A quick primer for the non-US readers: in US a lot of small business owners like us buy our policy from ACA Exchange, which is a government site. It presents us with policies from various private insurance companies, we pick one, it lasts a year, then it expires and we have to repeat the process. The private insurance carrier assigns our policy Member and Group numbers.
Our current policy is with Blue Cross Blue Shield of Texas. It’s set on automatic bank draft, because BCBSTX has a history of claiming to not receive payments when they are made in any other way. If the payment isn’t received, they cancel the policy.
Yesterday
Email.
Member ID – 92509677301
This is to let you know that your monthly payment amount has changed. Your new payment, scheduled to be taken on 09/18/2019, will now be $19,411.56.
Remember you can always log in to www.bcbstx.com and view your payment history or make updates to your payment options.
This is the member number for the policy that expired last year billed at the current year’s rate for 9 months. They are going to autodraft it.
Went to the website.
Another email.
Member ID – 925096773
We are sending you this reminder that your payment is due on the last day of each month. Please make your payment today to avoid being late and a possible disruption in coverage.
Not our member ID number. My name, but not the right number.
I call to member service and get a nice call center lady from India who absolutely cannot help me, because she’s been trained to answer basic questions and this is some sort of whatthefuckery she has never seen before. She transfers me to exchange.
Exchange, listening to everything: Okay, this is illegal and they can’t do that. The policy wasn’t cancelled. It expired. Call them tomorrow during business hours and try to go up the chain of command as high as you can.
Today
Member ID – 925096773
We are sending you this reminder that your payment is due on the last day of each month. Please make your payment today to avoid being late and a possible disruption in coverage.
Another email, with the member number from yesterday, which I haven’t seen before.
Website still inaccessible.
Me, calling to Member Services.
Representative, listening to the tale of woe: Let me put you on hold.
…..
…..
…..
Rep: I’m sending this to be fixed.
Me: What do you mean, fixed?
Rep, obviously not wanting to answer the question: This is an issue.
Me: What do you mean? Are you going to attempt to draft $19, 411.56 from my account?
Rep: Honestly, I don’t even see it. Look, there is an issue that’s affecting about 1,400 customers from the exchange. It will be fixed. Keep using your old member cards. Everything is fine.
My plan was to post a pretty post about my new African violet which has just bloomed.
And here is the Le Carousel, which is still not cherry, but is very pretty now in full bloom.
My flower joy is now quite diminished, for obvious reasons.
It’s pretty, right? ::sigh:: I guess I will wait till 18th to see if they try to draft $19K from our account.
I am sorry you are having to deal with this. I have learned in my 13 years of dealing with medical insurance companies and Medicare is that they are not beneficiary oriented. For 3 months after a doctor visit, I dealt with when are we getting paid calls, insurance company claiming not to have gotten monthly payments (yes they were monthly bank drafts), insurance company claiming beneficiary not covered, insurance company claiming secondary to Medicare, Medicare claiming secondary to primate insurance…. so I had bank make 2 notarized copies about every 6 month’s where drafts were done and sent to family lawyer along with lists of everyone I spoke with about issues etc. This went on until 2 years after Dad died.
Now Mother is 76 and lives with another sibling as i hit my doneness at 1p years. Now my sibling goes thru same routine. I had to get involved earlier this year as Medicare said her supplemental coverage was primary and they were secondary. Then they decided was a computer glitch.
So good luck. Keep written records in a safe place. And discuss with lawyer Texas protocols for handling.
Also to non-US readers: in the US, health insurance is a for-profit industry, one of the biggest in the country. It has big, big lobbyists so to make sure the government doesn’t do anything detrimental to them, such as set up a single-payer system, make insurance companies accountable to their members, or eve pass and enforce a true affordable care system.
I just moved to Texas. Back to Texas. Something. I was on Medicaid in Washington (state provided healthcare for poor people, who can’t afford to pay for any). It was excellent. Their income cut off — the maximum you could make to still be eligible — for a single adult not eligible for Medicare was $1397/month. Not a lot especially in the Seattle area where rent for a 1-bedroom apartment in an average area was around $2000/month. Yup. I lived with friends. I had to ask my manager at my part-time job to limit my hours so I didn’t go over the line while I looked for a better-paying job and/or. A job that offered benefits. I had looked into rates for individual health plans, the kind I paid for myself. For my circumstances, age, medical condition (do you take any meds regularly, what kind, do you have any chronic conditions) and found three that would cover me. I could pay $450/month and have a deductible of $10,000 that I’d have to satisfy before they’d pay for anything, even drugs. Or I could have a $1500 deductible plan that covered everything at 80%, for $850/month. Finally I moved. And in Texas? To be eligible for Medicaid you can make no money. $0/month. So, either stay completely poor and we’ll pay your medical, including the major depression you’ll have because you cannot work at even a low-paying job while you try to do better.
The only difference between Texas and Washington in this is that in Washington they dangle the illusion that you can have healthcare while you work up to being fully self-supporting. They call it the cycle of poverty for a reason. (BTW, before some difficulties, I was a higher-level professional in the tech sector. Almost everyone is only one major health crisis from deep poverty, or homelessness if you don’t have amazing friends or family who’ll take you in while you flail your way back up.)
Well, that got long.
Call you bank ASAP. Put a stop payment on the eft draft and notify BCBS. Send your regular payment in early by check and get a copy of the cancelled check that shows BCBS deposited it. Email a letter explaining your situation and a copy of the expired policy and a copy of the cancelled stop payment order and your current enrollment payment’s cancelled check to the BCBSTX producer email. (Producer_Service_Center@hcsc.net) – they might say you have the wrong area, but ask them to forward it to the appropriate service team and copy you on it.
Good luck on this, I manage the benefits for my company and it requires a ton of patience to get through.
Appreciate tips. Taking notes.
+1
Another route is to ask for a supervisor right away. As you experienced with your first call most customer service reps are on a script. Anything that deviates from said script they don’t know what to do with. Having dealt with several different insurance companies over the years being a medical biller, I always recommend to patients that are not receiving the results they want or the information that they need to do this. You pay for their services somebody at that company has got to be able give you that answer.
I mean the attorney in me is really rooting for them to actually deduct $19,000 because that smells like a lawsuit but the person beneath the attorney knows it isn’t worth it.
If it’s not fixed, you need to complain to the Blue Cross Association. That is when heads would roll. They control the local Blue Cross’ accreditation and they would take this very seriously.
Texas Department of Insurance.
No chance it’s a fake? I had that happen once. Thought I was dealing with a real insurance company, and it turned out to be a fraud the whole time. I finally just quit responding and they went away.
I know I should be sympathetic but I’m afraid all I can summon is mildly hysterical ‘Yep, I hear you Sister!’ type laughter! I suspect we’ve all been there. And I feel so sorry for the off-shore CSRs who must get heartily sick of being on the receiving end of First World disgruntlement and/or fury – I’ve know I’ve felt thoroughly ashamed of myself by the end of some of my less controlled phone calls. The flowers are pretty though – thank you for sharing!
For some reason fake ACA reps keep calling my work phone number. I have pretty good insurance through my employer (previously I got my insurance through the ACA marketplace, so I also sympathize with that), and I find it hilarious every time I get a phone call from them.
Your flowers are lovely.
Sruff like this makes me happy I just pay 38% in taxes and don’t worry about healthcare.
I pay more than that between federal and state taxes (Hawaii has 12%!!!) and still pay $2150/mo for my husband and I in health insurance. He had a heart attack 19 years ago (he was 40) and I had asthma, so we are both considered high risk. I really want universal healthcare here, but ,,, not the place for more here. We envy you.
Thank you, House Andrews, for the pretty flowers.
Here’s what really happened:
bozo#1: “Oops…”
bozo#2: “That doesn’t sound good. What did you oops?”
bozo#1: “I just deleted the customer database by accident”
bozo#2: “Whew, you had me worried for a moment there. Don’t worry, just restore the backup! I do that all the time when I don’t have enough coffee”
bozo#1:
bozo#1: “Ready to go to the pub?”
… days pass…
bozo#2: “Hey, remember when you restored the customer database?”
bozo#1: “Maybe?”
bozo#2: “Where did you get the backup from?”
bozo#1: “Folder 20180831, why?”
[grumbling] Can’t use greater than, less than in comments or the content disappears.
That empty line is supposed to say “restores backup”
When I read these kind of tales, I’m very glad I live in a country with a public healthcare system. It’s far from perfect and we have to pay high taxes for it, but at least it saves us lots of headaches. I hope you can fix it quickly and in the least painful way.
On the topic of healthcare costs my inbox today featured a book about this by a top Johns Hopkins surgeon.
https://articles.mercola.com/sites/articles/archive/2019/09/08/reinventing-health-care.aspx?utm_source=dnl&utm_medium=email&utm_content=art1ReadMore&utm_campaign=20190908Z1&et_cid=DM341209&et_rid=703765172
I am a Canadian who is oh so grateful for our healthcare system. I lived and worked in Galveston in 1978. The difference is quite dramatic. In Galveston I had to fill out a billing requisition for every Band-Aid, roll of tape, catheter and IV bag. When a patient needed oxygen it was billed by the minute and the flow rate. The closest I have seen to this here is occasionally a hospital will mail a patient a report itemizing the cost of the care they received on their hospital stay. Not an invoice just a statement of how much were spent.
My friend who lives in Jacksonville tells me the reason you cannot afford healthcare system is because of your military spending. I don’t know but it seems to me that is not why a bottle of insulin is 10 times the price here in Canada.
One way you can get safe information to help you make decisions on treatment and prescriptions is to check your diagnoses at lef.org. Life extension foundation has a medical team that reads double blind research studies published in peer reviewed journals and uses the information to create disease management protocols. Free to access and worth its weight in gold.
For instance part of the hypertension protocol includes a list of the top 10 medications prescribed. What the therapeutic ranges are and what the doctors commonly prescribe and how much that exceeds the therapeutic level.
Sandra
Helpful comment no. 1 (cough,cough)….don’t live in USA if you want health care…. ????. It really is the most inefficient and ineffective system imaginable. And I have studied systems in quite a lot of countries.
My thought is if you have to pay for insurance just in case you fall ill your living in a third world country, and yes the USA is a third world country.
My friend spent a year trying to get her deaf daughter new hearing aids from her insurance. Daughter has been deaf since birth and had 10 year old hearing aids that were just not working. She tracked the time she spent on this “project”. Over the year she averaged about 14 hours a week for 58 weeks. Much of it on hold. Did you know hearing aids are cosmetic? Because, of course, every little girl wants a hearing aid. Eventually a charity thru the school paid for them. $3000 plus the cost of the ear molds. She never did convince the insurance company that the hearing aids were well and truly dead.
Between our small business and my husband’s job last year with copays and premiums, 40% of our income (last year) went to medical expenses.
Medical costs in the US are just stupid. Not even counting the time I spend tracking down why something hasn’t been paid.
I also spend a good bit of time writing letters for veterans appealing decisions by the VA. THATS always fun. The approval department used to have 12 full time employees. Now they have 2. While nobody has outright said it, they’re so overwhelmed they seem to just refuse nearly all first claims and deal with them as they’re appealed. Many of the old vets just accept the denial and pay for the care on their own. I write a mean appeal letter…
Good luck dealing with your insurance issues…
I am so sorry that you or anyone else is dealing with this. I love the flowers especially the one with the speckles.
Focus on those lovely blooms and just breathe…
As a high consumer of health care, I feel your pain. Our system is all about profiting from disease, not caring for the ill.
Now excuse me, I have to get ready for a doc appointment.
You could go right to your U.S. Congressional representative. Give that person a chance to be a hero. Love the violets. Mine are not blooming now.
Might want to make sure it wasn’t a scam. Called the bank one time to activate a credit card and got a person instead. Unfortunately have them the number before deciding something wasn’t right. So went to the bank and asked and was told that’s not how it’s done. Got a new card.
Don’t know if your husband can get tri-care or not. Once your kids are working and can get their own insurance, would go with +1 which would cover both of you.
The US healthcare system makes no sense to me.
Anyway, you’re making me want to get some plants in my little apartment. I’m worried my cat will eat them though…
I WOULD EMPTY MY ACCOUNT LEAVING THE MINIMUM AMOUNT TO KEEP THE ACCOUNT OPEN OR A LITTLE MORE THAN WHAT YOUR PYMT SHOULD BE, AND TRANSFER ALL OTHER FUNDS TO A NEW …OR OTHER ACCOUNT. WHEN/IF THEY TRY TO STEAL THE $ FROM THAT ACCOUNT, IT WILL BOUNCE BUT YOU WILL HAVE PROOF THEY TRIED TO STEAL IT. I KNOW TECHNICALLY THEIR GLITCH IS NOT ATTEMPTED THEFT…BUT IT IS IN MY OPINION. HAVING AN AGENT OFFICE TO WALK INTO WOULD HAVE BEEN NICE. I WOULD THEN MAKE MY NEXT CALL TO THE TEXAS INSURANCE COMMISSIONER WITH ALL INFO AND HAVE IT READY TO EMAIL OR FAX TO THEM. Knowing that 1,400 others in Texas are having the same issue doesn’t leave anybody feeling warm and comfy.
Your African violets are looking beautiful. My mother grew them beautifully too. I haven’t found the right window, watering plan, or green thumb for them.
My mom could grow Africa violets, too. They were gorgeous. My green thumb is more yellow. I can kill anything it seems. ????
I work in the healthcare system, and I hate insurance with a passion. I also hate the bureaucracy that is the American healthcare system, so, I’m right there with ya sister… in other news…
What kind of violet is that purple one? It’s SOOOO Pretty. 😀
I cannot understand why your government is so resistant to universal health care. It’s not a perfect system but it doesn’t cost my family over $2000 a month to get messed around.
Oh man, I attempted to get my amount changed after I started working in the middle of the year (because you are supposed to and I didn’t want a big bill at the end of the year). Don’t do it! It took the rest if the year to straighten out the mess that happened! Gah! 6 months of weirdness and monthly phone calls. Good luck!
They had a computer problem that resulted in their having me listed as 2 different people. It took them 2 years to fix, and once they finally figured it out, I had to go back and re-file my tax return. Idiots.
Beautiful flowers. So very sorry you have insurance difficulties, the companies are so greedy now, you have to almost be an accountant to keep on top of them. I wish you luck and suggest you contact the Texas Insurance Commission. They may be of help.
Been there, done that. It’s pure horror every year. Fubars about everything, and having to spend days on the phone to fix things. Every year.
And know that, for all its faults, the ACA is loads better than things used to be 10+ years ago. I believe the long arc will bend towards improvement, but man it’s a slog getting there.
I know you posted this days ago. I hope the auto-pay issue has been fixed. I also want to encourage you to keep a close eye on your EOBs. I work in an office that sends claims to BCBS, and they have had more errors since January 2019 than the past several years combined. Things like randomly changing the copay rate for a recurring therapy service MID MONTH (I pulled up the policy details thinking maybe the individual had changed their coverage: nope), processing claims as having both a copay AND a coinsurance (one or the other, never both!), and not correctly applying patient costs to their deductible (patient had $530 left on their deductible before they paid us over $680, and BCBS still said they hadn’t met the deductible). I used to toss my EOBs, now I have to save them just in case. Oh, and because my HSA automatically pays what BCBS says I owe, I might not even get a bill to dispute!
It’s really frustrating because most people don’t know all of the details of their policy. Is your copay for mental health different from your copay for medical care? Does it make a difference if you are seen in a doctor’s office or a different type of facility? What about seeing your PCP vs another provider type? So, someone gets a bill and just assumes it’s right, and even if a percentage of people fight to fix the errors, those who don’t know how or don’t have the time just pay extra and the insurance company makes more “by mistake.”