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.
That is insane.
However, the flowers are indeed very beautiful.
The color of the purple violet is beautiful, especially the way it looks speckled. (You have my sympathy about the horrors of your healthcare issue.)
Oh boy, good luck! Too bad you can’t get Curran to go over and “talk” to them as he did with the real estate guys…
I’m so sorry for your insurance woes. I, briefly, had BCBS here in Illinois – it was not a happy time.
Your african violets are gorgeous – my luck in growing them is a quick death for said plants.
Could we not disappear to a proper civilized country with a delightfully chaotic Parliament, less machine guns and, stay with me on this one, universal healthcare? We don’t even have to tell the children, because they are technically adults.
I will take Brexit over this. I am not kidding.
Denmark is pretty nice. We do have a few weird politicians but none of them are orange. And very few machineguns.
True, never had to worry about health care here, but the incessant rain on the other hand…
Reading about this reminds to be thankful for the free healthcare here (Sweden). Especially with my reumatic psoriasis and the biological new medicin (expensive) I get that helps me keep healthy enough so I can have a mostly normal life, which includes working a pretty good job and earning a normal wage (and paying my taxes, that helps pay for free healthcare, which I tell myself when I think of the cost).
But I think even us Nordic countries are less stable lately (right Norway, Denmark?), since right suppremists are spreading and making their way into parliaments allover Europe, not just in the places you might have heard of, like Hungary and Greece.
And though I would like to say “come to Sweden, we’re great”, and we probably live up to Gordon’s list (slightly shaky parliament, but free health care), I think it’s too cold here if you’re used to Texas and a more tropical, if airid, climate. Denmark and the south of Sweden might be ok for you, though, if you’d be ok with the british islandsand their climate, and the summers are a lot warmer now than a few years ago so maybe you would like it. The heatwaves are the downside of global warming and they make me long for the cold, rainy summers we used to joke about, but that’s me and I don’t like heat, those of you used to heat might not think our heatwaves are as troublesome. I don’t think anyone died here, not like in France.
I myself am eying Island. I wouldn’t have to live between two electric fans all sum,er, and I like the low population (not much of a people person), and I’ve heard good things on their political progress feminist wise, while it feels like we’re just backrtracking here in Sweden right now…
How is Denmark doing right now btw? And you over in Norway? We pretty much have the same political problems with racist parties right? So moving over to you will just make me as hope-less about the future right?
I read a report about the New Zeeland school system a few years ago that made me positive to the educational policies, but then a friend said you guys don’t have parental leave? How is the political situation with you guys, is New Zeeland a good emigration-prospect?
As depressing as it is, I’ve always figured the grass isn’t greener anywhere else (everyone has problems of some sort, racism and sexism and conflicts, some worse than others definently, but always some problems), so I suppose we had better try to fix our corners of the world by not giving up and keep up the good fight and all that, but sometimes I just feel so tired, and wish there was some magic land to move to…
New Zealand has 22 weeks paid parental leave last time I looked, going up to 26 weeks from July 2020. We also have a public health system that’s stretched but still does an amazing job. We also have ACC (accident compensation corporation) that is also state owned so if you have an accident, as a NZer or a visitor to NZ, your cost of treatment is covered. But you can’t sue – that’s not really a thing here.
Also: our weather is mostly temperate depending on where you live. we only have two varieties of poisonous spider, no snakes, very few dangerous wild animals (pigs? Some goats can get gnarly in the back blocks), lots of beautiful outdoor spaces and a mostly friendly population. Very few guns, heck most of the time our police don’t even carry. I live in Wellington (the capital), in the ‘burbs about 20 mins from centre of town, 40 in rush hour. Temp ranges from around 5c (40f) in Winter to 30c (85f) in summer. We supposedly have more restaurants, cafes and bars per head of population than Manhattan, yet I get to listen to the morepork/Rufus (native owl) in the surrounding bush when I go to sleep at night. Bliss. Come live here!
Author Thea Harrison just moved to Costa Rica because she needed better healthcare insurance than she could get in the US. Apparently she could get what she needed in Costa Rica. Author Vella Day lives there too.
I was going to mention this, too.
I have a spare room ????
Canada has NHS as well, doesn’t it?
I just found out last week that I am the victim of identity theft. Folks are opening credit cards in my name! I’ve disputed it all over the place. Froze my credit. I suppose I am lucky I went so many years without this happening!
I filed a police report. First one ever. And I sincerely hope the last one too.
The flowers are stunning. 🙂
Unfortunately New Zealand is probably too cold for you…
Our parliament is only mildly chaotic (it’s been nearly 40 years since someone called a snap election while drunk) and our speaker of the house is well known for helping to make parliament a child friendly place…
https://time.com/5658588/new-zealand-speaker-feeds-baby-parliament/
(this was not actually a one off, he is apparently well known for being complete putty when it comes to babies).
The number of guns is also steadily going down (even the police do not routinely carry in their day to day business).
I have a ridiculously romantic view of New Zealand from too much Susan Napier reading.
Nalini Singh lives in New Zealand.
Kid 1 and Kid 2 are smart enough to track you down by IP address and then sic the dogs on you. I feel like they might feed them yummy stinky food and give them a lot of water before seeing you, too, so you’d get extra stinky reunion and excitement piddles.
We are definitely not perfect, the cost of living is high, the housing is pretty awful and the drivers are frequently insane (and the health system could be much better).
What we are though is small and often boring, kiwis overseas talk about being weirded out by the fact that car crashes don’t make front page headlines.
I could never get used to seeing guns on police when I was overseas…
We’ll totally take you two. You can have my spare room while you get settled. 😀
Take me with you!
This is why author Thea Harrison just moved to Costa Rica. They have affordable health care.
I know. She keeps torturing me with pictures of her beautiful house through Facebook Messenger.
My husband and I have discussed this. There are entire towns in Italy and Spain for sale.
We’ve discussed it too. But not seriously. 🙁 I’d move in a heartbeat.
And we get insurance from work so I can’t even complain about it.
But, I just heard last week that I am the victim of identity theft. Folks are opening credit cards in my name! I’ve disputed it all over the place. I suppose I am lucky I went so many years without this happening!
I filed a police report. First one ever. And I sincerely hope the last one too.
The flowers are stunning.
We’ve discussed it too. But not seriously. 🙁 I’d move in a heartbeat but hubby is not so keen.
I just found out last week that I am the victim of identity theft. Folks are opening credit cards in my name! I’ve disputed it all over the place. I suppose I am lucky I went so many years without this happening!
I filed a police report. First one ever. And I sincerely hope the last one too.
The flowers are stunning though. 🙂
Hi
Yes in Italy there is universal health care but it doesn’t work very well . if you have a heath isuue problem , the unique way is to go to private clinics and pay a lot because in the hospitals you have to wait months before that they look to you or you need to have a recommendation from the high planes.
Not everything that shine it’s gold.
Good luck with everything!
I’m with you, Gordon. Our health insurance is a joke, only none of its victims are laughing. Good luck getting your insurance mess cleared up.
Beautiful. It’s clear Dina has inherited her green tumb from Ilona.
I’ll recommend Spain… But even if our health care is great (in comparison, waiting lists are almost eternal i.e), the political issues are over the top and going up daily.
I’m over here looking at Colleges in Canada for my kids. They hate winter but I think they will be safer.
OMG! This system is so messed up! Fingers crossed they fix the issue and you don’t get to pay anything extra.
I am also experiencing WTFery with BCBSTX but in a slightly different way … they *lowered* my premium. O…KAY. But I feel like this will not go well, somehow.
And now I am fighting an uphill battle to have my out-of-network cancer care approved b/c my in-network oncologist absolutely says I can’t get treated by anyone locally and have to go to MD Anderson in Houston, which is of course requires the Hand of God at the highest levels of BCBS to sign off. So wish me luck. I’ve got PET scan results and two doctor statements backing me up, but we’ll see.
First, I am so sorry about cancer. I had no idea. Everything crossed for quick recovery.
Second, this is so messed up. So, so messed up. I am so sorry that they are giving yout he run around.
Can’t do any better than M D Anderson.
Best of luck with your insurance battle. I’m currently being treated for cancer at MD Anderson in Houston (and I’m a local resident here)–if you have any questions a patient can help answer, feel free to reach out to me. shasta@majorweather.com
❤️❤️❤️
@Rachel – I am so sorry to read this. It’s infuriating to be having to manage a serious health issue and insurance messes. I hope MD Anderson is miraculous – I know they will be kind.
I hate the exchange. Hate Blue Cross, which is my only option. Every year my policy gets cancelled, due to lost communication between the exchange and BC. Do they tell me? No. No notification that there is an issue, that funds haven’t been drafted from my account, or which one I need to talk to. Three years running. I find out when I go to the pharmacy to pick up my husband’s medications. We are sorry, your policy has been cancelled.
I have learned and I now call twice to make sure they actually have the damn policy active and on file.
Make sure you send them any overdraft fees!!!!!?
Can you set it to draft from a different bank account? I have a few different checking accounts. One is used just for payments for certain companies that have issues and only a certain amount of funds gets deposited into that account. For profit health insurance is the devil. You can call multiple times and get a different answer each time…and you have no recourse. It’s horribly frustrating and incredibly expensive.
Holy crap, that is some whacky sh** they’re trying to pull. Wow. Can the better business bureau help with this kind of fu**ery?
Hope all resolves and they don’t try to take almost 20 k which you will have to fight tooth and nail to get back …
I cannot even imagine the stress. Especially if you have medical anxiety, dealing with the admin part of it and having non responses like this is nightmare on toast. Sending you strength to even,
I can’t believe they want to bring this mess over to the U.K. ????????♀️
You make me love my country everytime healthcare comes up. So glad I don’t have to deal with that!
But lovely flowers!
From Cloudy Denmark
Some days it’s hard to like living in the USA.
Is there any way to notify your bank and have them refuse payment? I don’t know what your finances are like but that seems like a lot of money to try to get back.
Call your bank let them know whats going on and put a stop on the autodraft from their end until bcbs fixes things. you can choose to stop any autodrafts at your bank at any time.
The electronic payment systems in the US just baffles me. The most technological advanced country is so backwards in its approach to electronic payments. Most of my utilities charge us for making electronic payments, but paying by check is still free. Our name is wrong on our fire hydrant tax thingee, everything issued by the same department is correct, except this. I’ve called 3 times to try to correct it, and still, we got a slightly changed, but still wrong payment notice.
What I’m saying is: I feel your pain. But $19xxx is still a sh*t ton of money to be charged by mistake.
The most technologically advanced country…
South Korea? ;P
+1
Our system needs some serious reworking. I was in private practice, where we had to deal with both ends of the insurance. We had to get small business policies as well as deal with denials of care and other issues for our patients. The only ones who come out well are the very well paid insurance executives (multi-million dollar salaries) who show profit by not spending money for health care. We used to spend excessive amounts of time trying to get care covered for our patients, after the insurance companies ‘negotiated’ low rates for our services (barely break even in many cases).
It’s very pretty. My african violet, which was happy for years, is not happy right now and I need to figure out why. I’m glad yours are blooming so well and I can look at your pictures in the meantime :-). I’m sorry you’re on the Wretched Insurance Merry-Go-Round. I despise dealing with insurance and call systems.
Sheesh! No one needs that grief. I’m fortunate that the Bob’s state employee system has been pretty good.
The violets are gorgeous!
I can’t believe what Americans go through with health care. Terrible for a first world country. ????
Siobhan
+1
+1!
The flowers are beautiful! Dealing with health care is not. Good luck!
That sounds like a never ending nightmare! I am so sorry and I really hope they don’t take the 19k!! After spending 4 yrs in the US and 3+ years in Australia (as non citizens and non permanent residents) and getting taxed mercilessly for benefits we would never be able to avail, we jumped at the chance to move to Canada 2 months ago as permanent residents. Life is a tad bit more expensive here, and the husband is still looking for a job, but we also reap so many benefits – life with such security and stability feels surreal, in the best of ways! In our 1st week here I commented to my husband – “so this is what it feels like to really belong to a 1st world country!”
Also – the flowers are so pretty! I’m going to be getting a bunch of African Violets as well. We just bought a jasmine plant a month ago (our 1st plant!!). Finding flowering plants that are dog and cat safe is hard!
I’m just shaking my head. What a mess.
By the way, this is one of my “soapbox” health policy areas. What do I mean? This is one of the many health care topics I could really go on about. When someone asks, I’ll ask back, “do you want the short or long version?”
Oh Lord. They absolutely will steal $19,000 and you will NEVER GET IT BACK. I think we should all move to Canada.
Not if they decide to move that money to a different account. Or it’s not there for some other reason. But then there will be a bank fee ????
The USA insurance systems scares me a lot, I’m sure good people end up suffering because of it. The NHS isn’t perfect and is always short of funding but we know that whatever happens to us, big or small, our bank balances will not be touched, like our dentistry,which is not free but hugely subsidised, If I had a crown, 2 fillings, healthcheck and the hygienists the maximum it would cost me is £216.however long it took and all follow ups. I can’t understand how a huge, wealthy and health aware country like the USA have not sorted something like it of their own ? I’m not trying to start a ‘ ours is better than yours’, conversation, I’m genuinely trying to understand why ?? What can people do if they can’t afford insurance? Is it affordable? Is there basic cover and richer people can upgrade? Is it compulsory? If you don’t have insurance will you still get treatment? It just seems overwhelming.
I hope you don’t tear out too much of your lovely hair xxx
Love the flowers!
At the strong risk of descending into politics: The USA operates on a philosophy of “personal responsibility” in many areas. This is one of them. The fundamental problem with the philosophy as applied to health care is that your health is not under your ultimate control– so, if I get cancer due to a collection of random factors, I can’t actively make that not happen. There are networks of providers that insurance companies have agreements with, which reduces the cost of medical care for the insurance companies if their consumers use those providers. If not, the charge is passed on to the consumers. The idea of coinsurance/copays is (allegedly) to encourage consumers to be “thoughtful” users of medical care (we are told). Fundamentally, though, how “thoughtful” can you be? If I break my ankle (as I did a couple of years ago), my medical insurance requiring me to pay >$2K of cost myself does not alter the fact that I needed to have x-rays, an emergency splint, surgery to fix both leg bones (I snapped both at the ankle), and several follow-up visits with x-rays to monitor how it was healing. (I mean, sure, I could have made the “thoughtful” decision that I couldn’t afford surgery and given up on walking for the rest of my life, but that comes with costs as well.) I also had to use 2 months of disability leave since the surgeon indicated I wasn’t permitted to do any work while rehabilitating.
So, what happens if you can’t afford medical care? The emergency room is required to provide care to you. Other providers are not, but usually will, and will attempt to set up payment plans for you. If you can’t make the payments, collection agencies will come after you for them. One of the more common reasons people go bankrupt is due to medical care; avoiding this is the reason that people sue.
(The way to get additional money out of an insurance company is to file suit against the holder of the policy; these are roundly mocked as frivolous suits, but if you’re facing $20K of “your cost” because someone’s dog bit you or your child in the face [actual example– cost includes hospitalization and plastic surgery], then you sue them to force their insurance to pay it. This is also what happened with the hot coffee lawsuit filed against McDonald’s, where the woman had 3rd degree burns across her thighs and genitalia, had to have skin grafts, and had $20K in costs to cover which she couldn’t afford. She asked for the $20K; McDonald’s offered $800. The jury awarded her $2.8M because they felt McDonald’s had been shockingly negligent given a series of past complaints about the temperature and, also, several people who experienced burns on the hand, etc. Though I think she actually got only $640K of it. Still.)
What if people can’t afford insurance? This is tricky; if you are poor enough, you are covered by Medicaid. Eligibility differs by state; Obamacare tried to expand coverage, but several (Republican-led) states rejected the expansion, leaving groups of people uncovered. Note that providers are not required to accept Medicaid patients. If you are employed full time (or, I think, at least 3/4 time?) by a business with over a particular number of employees (I think 50?), the company is required to purchase insurance as part of a group plan. Note that the cost to cover this insurance reduces the amount the company is willing to pay you, and a portion of the coverage cost also is taken out of your monthly paycheck.
If you are elderly (the cutoff changes over time), you will receive coverage through Medicare and may purchase expanded coverage (e.g., to cover prescription drugs) if you can afford it. Note that providers can limit the number of Medicare patients they accept (because they don’t pay as well).
Is there basic coverage that covers everyone? Eh, not really. Your employer may have “tiers” of insurance that balance cost to you with coverage.
As you can see, there are definite holes in coverage. What if you work for a company with < 50 employees? Well, then you need to either get added on to a spouse's policy (most likely) or purchase insurance for yourself. The cost of the latter was traditionally enormous– and still isn't small (though the state exchanges created for Obamacare attempt to address this problem). What if you work < 30 hours per week? Same issue. What if you want to retire early? Be careful, because you lose your employer-provided healthcare when you do. What if you start your own small business? The need to hold on to healthcare is something that prevents people from doing so, actually. And historically, people who have done so anyway (say, writers) have died because they couldn't afford insurance and medical care.
As to why we haven't sorted it out better… there's the personal responsibility philosophy (which carries a lot of weight), a general dislike of anything that smacks of socialism (though Medicare and Social Security are popular programs, people think of them incorrectly as if they were some sort of "savings bank"– where the money they paid in is used to cover them in the future), and a strong lack of faith in the government managing anything. When Obamacare was discussed, there were a bunch of claims that government would set up "death panels" and refuse to cover some people's medical care because it was too expensive. (This is confusing, because this is manifestly what insurance companies already do, and you have no ability to choose another one– you're stuck with what your employer chooses.) There were also arguments that people should be able to choose how much coverage they need and pay accordingly (i.e., that people should be able to select an absolute bare-bones plan if they want). This is also confusing, because you have no idea how much coverage you actually need. I wasn't planning to break my ankle. A former coworker of mine wasn't planning to get fast-moving oral cancer in her late '20s. A friend wasn't planning for his daughter to be diagnosed with a brain-stem tumor in elementary school.
(All of that said, I remember having no money in college and graduate school, and how much I resented any expense, because it impacted my food budget. If you work part time for a low wage, aren't covered by Medicaid, and have to buy your own insurance– this is not a good situation. But I'm not kidding about unexpected accidents.)
Thank you, that is an incredibly informative answer, it’s so complicated, it must be so stressful, when you are ill and already worried and at a low ebb to have all that concern too. I don’t know how you all do it !
This is insane. Where I live you get national insurance and each employee automatically gets the right amount of taxes deducted from their paycheck. The only thing you need to do as a business owner is to download the employees tax card, apply the right tax percentage and send the tax money to the government. Most companies have systems that do that automatically actually.
I feel your pain.
How wonderful it is to work with companies that have no clue. I re-did my kitchen with Lowes, floor, babinets, lighting, and a quartz countertop. There were several problems during the job but the countertop is the worst. The part of the countertop that is on the bar between the kitchen and breakfast nook had a man- or machine- made flaw. They replaced it….with another one that was flawed….and then again. I have now been waiting for three months since the last replacement to have a countertop without a flaw installed. I feel like I am speaking Latin (you know, the dead language) whenever I try to contact someone to help me.
cabinets not babinets. Also, I realize my problem with my kitchen is small potatoes compared to health insurance. Good luck!!
I know this is not on the level of health insurance. Good luck!!
I am so sorry that you are having to deal with this! I always dread anytime I have a big problem and need to deal with customer service on the phone. I hope it gets resolved soon.
The flowers are beautiful!
OMG. Have you tried the Texas Dept. of Insurance?
https://www.tdi.texas.gov/consumer/get-help-with-an-insurance-complaint.html
Call Consumer Help Line at 1-800-252-3439. The help line is open Monday through Friday, 8 a.m. to 5 p.m. Central time.
This is awful. Hope the TDI can help.
PS I enjoyed your pretty flowers; thanks for sharing. My grandparents raised African violets and there used to be a hybridizer in our area. Those plants were awesome!
The last thing the Rep said has me thinking of the Chinese doctor from WWZ (the book), when he said, “Don’t worry, everything’s going to be all right.” Let’s just hope this isn’t a zombie apocalypse.
Btw, I absolutely love your spotted AV. I didn’t know they could be spotted. Beautiful.
“whatthefuckery”! I so love the expressions you use. Having you put into words some of the crap I experience is SUCH a joy. I empathize with you. And am sorry you, or anyone for that matter, have to go through this crap. Bad enough to have to go to a doctor, but then to try to pay for it, let alone trying to pay the correct amount…
Woah. What the fuckery indeed. Can you call the bank and tell them not to let it go through, if they try?
Your flowers are lovely. My grandmother had African violets. Yours make me think of her.
Omg!! We just got billed $15k for a visit a year ago. Our insurance didn’t do their job. The healthcare agency keeps changing names and it’s all whacky. I wish that healthcare was less confusing and…wacky.
Back in the days before grad school I worked on the BCBS customer service lines. Most painful job I ever had. Lots of pressure, not enough information, and I felt useless or even lower as I couldn’t solve people’s problems.
One thing you could do is ask them to read the notes in your file to be sure that the problem was understood so that when you call in again you don’t have to repeat the whole incident. Save your blood pressure, perhaps. Best of luck!
The flowers are gorgeous; your insurance woes, not so much so. I can imagine this as a scene in some upcoming story.
Your flowers are pretty. Our insurance system in the U.S. is broken, but that customer service is off the wall a mess. You guys probably arent the only ones calling or getting emails. Maybe you can ask the bank to stop payment if its above a certain amount, so it doesn’t block the company out right.
That is horrible. I am so sorry you are going through this. Your flowers are so pretty. Hugs, good thoughts and hope for the lessening of your stress levels for the immediately.
I will never ever ever ever ever complain about the NHS again, ever
This is one of those moments I‘m sooooo glad to be German… no one ever thinks about medical insurance here, because everyone always has it. For a reasonable price. I can’t imagine to have to deal with stuff this…
And: tech problems are just plain scary.
+1
You are welcome here in Germany anytime!
Canada is nice. Not as warm as Costa Rica though.
That is awful. I can’t even imagine how frustrated you must be.
Come to Canada! You are already very much loved and respected authors here.
Holy moly, thats just wow. I’m sorry. I would hit the ceiling. I’ll pray it gets fixed so your head doesn’t explode. This system is so messed up. I wish I had any faith it would ever get better…. I’ll stop now b/c otherwise it will just get more depressing.
My hubs is one f the leading experts on insurance in the country. You’ll find him quoted in NYT quite a bit. He is currently the expert witness in the largest anti-trust suit ever to be brought in the U.S. It’s against the blue crosses and Anthem. He will find this fascinating.
I am British. Mum has just gone into hospital for the second time in three months, she’s got breathing and heart problems and is currently described as critical. I cannot imagine how I would deal with what you guys in the US have to deal with!
BCBS is a concatenation of incompetence and malevolence rarely seen on this plane. I am so sorry you have to deal with them ever at all.
I had a catastrophic injury a few years back and had truly great insurance and excellent rehab experiences. Once outpatient, I was saddened (but unsurprised) to learn that rehab equipment considered state of the art, extra-fancy and prohibitively expensive in the US is pretty much the standard in much of the EU. I am staying off my hobbyhorse of the differences in access to quality care based on gender, race and insurance coverage.
A dear friend is now separated – not because the marriage is rocky, but because her husband needs (non-elective) back surgery and the best (and most affordable) place for the surgery and follow up care is in South Korea. So for the next eight months, he’s in SK with her mom, and she’s in Texas with 3 kids under 7 and his dad. The surgeries, followup therapies, living and travel expenses – that all comes in at 40% of what their copays would be if he stayed in the states. His employer is letting him work remotely for the entire time.
I encourage my friends with children who can emigrate to do so.
Austria is lovely this week. That’s the weather. The healthcare is easy, hassle-free, and lovely all year round. As long as we’re throwing out suggestions on where to emigrate.
This is some first class bullshit here.
I feel your pain. I’m in that horrible age bracket between 50 and 62. I don’t get insurance from my employer. When the federal mandate for insurance was removed, I cancelled the insurance I had been paying for because I honestly couldn’t afford it. We’re very limited in insurance carriers in northern California, basically Blue Cross or Blue Shield. The insurance company charged $1,000 a month for the coverage. Because I don’t have $1,000 a month extra, I had to use the subsidy, which was around $800 a month. I then had to multiply that $800 by 12 and count that figure as additional income and PAY TAXES ON IT!!!! And, I had to go with the Silver plan, according to how much money I was making at the time. Otherwise, I would have been up the you know what creek. So, goody, I get to cancel the insurance and have a wee bit of breathing room. Only to find out in June of this year that California’s new governor is going to institute a STATE mandate on health insurance. Now I don’t know what’s going to happen, except that I’m frustrated as all get out and wish all the politicians would just… Uhm, nevermind that part. It could get me in trouble. The flowers are very pretty, by the way. 🙂
Clearly, dealing with insurance issues is one of the circles of Hell, along with buying jeans, bras, and bathing suits! ????????
I’m sorry you’ve encountered this unpleasant detour through the netherworld, but your flowers are enviably beautiful. Sadly, I have a black thumb and successfully and quickly murder all house plants (and many outdoor ones, as well). ????
Gordon’s idea sounds pretty good, but at the risk of getting on his bad side, I have to say that I think he has at least one ulterior motive. I think he’s just angling to finally get a house with a moat. LOL
It seems that until our (US) elected officials are required (“shall” not “may”) receive the same {the least friendly/worst coverage) medical insurance as any of those they “represent” the situati0on won’t change. Unfortunately, as the elected officials make the rules and aren’t likely to fund what adversely affects themselves this is unlikely.
I’m feeling a bit spoiled having Kaiser right now.
Are your auto-drafts for the current year plan still being removed? Was the payment at the end of August/beginning of September taken? I would worry that the “glitch,” in addition to billing you for nine months of 2018’s plan, also stopped taking payments on 2019’s plan, which could cause you to be disenrolled.
It couldn’t hurt to make a printout of the invoice and payment history for the current year in case you need it. It sounds like they know they had a problem with their billing software, but you want to stay on top of it til they resolve the issue, preferably with no overpayments or membership issues for you.
Just in case, this might be a useful site: https://www.tdi.texas.gov/consumer/index.html
Former BCBS employee
+1
I’d pay for the stop payment at the bank just in case it comes through. It’ll be a nightmare trying to get it refunded.
The U.S. Congress IS required to use the Marketplace for insurance and I think they all make too much for subsidies.
Pretty sure I would need immediate medical attention for the heart attack I would have if they told me they were going to auto-draft $19k. ???? Fingers crossed that it gets cleared up quickly and correctly!
+1
ikr.
I’m like ‘fuuuuuuuuu…’
Hell, if it was 19k per year I’d still lose control of my bladder.
Lovely flowers and such pretty colours. We were on holiday in Florida last year and a visit to the hospital was nearly thirteen thousand dollars . Our insurance eventually paid it but we had a few threatening letters from the hospital even though the hospital was in contact with our insurance company.
I would panic at the thought of someone cancelling my insurance and would be checking daily just in case they accidentally pressed the wrong button on the computer.
I can’t understand why you don’t have some kind of health care like we do in the UK or like Canada.
I do hope that they fix this problem you have soon.
As long as the private insurance companies bankroll the election campaigns for US politicians, things will not change for the better.
It is a shame that even a modest improvement like the ACA is being attacked now.
I am on Medicare. It matters to me.
(I have tried to keep this as non-political as I can. My apologies if I have not succeeded. Please feel free to delete.)
OK. One of the (many) major reasons why I am glad the folks immigrated to Canada.
Sorry. It is sad that you are held hostage by your insurance company for health care. We have problems but if any one I love has any wrongness, I never, ever think how much it will cost to get it taken care of. We just go to emergency and know that we will be looked at — even if it takes some time, which we do complain about.
How can a First World country have such a Third World or Worse health care system?
Whatever you do, never get rid of old bcbs insurance cards and proof that you had it. They retroactively took back what they paid for my mom’s cancer surgery 10 years later and insisted she never had insurance with them . They magically discovered all the proof right after notarized copies of all the cards, Bill’s, eobs, and proof of premium payment was sent through a lawyer
Wow. By ten years most people would have thrown out the paperwork. This is scary. Glad your family still had it all!
You’re correct. Never throw away your old insurance cards. I keep all my old medical and my car insurance cards, going back years, in file folders. Just in case. You never know if you might need it.
Yes, ABSOLUTELY keep old auto insurance cards. We ended up owing almost $15,000 in “back taxes” to [undisclosed state] for an old car (which we owned for less than two years) almost twenty years ago, because we couldn’t prove that we didn’t live in that state at the time, AND we didn’t have auto insurance records going that far back, AND neither did the insurance company! Needless to say, I refused to pay the taxes, but this scenario isn’t all that uncommon.
Wow. Why couldn’t you prove that you didn’t live in that state?
The only documentation they would accept was proof of having our car insured in another state after we moved. Neither we nor the insurance company had kept proof because it had been more than ten years in the past. Why would we need it?
Oh, gods, this reminds me of a fun tax situation I went through.
First, my new accountant (I’d just moved to the state when I hired him, but he really had been recommended…) prepared everything, gave me the forms, gave me the slip to send in… and didn’t actually e-file. So the check I send in was deposited, I thought everything was fine, and then a few years later (in the middle of going through spine surgery, while working on my doctorate and really not having the cope, I start getting all kinds of dire warning from the IRS. Who of course also contacts my broker.*
So. Eventually things settle down enough that I figure out how to deal with this. (Look, the surgery was rough, and I never did take time off from graduate school. And most of my spare energy was going to dealing with insurance companies, even though I had decent enough insurance through the university.) All the papers are sent in, and while it takes a long time to get processed, the IRS decides that yes, they never should have taken that money, and they also owe me returns from a couple of other years.
…at which point the state of Ohio steps in, and says that I owe them back taxes from the years before I moved there. See, there was no record of me paying income taxes in any other state. (Because I was living in Washington, which doesn’t have a state income tax.) So most of the money the IRS owed me was seized by Ohio. So then I get to prove that I was living there. Which is easy for the bit where I lived in my house. However, neither I nor my landlord can find the rental agreement for the housebarge I lived in after I left my ex-husband. And my landlord kept all the utilities in his name. And my bank had since been bought to other banks multiple times… (This did eventually all get settled. Though one of the checks did get mailed to the ex-husband, who claimed to forward it, though it was never seen again.)
* Amusing note – keep in mind, I’m most existing on a tiny graduate stipend at this point, for all that I have investments. Just to deal with the immediate situation, I chose to pay, and pulled most of my investments out of my European portfolio… two weeks before Europe really started crashing. There was a bit there when I could say that the best part of my investments were the part that were being mistakenly held by the IRS.
You can thank the Democrats and Obama for this mess as they passed this travesty, of course none of them pay for it or need to use it. It’s really sad that health insurance costs as much as a house payment on top of a gigantic deductible. Obama care is nothing but a Ponzi scheme. Good luck getting the mess sorted out.
No politics on this site please.
Let’s not start slinging political mud here please.
Yeah, we were so much better off without the Affordable Care Act and trying to qualify and afford insurance with no pre-existing conditions. Hint: they didn’t exist.
This is inaccurate. Obama wanted something closer to what he promised during his campaign, but the Repubs blocked him at every turn. What you ended up with was basically Romneycare with Obamas name on it.
This isn’t what is important though. The powers that be want Democrats and Conservatives (citizens not politicians) at each others throats. You need to work together since this is something that will benefits all the regular hardworking joes.
Conservatives and Liberals here in Canada don’t agree on a lot either, but our health insurance is something nobody is willing to give up.
Lisa, you seem to have the most accurate view of the mess.
Please don’t post your political agenda here. This is one of the very few places I can go today without fear of being told how the world is ending from one side or another. I, as well as everyone else I know, am perfectly aware that there are huge problems that need to be solved. The difference between this blog and others is that for the most part we all agree that good always triumphs over evil in the end. We also believe that everyone deserves a happily ever after. Your opinions about who is to blame are just not helpful. What good comes from rehashing history and pointing fingers? If you want to make a difference, then DO something. Help someone. Thank someone. Be grateful for your life and your blessings. Tell us about that….. I love cats too! Tell me about how we’re alike- don’t try too create barriers!
Dear Obama, thank you that I have medical insurance. Nobody would insure my family before you passed ACA. Would vote for you again!
Ilona
My daughter was told she was uninsurable and she had trouble getting a job because no company would insure her. The relief was ….. When the ACA was passed. Thank you Obama.
+1
+1
+1
Agree!
You Go Girl!!!
The USA biomedical coverage is so, so broken. I am so sorry you are having to deal with this whatfukery. The ACA is the one bright spot, and giving it more teeth would be nice.
+
Obama’s health plan saved my daughter’s life. Period.
+1
The ACA allowed my sister to get insurance for the first time as an adult, when she was still a poor artist. (Now she’s a fairly well off artist, but still – central exchanges are great.)
It was only a first step, but…
+1,999,999
Catlover: I thank Barack Obama everyday for the ACA!!
+1 Me, too!
I do miss, back in the sixties, when health insurance companies had to be nonprofit.
+1
+ infinity
And hospitals too. What a disaster taking them private has been.
This comment was redacted for breaking the blog rules. – Ilona.
My plan would be to make sure there was no way 19k “could” be drafted from my account. Once they’ve got it, they wont give it back unless you make them =S
My folks and sister deal with the effery that is the tejas exchanges. It is not fun times.
Agreed. Once they have it, it’s almost guaranteed you’ll have to take legal action to get it back.
Maybe talk to your bank and see what options you have on that end?
It’s tales like this that make me so very thankful I live in Australia. It’s not right that health care should come with so much uncertainty. I hope it gets sorted for you soon. The flowers are stunning!
Wait until you get Medicare! https://twitter.com/akkitwts/status/1169817087646171136?s=20
This dog is HILARIOUS!!!????????????
Oh my God, thank you for this !!!!! Lol
+11111
Come to Australia, we have Medicare, and kangaroo paws
I am so thankful that I live in a country where no one has to worry about medical insurance.
My mother after listening to me read this to her, says to call the insurance commissioner. Also she deals with insurance companies daily.
Filing a complaint with the state insurance board usually gets results quicker than other options.
Im so sorry you live in a world where you need to deal with this and feel thankful for our shitty healthcare here in Slovakia. I never worry if I get taken care of, just when, never worry about any costs except for meds too.
The corruption when it comes to medical insurance in the US is unbelievable. Look, I would never tell anyone to vote for anyone specifically, but if your choice candidate refuses to support Medicare for all, you should be moving on. I don’t care if you are Democrat, Conservation or Independent, you should be putting the candidates’ feet to the fire.
Our system in Canada isn’t perfect, but I’m very thankful for it whenever I hear the medical horror stories coming from the US. People dying because they were denied treatment. The medical bills people receive even though they are supposed to be insured. The bankruptcies. It’s heartbreaking.
Wow that is unacceptable and so stressful!!! I have nothing good to say about the US medical insurance industry.
I’m actually in the emergency room right now. Avoided coming here for two days because I was and am terrified of the bill that’s going to come out of this. I tried to go to the doctor but they said there’s just no appointment available so had to wait until today and then they ended up sending me to the ER anyway…
Horrible that people have to worry about affording bills vs getting necessary medical treatment.
One good thing from this is that I had time to finish Sapphire Flames 🙂 in the waiting room. What to read now?!
Read Ben Aaronavith’s Rivers of London series. So good.
Should be Aaronovitch’s
Thank you! I’m being admitted so will have some time to read!
If you’re into audiobooks the Rivers of London has an amazing narrator.
+1
Re the ER, I have had good luck with the Urgent Care facility in the next town (the one in our town is across the street from the fire station, and if you need care that urgently you’re better off going straight to the EMTs, because the urgent care place here sucks). They can take care of most things that are not fire-engine emergencies, and it’s a lot faster than the ER. Of course since you ended up being admitted, the ER might have been a good call in your case. Enjoy the Rivers!
If you like HEA contemporary romance, Lucy Parker’s London Celebrities series is great fun. Snarky, great dialogue, solid writing.
Good luck at the hospital!
I finished SF but even reading other books I like, I keep drifting back mentally to SF and SOB. Plot speculation, anticipation of when we will see the next one. Re reading while other titles languish because they just arent good enough. Its
not that I got ahold of the latest Ilona Andrews. The books got ahold of me. They dont seem willing to let go. LOL
Insurance sucks.
But I do get a big smile on my face every time you post an African Violet photo. My Grandma’s mom ran a florist shop and grew most of her own flowers in her greenhouse. My Grandfather was a rancher and farmer. My Grandma was always upset because of her “black thumb”. But the one thing she could grow like nobody’s business was African Violets. They were all over her house. She passed a decade ago, so I love little reminders of her in the world.
Really good book by Karen Addison, The Goblin Emporer. The names make my brain hurt, and it’s more Patrick Rothfuss in the pacing, but about every two years I have to go back and read it again.
To be honest health care in the USA completely and utterly freaks me out. As a child of the NHS in the UK I can’t understand how anyone copes with finding an appropriate policy, paying for it and monitoring it to ensure cover. So sorry you are having to deal with such incompetence.
The flowers are lovely, I especially like the purple one.
This is why my husband and I work at jobs that have health insurance benefits …..
While I’m happy to be able to access insurance through our employers, I’m awfully grateful that Ilona and Gordon have chosen to be writers, and think it’s ridiculous that they have to go through hell to get medical coverage. We are the only first-world country that puts profits for shareholders above the health of our citizens. Incidentally, my family was traveling in Belize this past spring and my husband was injured while we were exploring a cave. The local ER docs stitched him up and sent him next door for a bottle of antibiotics. All gratis for non-citizens. Belize is a poor country but their healthcare is top-notch. Makes one wonder why our very wealthy country can’t do better.
+1
And that wonderful how Belize treated you.
Call your BANK! … Tell them what’s going on & to refuse to accept the draft, if it should occur. I have always found my banks (and credit card issuers) to be helpful: they actually want to keep my business.
Let me tell you. Insurance is horrible on the Doctor’s end too. My husband regularly spends 2 hours A DAY to get basic test approved, for cancer! This started summer of 2017 {hint, problem WASN’T Obamacare} . They turn down EVERYTHING automatically. They also set the price for a procedure and drug, {and rarely pay that rate to the doctor} and then make the docs resubmit over and over to get less than owed, knowing the Docs will just eat the last 10 or 15% rather than pay for paperwork. AND they have gone back and retroactively decided they payed too much {even tho it was the amount agreed at the time} and subtract that amount from current reimbursements.
So basically, insurance companies are screwing EVERYONE, Docs and patients.
Pretty Flowers!
Holy moly! If I received those notices, in Maine, I would be on the phone to the insurance commissioner and the AG’s office and maybe the local newspaper. Don’t know if that’s how it works in TX. Good luck!
I haveAetna BlueCross insurance. I set up a reoccurring monthly payment through my on-line banking system. You have to call the BlueCross number on your statement, tell them that you’re setting up payment through your banking system and ask for the correct account number to ensure that it goes through properly. If you do this they can’t charge you $19K for a monthly premium because you’re controlling the funds, not them.
Politics aside, all insurance companies are evil by nature. I am insured by my employer, and relatively speaking (for example, compared to an illegal immigrant working at McDonalds) I have pretty good insurance. It’s still evil, and the company goes out of its way to make sure that no one understands a word it’s saying ever. It would be so awesome not to ever have to try and figure out the Gordian knot that is medical billing and insurance payments and co-payments.
Thank you for the lovely, lovely pictures of your African violets.
I find them terribly tempting, but realize that even if I could grow them, my cats would eat them. The only thing safe seems to be a variegated ivy, since it evidently tastes bad to them. This is good as it is also not good for their health, according to the SPCA list of poisonous plants for cats.
I am completely in agreement with you on the whole WTFery front. It does not have to be hard, it should not be hard, to have decent health insurance. Or even decent health care.
Our current system is a disgrace. The only thing worse is what we had before the ACA, which was an open invitation for the insurance companies to lie, cheat, and steal both from the patient and the doctor or hospital. But the investors loved the profits.
It makes me sick – which I cannot afford.
Oh the joys of dealing with foreign call centres- we’ve all been there and FEEL your pain. Loving the African violet pics ????
I have BC/BS TX. The problem I keep having, is that BC/BS TX is not part of or affiliated with BC/BS in the other 49 States. I have to make that distinction everytime I am asked for my Health Insurance. My insurance ID is unique and significantly different. If the pharmacy or other requester calls for approval they ask for the generic BC/BS and not the Texas Company. Havoc follows.
Good thing to note.
From a banking perspective, you’ll most likely need to alert your bank on the same day as the withdrawal, if they do try it. It would need to be returned as Not Authorized (you don’t really want stop payment because that could get you cancelled with BCBS and since it’s their fault it really should be Not Authorized). If the account is a personal account (using a SSN) then you’d have 60 days, but I’m guessing it’s a business account (using a EIN or TIN) so you’d only have 24 hours. You’ll have to sign at least 1 form (a WSUD), but depending on the bank, it might be more. If it is a business account, it’s a good idea to check it everyday, if you don’t already, to look for errors. Non-consumer accounts don’t generally have the same fraud protections as consumer accounts. Good luck! ????
And yet, BCBS did not make the Medical Loss Ratio required by the state of Texas last year, so they’re issuing premium refunds to individual members who paid them last year.
Maybe it’s a $19k refund?
Every time I hear of experiences like these I thank heaven that I moved from the US to Canada in my 20s. I pay a small amount for provincial insurance annually on my tax returns, but don’t have to fuss with bills or worry that I will lose my house if I get sick. There are restrictions – like I can only have a routine eye exam only every 2 years – but that pales against the psychological relief from not having to worry about finances.
It also seems like our doctors spend more time practicing medicine than dealing with arcane billing systems (70000 codes in the US) or collections. I feel for the people in the US when leaders seem to prioritize military spending takes over the health of its own people.
I think your problems have more to do with your state than the ACA. In California most people I have spoken with are very happy. In AZ people are having trouble too because of bureaucratic red tape. And in WA the marketplace seems to be working well so that thousands of people who could not afford medical insurance now have coverage.
I am sorry about your insurance problems, but you can afford health insurance. Too many Americans couldn’t afford it without the ACA.
Violets are fun to grow and they seem flourish in my sunny kitchen.
First, I didn’t blame the ACA. Second, you’re right, I can afford health insurance. What I can’t afford is the extra $20,000 bill for insurance policy that does not exist.
This is one of those cases where I wonder if the person skimmed the post and didn’t actually read it.
Beautiful flowers! I’m jealous of your green thumb 🙂
There is only one solution to your problem – you need to move north! Ottawa is a lovely city, and it only snows about 7 months of the year. There are no scorpions, although sometimes the elk get lost and meander through downtown. And almost one million tulips bloom each May for the Tulip Festival!
Make sure to check the sender’s email address to make sure the domain is one you recognize (e.g. from xyz@bcbstx.com and not from xyz@hotmail.com). Also, never click on the links in the e-mail. I vaguely recall reading something on their site about phishing.
Yeah, having health insurance is better than not having insurance, but not all health insurance is equal! I like to believe that I would have options, at least, if I was using the ACA exchange.
My previous job used a state-run program that was…better than nothing. Their main issue was(is?) they don’t like to actually PAY. So when I wrecked my knee the 2nd time they just kept lying to me and saying that they would or had paid. Thought I had it taken care of before I got deployed to the desert w my Guard unit in ’09, only to have to go after them AGAIN while I was deployed w my .mil address n all. So they tell me it will be taken care of. 1 month after I get home, I start receiving collection calls on my cell! I talk to my insurance, they say they paid –it’s probably a scam. I check w my hospital, they say they have no record of the bill (turns out that’s cuz they sent it to the collection agency), so i believe its probly a scam. UNTIL i get the Judgement Notice!!!! Livid? Why yes I was! So then I raise 8 or 9 kinds of hell, finally get an insurance rep to pay their part so I can pay my part. Aaaaaand they stuck me with the court fee ($50) but at the time I just wanted to get right w my local hospital, who never deserved to get screwed that way.
So I like to believe, if I was on the ACA exchange, I could get a better company than that 1!!!
First: I’m so sorry you are going through this. I know they will get it fixed, but you may feel the need to murder a few people before they do. I suggest doing it to fictional people– it’s too hot to dig holes in Texas right now.
Second: Your flowers are just beautiful. My mom always watered her African Violets with diluted coffee water. She said the acid was good for them. I make no claims for or against this plan, but Mom’s violets bloomed like nobody’s business.
God bless and I hope all your annoying insurance hijinks get handled quickly and painlessly from here on out.
Good gravy I’m so sorry that happened to you! Even though some here are clumsy I hope you feel our support and appreciation for your candor and sharing. Love the plants. I hope they send you some freebies becuz I didn’t know about them and now I do and bought stuff. Finally not one up just common world weirdness. New neighbors moved into our quiet neighborhood. They offered seller $100000 above asking price 30 day escrow. Turns out ex husband was MAJOR gangbanger kingpin. They had party drive by shooters 5 in car discharged 60 rounds. No one hurt. BUT THEY SHOT MY CAR! Thru the headlight bounced around inside engine nicked transmission killed a.c. compressor. Damages $7600-8000. Mechanic will not agree to gunshot because of fear retaliation so no insurance coverage. Can cover but will really really REALLY hurt for 2+years to recover. My stomach hurt all day. We will survive this krap. Eyes up. Forward!
That is so scary and I’m glad nobody was hurt!
If you took it to a dealer away from your area (I know, a pain) could you get them to go with the truth? Also, you could try having your insurance send an adjuster to look at it instead of having the auto shop do it. Sometimes that gets better results, but it depends on the insurance company too. Good luck!
Thanks for good info.
Well, our social and healthcare insurance is a universal health coverage handled and owned by government, not a private one. Cheap, relieable, and if the citizen is broke, the government will bail us out and pay for our healthcare. Currently, I pay 8 usdollar a month for it, equivalent with 4 times average cost of dinner. Sooo cheap. And for the past 7 years I have the healthcare, I already hospitalized 2 times with total cost of around 30.000 us dollar.
That’s insane. You should put this post on their Facebook page. I’ve noticed that companies *seem* more open to communication and resolving an issue when it’s there for the world to see.
That is just so wrong.. But just to make you feel better these insurance problems are over the other side of the pond as well. We had an insurance expire and we went with a different company instead of renewing it with the same people as we found a cheaper offer. And because it expired we didn’t think we had to personally notify them. They renewed it automatically without asking or even notifying and continued to charge us so we were double insured and they wouldn’t cancel it because it renewed. Does that make sense? Because it didn’t for me. Took us 6 months of arguing back and forth to sort it.
Post this on their Facebook page. You may get action but if nothing else it gets documented. I have had good luck resolving issues this way, but with insurance companies, who knows.
Maybe also the Texas insurance commissioner?
Time to move to Canada? But not Ontario, their Conservative government is trying to privatize healthcare.
I am so sorry you are going through this. I feel your pain. You’re screwed one way or another – pay the bill and lose an enormous amount from your budget, don’t pay the bill and lose your insurance. If it were me, my stomach would be a fountain of acid. I have no advice. All I can say is God help you and bless you.
I’m so sorry this is happening but I have to say I was laughing so hard at your descriptions that I could barely type!! I forwarded this to my daughter who handles insurances for a doctor’s office so she could laugh, too. BCBS is famous for the website, premiums and billing crap. I never can get info from it. There’s a US federal law that insurance companies have to spend a certain percentage of premiums paid to them on patients care or rebate some to patients(can’t remember percentages). My husband has BCBS thru the marketplace and he received a lovely letter stating “Thank you for trusting us with your health plan needs”. then “The good news is we paid out less on medical costs than we expected in 2018. So we’re giving you back a portion of your 2018 plan premiums”. Now, mind you, his premiums were about $700/month because of an unexpected income windfall. The check they sent was for $32.94!! Sad but it did make us laugh.
As for the African Violets, they are gorgeous!! I have a black thumb(my daughters always laugh and tell me that) but years ago, I had a dozen African Violets blooming like crazy, growing like crazy. I learned how to split them, talk to them and not over water them, The spot in my house was I believe a north facing window. It got some late day sun. The minute we moved to a new house, they all died within 2 days!!! I’m not kidding. I had the same type of light, watering, etc but they died from the shock of moving. Yours are so beautiful, enjoy them!
I am laughing because it is futile to argue with people who think they have you over a barrel. The policy numbers are not yours, so simply call them and cancel the policies with those numbers. End of fight. Someone else will get notices of their policies being cancelled, but you’re out of it.
Alternately, call and tell them you want to talk about the policy with the number they used, but do not tell them your name. Tell them you got a bill for policy number xxx and you need to discuss it.
Because I was born and raised in the USA, when I get a call center person from India, I say I need to talk to someone who speaks English as a first language (because Americans never learn foreign languages and nuances of speech demand that I get an explanation I can understand) and I refuse to discuss it with someone who cannot understand what the problem is. The real problem is that people in India do not deal with situations we run into with our country’s rules and laws and business dealings. They really don’t see the problem from our point of view. The reason they are answering those phones is that they get paid very little because there are no jobs where they live. Never imagine they answer those phones because it’s fun. Just a thought here for Ilona, won’t work for everyone: When you get someone who can’t or won’t answer you because that person does not understand English well enough to be answering that phone, try talking in your native language. You’ll get someone else higher up the chain who just might actually have a clue.
If they take money for that policy out of your account — or even if you get the bank to not allow it and they TRY to take that money — call law enforcement (maybe you need an attorney to do it) and have them cited for attempted theft. Definitely contact the regulating board in your state immediately. Get someone well above their heads involved, and the fight becomes a struggle between two huge agencies.
I spent years arguing with an insurance company about an emergency surgery my husband had. They paid it at first, then they called me well over a year later demanding that money back because it was “unauthorized elective surgery”. I had no clue what they were talking about. I told them no, I wasn’t paying, hung up the phone. It took two years before they actually had a person with an IQ higher that the average turnip call me, at which time I told the person to please explain to me how that surgery was in any way, shape, or form “elective”. “What was elective about it?”, I asked. “It was cosmetic,” I was told. “What do your records say that surgery was, exactly?” I asked. She flipped some stuff around, looked it up, and said, very quietly, “Oh. Partial amputation of two fingers. I’ll change the classification.” Click. Moral of the story: Stand your ground.
Just incidentally, I am currently “on Medicare” and it pays for just about nothing. To get any real benefits from it, you have to get a “Medicare Advantage Plan”, and then you get flat rates you know ahead of time for what you need. So far, I’m winning, because my meds used to cost me more than the premiums for the Advantage Plan, and they are free by mail with the plan. Also, Medicare is not free. So I pay for Medicare, I pay for the plan, and then I pay flat rates for the care I need. No matter what, medical care is expensive, but without it, where would we be?
My father did not use credit. He bought a riding lawn over for cash. He got a credit card bill from Sears.
He went in person, since this is before major online stuff. They admitted they saw the purchae and assumed clerical error made up a credit card and number and sent him a bill.
Just in case.
What the heck?!?! So illegal!
I have BCBS TX through ACA. All I can say is yup. I have suffered many times at their hands. Commiserations.
What may be happening is that the email system is just sending to the wrong person. This sounds like a software bug to me (especially since they can identify the number of people affected). Sounds like the email system probably broke for a couple of days (and may now be fixed?); the email system is probably not linked up to the bank account charging system, so they may have just had an error in one.
I can understand in that case why they might be cagey about giving a straight answer; that sounds like a scary privacy issue.
Not to say that you shouldn’t take precautions, though.
A few years ago I get sudden asthma, am kept in hospital. I get c-diff infection. While lying in isolation, my leg hurts.
I have developed an artery blood clot. . I may lose my left foot.
Billing calls me, in hospital.
Sorry but your (retired coverage) medical benefits plan has a lifetime limit of $250,000. You used it up and have no insurance left.
They cannot get clot to dissolve. I need operation to remove it. I still may lose foot.
Terrorized. Crying. Lifetime of medical coverage woes hits again.
The billing office calls back. The new Obamacare does not allow them to put a limit!!!!
I have insurance!
I would vote for Obama forever.
Big scar on leg, I have that foot.
What a nightmare…
USA is such a wonderful country, but Us healthcare system is horrible.. I can’t imagine how anxious and scared I would be if I were a US citizen. Illness is hard enough as it is, so having to worrying over debts on top of that….
I would have an ulcer by now. Wow. Is there any way your bank can put a limit on an automatic draft, so that your account it not overdrawn?
Notify your bank of this and the amount and make an arrangement so that no autodraft greater than x amount can go through without notification and call to you. I have done this with bank of america- praying you can do it too! And so you know it isnt any less crazy for us doctors- if medicare decides at any point in our entire career they paid us too much for something they can demand they money back and the doctor cannot fight it- its in our contract as a medicare provider ????????
My commiserations Ilona, what a nightmare. My son and family are in Seattle and work pays their medical insurance but I’m always appalled how much even a short visit to the drs office costs over and above the insurance. Here in the UK things may be going to hell in a handcart, but the NHS is always there- the ER is always open even if we have to wait; anyone who needs medication for life is certain to get it; we don’t have to worry about seeing the GP, tho we may have to wait a week or so to get an appointment unless it’s really urgent. I don’t think people realise just how lucky we are, that in the midst of the greatest political upheaval in living memory, our healthcare remains dependable and free (altho some new and very expensive drugs maybe only available privately) despite diminishing funding.
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.”