
It would've been easier to stick with our old company and pay the extra $$$ per month! So frustrating!
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Post by ntsf on Jan 20, 2018 1:22:31 GMT
you might contact state insurance commissioner's office for help iif needed.
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Post by Really Red on Jan 20, 2018 1:34:56 GMT
I feel hostile for you.
I'd call back on Monday and ask to "escalate" the call. They'll put you on the phone with a supervisor. If the supervisor can't help you, and I assume she/he will not be able to do so, ask her/him for the number to contact the state insurance commissioner. Trust me when I tell you they do NOT want that. Hopefully, it will not come to that, but this is insane!!! They never tried to contact you at all!!!
I'm sorry. Good luck!
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Post by revirdsuba99 on Jan 20, 2018 2:40:53 GMT
I feel hostile for you. I'd call back on Monday and ask to "escalate" the call. They'll put you on the phone with a supervisor. If the supervisor can't help you, and I assume she/he will not be able to do so, ask her/him for the number to contact the state insurance commissioner. Trust me when I tell you they do NOT want that. Hopefully, it will not come to that, but this is insane!!! They never tried to contact you at all!!! I'm sorry. Good luck! YES!! 100% agree! |
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Post by mikklynn on Jan 20, 2018 2:51:22 GMT
Keep appealing it higher up.
Good luck. I am Pea livid for you.
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Rhondito
Pearl Clutcher
MississipPea
Posts: 4,661
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Post by Rhondito on Jan 20, 2018 2:57:53 GMT
What's even more ridiculous is that their system sent an email stating you needed to pay your premium. Then you got another email stating the same thing the second time you signed up for coverage. Someone needs to fix their system if people aren't supposed to make a payment when asked for one.
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Post by birukitty on Jan 20, 2018 7:50:18 GMT
I feel hostile for you. I'd call back on Monday and ask to "escalate" the call. They'll put you on the phone with a supervisor. If the supervisor can't help you, and I assume she/he will not be able to do so, ask her/him for the number to contact the state insurance commissioner. Trust me when I tell you they do NOT want that. Hopefully, it will not come to that, but this is insane!!! They never tried to contact you at all!!! I'm sorry. Good luck! This 100% I wouldn't give up and most importantly in my opinion pay the premium that is due currently if there is a way you can do that. I think I read that one of the people you spoke with told you not to pay it? I'm sorry I have a migraine starting up and I'm not thinking clearly. In my opinion once you stop paying the premiums you are in fact cancelling the insurance yourself and that is something you don't want to do. Even if at this point they made an enormous mistake and cancelled your insurance that is their fault. At this point you want to be seen as being complainant with all of the rules going back to paying for your original policy that you set up and signed up in mid-November. Do you understand what I mean? This way you can fight it by saying you did everything right from mid November on paying your premiums on time. Although since they already cancelled your original policy there may not be a way to do it. They should never have cancelled your insurance like that! It is illegal and I don't think they can get away with it. The problem will be fighting with them and finding the right person to correct the paperwork. That will mean a lot of time on the phone for you and insisting to talk a supervisor. If that supervisor doesn't give you the correct information for satisfaction insist on speaking to their supervisor. Stay calm on the phone if you can (hard as heck to do, I know) and take notes. Always ask for names. This total BS of them cancelling the policy you signed up and paid for and setting you up with a policy that won't take effect until March 1st. At the very least it should absolutely be retroactive to January 1st so that anything you need coverage for should be 100% paid for. More than that you should have your original policy! It was their error and they cancelled your original policy which they cannot do legally! In fact I would call them back once, tell them everything above (if you decide to go this way) and tell them if they don't fix it within a certain amount of days (your choice) you are contacting your state's insurance commissioner's office. Or tell them you are contacting them that day. Whatever you feel is best. I wish you the best of luck! |
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RedSquirrelUK
Drama Llama
Posts: 6,732
Location: The UK's beautiful West Country
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Post by RedSquirrelUK on Jan 20, 2018 9:14:15 GMT
Medical stuff is different in the UK, but having been through some things lately, I keep thinking of what my brother often says: 'you have to be fit to be ill'. He's so right. I hope you get it sorted out miyooper2b |
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miyooper2b
Full Member
Posts: 329
Location: Central Indiana
Jun 27, 2014 15:38:05 GMT
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Post by miyooper2b on Jan 20, 2018 13:07:55 GMT
Thanks for all the advice! I appreciate it. I’ll get on this again this afternoon. Thank you so much! I love the peas!
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Post by genny on Jan 20, 2018 14:58:36 GMT
I had a very similar situation happen at the end of 2015 for my 2016 insurance. A few of the details are different but very very close. Our insurance was cancelled and the premium I paid was credited back to my bank account. I called, I fought. I had Humana do an internal investigation and I went through the marketplace to do the same. I did not get my insurance back. Of course during that year DD got a concussion and had to go to the ER. DH had a kidney stone, another ER trip. That fall we found out DD had been cutting and attempted to end her life and had to be put in an inpatient facility for a week. NO INSURANCE. DS has lymphocytic colitis and was still on daily meds in 2016. It was awful. Then DD had to start seeing a psychiatrist AND a counselor and was on 2 different meds. All out of pocket. It was a tough year. I wrote the last check this past week to finish paying off DH's hospital bill from the kidney stone. I'm still paying on the concussion Bill.
To add insult, when I got whatever tax form it is you have to file showing what you paid on the marketplace it showed that I had had Humana insurance all year long, at the rate of the first premium I paid. I had to call both Humana and the Marketplace to get it straight. It took about 2 months for them to figure out WTF happened and get me a correct tax form to give my accountant. I ended up having to file an extension because of this. It was a f*cking nightmare. During the process of getting that fixed I had to explain multiple times what had happened and was asked more than once why I hadn't requested an investigation into it...I HAD with both the company and the marketplace and there was no record of it.
Write down every name and extension of the people you talk to. Screen shot everything you do online. I ddin't do that becuase I didn't think I needed to, I knew the error was on their end, it was admitted to me on the phone when the whole fiasco started, so I was just sure they were goign to do the right thing and fix it. Nope. And I didn't properly cover my ass out of naivety an the belief that people would just do the right thing.
I'm really sorry this is happening to you and I pray you get it straight. Take a lesson from me though and start documenting every single thing about this and keep it all, and don't give up!
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I was so angry! The young man was trying to help me but he couldn't really do anything (yes, I was nice but he could tell I was really upset!). He said that I'd have to go through the Marketplace and reapply. He could see the policy, he could see the payment, yadda, yadda, yadda but no go on the insurance. I told him that the young lady I talked to a couple of weeks ago never mention the policy was cancelled. He could see that it had been when she spoke to me but failed to tell me this important piece of information! If I had known that I would have done something about it then and there! 
DH and I have been unknowingly walking around for two weeks without any healthcare coverage and may not have any for the next six weeks. 
