So if you don’t want to read a long, whiney post, just keep on scrolling. I posted something earlier today that’s a whole lot more uplifting.
I officially left the workforce in November. From an insurance standpoint, this means that I was covered by employer’s policy through the end of the November. In December, I was able to continue that coverage under COBRA which simply meant that I paid 100% of the premium instead of the company paying a portion. As I had met 100% of deductibles, out-of-pocket, etc. and everything (including prescriptions) was being paid, it was a good deal. It took some diligence to make sure everything was in place and that coverage didn’t lapse. The Thanksgiving holiday slowed some progress, but everything worked out.
Now last year, through December, medical coverage was through Insurance Company A. My ex-employer switched insurance providers starting January 1 to Insurance Company B. In order for me to continue coverage, I had to pay my December premium to Company A. Once I paid for December, my information was to be transferred to Company B for coverage under the new policy starting in January. I then had to pay my January premium by a certain point in December. With some hand wringing and tooth gnashing on my part, all of that happened but we got down to December 28 and I had no confirmation (even though I paid the premium) that I actually had health insurance coverage starting January 1. This was important because the first two weeks of January, I have scheduled two sets of labs, one X-Ray, three doctors’ appointments, my Actemra infusion, three prescription refills, and four physical therapy sessions — all of which had to be verified with the new Insurance Company B. But finally on December 28 I was able to print out a temporary insurance card and start providing the pertinent numbers to those various people who needed it.
So I’m feeling pretty good. I start January with a sense of accomplishment that even though I had been treading some pretty treacherous waters, I had successfully transitioned from group coverage to COBRA and then to a new insurance provider.
I guess being smug is the same thing as pride because I was feeling smug and there was definitely a fall in my future.
I was on Insurance Company B’s website checking to make sure that my dentist (with whom I have an upcoming appointment) was in network. But the weird thing was that I didn’t see any dental insurance coverage listed.
I contacted my old HR department. We went around the mulberry bush a few times (metaphorically speaking) before we figured out what happened. In addition to the health insurance election I made back in December, I was to have also made elections (if I wanted) for continuation of dental and vision insurance. But guess what? Those were never transmitted to me, so I had no opportunity to make the elections. So my dental and vision coverages had actually lapsed in December and therefore had not been transferred to the new provider to begin coverage in January. I didn’t know they weren’t bundled altogether, so I didn’t raise a flag at the time. I selected the only thing that was made available, which looked like this (whatever those codes mean):
The “fix” was to go back to Insurance Company A, turn on those elections and pay the December premiums. Theoretically this would then automatically flow through to Insurance Company B where I could then pay the January premiums and once again have my eyes and teeth covered. Oh, and it’s now the first week of January and I only have until January 14 to make all this happen or I lose eligibility. Previously, it took more than two weeks for each step of the process for medical coverage.
So I immediately thought to myself, “Self: It’s still open enrollment. You can just find an individual dental policy and sign up for it and skip all that trauma.” So while I had my old HR department chasing down how to “turn on” the original elections that should have been available to me two months ago, I start on a multiple-hour investigative journey into the land of dental policies to see if I can find a reasonable replacement on my own.
I’m sitting there after a few hours, my desk littered with printouts of policies, trying to sort out which are affordable, which have my dentist in-network, which are insurance companies I’ve actually heard of, and my phone rings.
It’s my physical therapy provider. They can’t verify health insurance benefits for my PT appointment the following morning. It appears that Insurance Company B has my birthdate wrong. Since my provider has the correct birthdate, it doesn’t match what the insurance company (incorrectly) has and they won’t verify that I’m covered.
So this is the first Monday of the new year, right? Insurance companies are getting slammed by people with questions. Insurance Company B’s website has crashed. It won’t even load. (They eventually put up an error message.) I call the customer service number. I am on hold for 46 minutes until I finally get a representative. (Thank you, Sprint for unlimited minutes …) She immediately asks me to verify my birthdate. You can only imagine how that conversation goes.
It doesn’t get much better after that, compounded by the fact that English is obviously not her first language. But she tries to be helpful and eventually, after about 17 security questions, decides she’s actually speaking to me and tries to fix my birthdate. She can’t do it. It’s one of those protected fields that only authorized users can change and she obviously isn’t authorized enough. She says she’s sent the request to “operations” but it may take three to five days for it to be corrected. I explain that’s not good enough and ask if there is a supervisor or someone else who might be able to help. She puts me on hold. Comes back. Puts me on hold again. She finally comes back and tells me that no one is answering — she is rolling directly to voicemail. So after more than an hour, I’m not really any closer to getting the situation fixed than when I started. She did, however, tell me the issue with my birthdate. The last four digits of my Social Security number (which actually form a valid date) got input as my birth year. (I am momentarily elated as this makes me much, much younger than I actually am …) She also told me that my old company should be able to correct this issue on their administrator screens.
So I go back to my old company’s HR department (who is still trying to work on my dental and vision elections) and explain the new problem. No, they can’t fix it on their screens. But they did send in an urgent request to their Insurance Company representative.
Deflated, but not yet defeated, I return to my quest for dental coverage. It turns out the best policy I can find will cost about 20% more than what coverage would be through my old employer. That’s actually not a lot of money as dental premiums are not that expensive for one person. The problem is, that since my dental coverage actually lapsed (through no fault of my own), I was looking at a six- to 12-month waiting period for any kind of dental procedure other than a simple clean and check. I have not one, but two crowns that need to be replaced, so that issue made my finding my own, separate dental policy a really bad idea.
The next morning there is an email for me from the company HR department. They say the birthdate issue on the health insurance is now corrected. Sure enough, when I arrive at the PT appointment, they are able to verify coverage and my pharmacy has also been able to process my prescription refills.
I call Insurance Company A and ask them what the December premiums will be for dental and vision insurance. Even though neither the elections nor the premiums are showing up yet on the website, I make a payment online. As soon as the premium notice shows up, I need to have the payment waiting for it. Because it still has to be processed then transmitted to Insurance Company B in order for me to pay the January premium.
So things aren’t perfect (yet). But the truly large issue of health insurance has, at least, been addressed for the moment. I have people helping me work the issue of the dental and the vision coverage. True these are, no doubt, the same people who caused the screw up in the first place, but who better motivated to correct the situation?
It’s now the third work day of the new year. I hope this week is not a harbinger of the rest of the year. But I do hope your 2016 is not only starting well but will be filled with both health and happiness.
Thanks for checking in.