Premium refund?

[Alexandra813]

What is the name of your state (only U.S. law)? Missouri

I signed up for insurance through my employer, and had premiums taken out starting October 25th 2008. I had never received an ID card and was ill and needed to visit my doctor, so I called the insurance company to find out what was wrong and if I could still go to the doctor, only to find out that the company had no record of me whatsoever.
After a long, drawn out battle with both the insurance company and my HR, I have only been recognized as a member by my insurance company as of today and have not been able to visit a doctor or get my prescriptions filled for two months.
My question is this, and please try not to be patronizing, am I entitled to any kind of refund since I would have been just as well off setting my money on fire?
I have signed up with a new insurance company for next year.

 

[ecmst12]

If you paid for coverage you did not receive, then yes you should get that money back.

 

[momm2500]

go back to HR and demand that they make your insurance effective when you signed up and have them look at your payroll records. you need this to cover your visits in the mean time.

 

[Conoutofconsume]

If you paid and you have evidence of payment you should be covered

From what I understand you are saying that you have a payroll deduction for insurance premiums for some date prior to the date you sought medical care. If this is true, you had insurance from the date the payments began.
1-Retrieve all evidence of your payments for health insurance premiums, specifically your paychecks
2-Include copies of bills for your medical expenses
3-Fax your employer and get the names of everyone you speak to, further, confirm in writing what is covered during each conversation
4-Simultaneously copy all communications and forms to your insurance company
5-You should receive insurance company statements explaining the reason for your denial, if they claim you did not have coverage then go to the back of that statement and include your evidence of payment and write to them at the "appeal" address
6-These appeals usually have to be answered within 30 days
7-After you gather written explanations of why you are being denied coverage, compare the statements...for instance if the health insurer says you have not paid and you have a statement from your employer reflecting payment then someone is fibbing
8-In the event you get no satisfaction from your employer or your insurer, plan on notifying the state insurance department AND send a written copy to the insurer

 

[Zigner]

From what I understand you are saying that you have a payroll deduction for insurance premiums for some date prior to the date you sought medical care. If this is true, you had insurance from the date the payments began.
1-Retrieve all evidence of your payments for health insurance premiums, specifically your paychecks
2-Include copies of bills for your medical expenses
3-Fax your employer and get the names of everyone you speak to, further, confirm in writing what is covered during each conversation
4-Simultaneously copy all communications and forms to your insurance company
5-You should receive insurance company statements explaining the reason for your denial, if they claim you did not have coverage then go to the back of that statement and include your evidence of payment and write to them at the "appeal" address
6-These appeals usually have to be answered within 30 days
7-After you gather written explanations of why you are being denied coverage, compare the statements...for instance if the health insurer says you have not paid and you have a statement from your employer reflecting payment then someone is fibbing
8-In the event you get no satisfaction from your employer or your insurer, plan on notifying the state insurance department AND send a written copy to the insurer

If the insurer never received enrollment information, then the employee is not covered. Appealing and cc'ing to the insurance company would do no good.

 

[momm2500]

Then that is the employer's fault and have to make good on it for the employee!

 

[Alexandra813]

The problem is that I do not know who is at fault. My premiums were being deducted, and (I was told) being sent to Aenta. No one can tell me who effed up. So I don't know who to hold responsible. And Aetna refuses to give me any money back.

 

[ecmst12]

Aetna isn't responsible to give you your money back, your employer is.

 

[momm2500]

your employer is the one to notify Aetna if you are to be covered. your employer is the one that sends the premiums in for the health insurance. you need to go back to you employer and speak with them. they are the ones that supply the information to the insurance company! they are the ones that need to refund you any premiums or make your insurance effective when it should have been.