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Healthcare Market place error

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#1
Hello,
I have BCBS insurance I obtained thru the Market Place. They made an error on our plan by excluding our adult daughter as a dependent for the month of November, which lowered our tax credit and raised our premium from $138 to 821, which we could not afford. I have appealed the case, however, since they are needing to review the case, my insurance was due to terminate and it has been showing us ineligible due to non-payment of that 821 premium for November. We did make a payment of what it should have been ($138) but BCBS still showed us ineligible.

In the mean time, I had to have emergency surgery on 12/28. On that day, I was told I was self pay and that my insurance was not valid, even though my medical group said I was. My wife was in for depression/suicidal (11/13/2018) and enrolled in an outpatient program. SHe has been dropped(as of today) because the insurance wont allow anymore days. My wife cannot find a psychiatrist/therapist due to the status of the insurance.

We have had to skip a mortgage payment in order to keep our coverage going in order, and now I ma working with my lender for a loan modification. Is there anything I can do about the hardship that their mistake has put on us?

Thank you in advance!
Dave
 


quincy

Senior Member
#2
Hello,
I have BCBS insurance I obtained thru the Market Place. They made an error on our plan by excluding our adult daughter as a dependent for the month of November, which lowered our tax credit and raised our premium from $138 to 821, which we could not afford. I have appealed the case, however, since they are needing to review the case, my insurance was due to terminate and it has been showing us ineligible due to non-payment of that 821 premium for November. We did make a payment of what it should have been ($138) but BCBS still showed us ineligible.

In the mean time, I had to have emergency surgery on 12/28. On that day, I was told I was self pay and that my insurance was not valid, even though my medical group said I was. My wife was in for depression/suicidal (11/13/2018) and enrolled in an outpatient program. SHe has been dropped(as of today) because the insurance wont allow anymore days. My wife cannot find a psychiatrist/therapist due to the status of the insurance.

We have had to skip a mortgage payment in order to keep our coverage going in order, and now I ma working with my lender for a loan modification. Is there anything I can do about the hardship that their mistake has put on us?

Thank you in advance!
Dave
What is the name of your state?

You potentially could file a complaint with your state's insurance board.
 

quincy

Senior Member
#6
Thank you for the information.
You're welcome, kb9mnm. I appreciate the thanks.

I hope you can get the loan modification you are seeking and that your insurance issues are resolved in your favor, so that you and your wife and daughter have proper health coverage.

Good luck.
 
#7
Thank you Quincy. Yes, we are caught up now with our monthly premiums, so we are showing eligible. Plus on top of all this, the Market Place, when trying to fix their mistake, put us on 2 different plans; one for November with higher co-pays then one in December with our previous co-pays. The kicker is, they, and I don't know if they have control over this, had us with the same policy/group #s so my health group didn't show the December plan as active and were charging us for the November co-pays. So I am adding that to the complaint as well. Very valuable assistance and I appreciate it!
 

quincy

Senior Member
#8
Thank you Quincy. Yes, we are caught up now with our monthly premiums, so we are showing eligible. Plus on top of all this, the Market Place, when trying to fix their mistake, put us on 2 different plans; one for November with higher co-pays then one in December with our previous co-pays. The kicker is, they, and I don't know if they have control over this, had us with the same policy/group #s so my health group didn't show the December plan as active and were charging us for the November co-pays. So I am adding that to the complaint as well. Very valuable assistance and I appreciate it!
The source of the problem is known, at least, which can often be the biggest challenge when trying to correct an error of the sort you experienced.

I wish you and family good health and good luck. Again, I appreciate the thanks.
 
#9
Hi Quincy,
Yes, that helps tons. And the trickle down affect this has had is unreal. We've had to modify our mortgage to pay the past due premium or we would lose coverage. I filed my complaint this morning, so I'm now patiently waiting. Enjoy your day!

Dave
 

quincy

Senior Member
#10
Hi Quincy,
Yes, that helps tons. And the trickle down affect this has had is unreal. We've had to modify our mortgage to pay the past due premium or we would lose coverage. I filed my complaint this morning, so I'm now patiently waiting. Enjoy your day!

Dave
If you have the chance, I would be interested in knowing how this works out for you. I will hope for the best.
 
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