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No health insurance coverage for December--what would you do?

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Posted 11/29/2014 1:42 AM (GMT 0)
Hi everyone,

I need your advice. I currently have COBRA coverage through my previous employer. It's crazy expensive, but it's a great plan...a lot is covered 100% after meeting the annual deductible, and I met the deductible in April.

Last week I received a letter from the insurance company highlighting that my coverage is ending at the end of November. I called the HR contact with my previous employer to express my concern and left a message, explaining that I already paid them for December, they cashed/deposited the check and I need to know what's going on. I was told that they sent me a letter (I never received it) and that open enrollment is happening and I need to let them know if I want the new plan. I said yes, please sign me up for the new plan.

I followed up and haven't heard anything yet. This has been stressing me out and I have no idea what I should do. I already picked a plan for 2015 with BCBS, but as of right now, I have no coverage for the month of December. I am not eligible for Medicare/Medicaid and my current employer is a small company and does not offer health insurance.

Please, please, please send any advice you may have. I don't think it's fair that I should have to be uninsured for a month when I wasn't notified in time to do something about it.
Posted 11/29/2014 2:11 AM (GMT 0)
Can you call your state insurance commissioner's office and explain your problem?
Get a copy of your cancelled check to prove you paid but the insurer is saying you are not covered.
Sorry for your stress, sucks that you've met your deductible and they are weaseling out.
Posted 11/29/2014 2:58 AM (GMT 0)
Thanks imagardener, it really sucks worrying about this. The way my COBRA plan was set up is that I pay my previous employer and then they pay BCBS. So my previous employer cashed my check but cancelled my current plan (I called the insurance company and they told me that my employer asked to cancel my coverage).

I asked my previous employer to please either refund my money or ensure I'm covered for December. They said they'd sign me up for the new plan and that they'd send me the difference, but then when I tried to follow-up I received no response. I will call the insurance company again to see if they can offer a solution. My previous employer didn't even tell me how much the new coverage is and I don't know enough about what happens with continuation coverage when your employer changes their plan. :(
Posted 11/29/2014 3:50 AM (GMT 0)
Go to the healthcare.gov site. You can sign up at anytime if you lose coverage and have none available at work.
Posted 11/29/2014 4:14 AM (GMT 0)
you said: The way my COBRA plan was set up is that I pay my previous employer and then they pay BCBS. So my previous employer cashed my check but cancelled my current plan (I called the insurance company and they told me that my employer asked to cancel my coverage).

Well now that sounds like fraud. They are sure out on a limb if something medically expensive happens to you after they cancelled your insurance and kept your money. Of course it is a huge hassle to hire a lawyer and threaten to sue them, which they likely know, but I would still contact state insurance commissioner and let them make those creeps life a little worse.
Posted 11/29/2014 5:54 AM (GMT 0)
I can see how one department cashed the check, and another department jammed you up after you did not participate in open enrollment. Sucks, but it happens.

Still, the enrollment was for 2015, so the old plan should have gone thru Dec even if they are dropping it. The combination of being on cobra, not participating in enrollment, and them switching plans was just a triple hex.

I think the best bet is if you can get you old employer to say the cancellation was a mistake. I am not sure you can get anywhere dealing directly with BCBS because you were not the one sending them money.

Hope it works out.

Post Edited (DBwithUC) : 11/29/2014 2:34:22 PM (GMT-7)

Posted 11/29/2014 6:21 AM (GMT 0)
I had a similar problem with Obamacare recently, where it was impossible for me to have coverage for one month. I would say to visit your doctor ASAP if possible and explain the situation and get everything done you may need for now. If he/she can't see you, see if you can at least get any prescriptions you might need.


I find this stuff so stressful. I'm doing my best to take care of myself but I feel like insurance sure doesn't make it easy. Good luck!
Posted 11/29/2014 7:02 AM (GMT 0)
How long have you been on Cobra? You can stay on it for at least 18 months so they can't refuse to provide coverage if it's been less than 18 months.

From http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html

Q12: Can continuation coverage be terminated early for any reason?
A group health plan may terminate coverage earlier than the end of the maximum period for any of the following reasons:
Premiums are not paid in full on a timely basis;
The employer ceases to maintain any group health plan;
A qualified beneficiary begins coverage under another group health plan after electing continuation coverage;
A qualified beneficiary becomes entitled to Medicare benefits after electing continuation coverage; or
A qualified beneficiary engages in conduct that would justify the plan in terminating coverage of a similarly situated participant or beneficiary not receiving continuation coverage (such as fraud).
If continuation coverage is terminated early, the plan must provide the qualified beneficiary with an early termination notice. The notice must be given as soon as practicable after the decision is made, and it must describe the date coverage will terminate, the reason for termination, and any rights the qualified beneficiary may have under the plan or applicable law to elect alternative group or individual coverage.
Posted 11/29/2014 9:02 AM (GMT 0)
Thank you all. I appreciate the advice.

I have only been on COBRA for 9 months. The open enrollment/new coverage from my ex employer would have started in December if they had signed me up (which is surprising because my current plan is Jan. to Dec.). I don't understand how they can cancel a plan one month early to opt for a new one.

The coverage I picked for 2015 was not under COBRA. I called BCBS a second time to pick a plan for next year so that I don't have to deal with my ex employer anymore. So I just need my ex employer to either sign me up for December or refund my money.

As kiptyn mentioned, my ex employer should've notified me of any changes since I'm still eligible for COBRA. I found out from the insurance company that I was terminated under my current plan (by my ex employer).

I'll call the state insurance commissioner and my ex employer on Monday. I'll also check out the healthcare.gov site to get December coverage.
Posted 11/29/2014 4:28 PM (GMT 0)
Unfortunately I don't think you can get coverage so fast, not in NY at least. My debacle happened where I tried switching insurance on the 16th of the month and they canceled my old insurance and said my new one wouldn't begin until the mint after, because I switched after the 25th of the month. Not a great system, and now I just found out Lialda isn't covered!!
Posted 11/29/2014 6:38 PM (GMT 0)
Hi parallelograms,

I'm so sorry that your prescription isn't covered under your new plan and that you don't have coverage right now. I hope everything turns out okay.

I just looked at the healthcare.gov website and called the phone # listed. I explained the situation and was told I can enroll for December as part of the special enrollment period. But, there will be a delay, like you said. It takes 72 hours for the insurance company to receive/process the information, and then they need to receive payment before I'm actually enrolled. Then I can call them to request my member ID #.

I'm hoping that I'll officially have coverage after the first week of December. I have a doctor's appointment on the 16th and will likely have bloodwork too. I'm very fortunate to be healthier than I was earlier this year, so I don't anticipate any emergencies. It just stinks putting so much time and effort into something I thought had been taken care of for 2014. I hope I can get my money back from my previous employer soon.

Thank you again to everyone who responded to my post. It really helped me a lot.
Posted 11/29/2014 6:43 PM (GMT 0)
I actually just called my insurance and found out my premium is going up 200% and my deductible is going up 800% on Obamacare. And my subsidy was cut by 50%. I have had nothing but my problems with my insurance since joining the health exchange, I wouldn't recommend it as a long term solution.
Posted 11/29/2014 7:47 PM (GMT 0)

parallelograms said...
I actually just called my insurance and found out my premium is going up 200% and my deductible is going up 800% on Obamacare. And my subsidy was cut by 50%. I have had nothing but my problems with my insurance since joining the health exchange, I wouldn't recommend it as a long term solution.

If that information is only from your insurance company, verify it. If your income is the same, your subsidy should be going up not down. The subsidy is based on a percentage of income and has not changed. The only thing worse than the federal and some state market places is some of the insurance companies for bad information. On the federal site, the only way you get correct info on deductibles and copays, and the amount of your premium is to actually sign in and apply especially if you have a silver plan and receive subsidies.

I did not find a single insurance company that would even quote a real price and detail coverage details for 2015. My company told me only my premium payment amount and only for my current policy. They just told me to go to the federal website. I am going to "shop" starting after Jan 1-feb 15 when the details will be out. Same BS insurance companies pull with medicare supplements.

ps for those that do not know, you get no subsidy of any kind unless you buy through the healthcare.gov site. My insurance companies are trying to peddle direct and aren't clear about that.
Posted 11/29/2014 8:46 PM (GMT 0)
Just to expand on AZ, in the states that have their own exchanges you can only get subsidies if you go through the state's exchange and that has nothing to do with healthcare.gov, other than healthcare.gov will steer you to your state's excghange.
Posted Yesterday 12:13 AM (GMT 0)
@AZYooper - My insurance has actually been more helpful than the exchange so far. I logged on to see what was going on and it wouldn't let me access anything useful, including what my income is listed as. I haven't updated anything, so I have no idea what could have changed. Fingers crossed that it's all a mistake.
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