Tuesday, September 9, 2014

Beware: Anthem Dental and The Healthcare Exchange

After a day of intense frustration, I found myself sending the following letter to all my representatives, as well as Anthem Dental, entitled "healthcare snafu":


Dear fellow representatives (US Senator Joe Donnelly, US Senator Dan Coats, US Representative Peter Visclosky, Indiana State Senator Karen Tallian, Indiana State Representative Scott Pelath),

This year, as my COBRA insurance was ending on July 31, I obtained medical and dental insurance through the healthcare exchange, to begin August 1. The medical coverage is through PHPNI (Physicians Health Plan Northern Indiana), and the dental through Anthem Blue Cross. I selected these plans for both cost reasons, and because their own website documentation listed my existing providers as being "in network".

In August, I learned from my dentist that the Anthem insurance was not fully accepted, contrary to Anthem's website information.

I called Anthem to cancel my insurance so that I could sign up with another dental insurer and thus not have to switch providers.

Anthem directed my call to the healthcare exchange. There, one Veronica first told me that she couldn't cancel just the dental; she would have to cancel the medical portion as well. Furthermore, should I cancel my medical coverage, I would not be eligible to enroll in another medical plan until November, effective January 1, 2015. That was a completely untenable proposition, because I was due for my yearly physical and prescriptions for necessary medications.

After I complained that "there must be a way", Veronica finally said, "Oh, I see how to do it now!", and she did something on her end, and told me that she had accomplished what I desired: she had canceled my dental insurance plan, but not the medical. Fine. Thanking her, I waited about a week (because she said the cancellation would take 2-3 business days to complete), and obtained new dental insurance with Humana so that I could see my dentist, because I was due for a cleaning and checkup scheduled six months earlier.

That appointment went well.

Fast forward to September 8. That morning - the day of my yearly medical exam - I received a "late notice" from Anthem, saying I was late with my payment. This, despite having been told by Veronica (of the healthcare exchange) that my Anthem policy was canceled.

I called Anthem, and they said my policy was *not* canceled. I called the healthcare exchange, where I was told in no uncertain terms that they cannot cancel just the dental, that I would have to cancel both (this is the day of my yearly checkup and prescription renewals, mind you!) and wait until January 1, 2015 to have coverage again! Furthermore, they said that Veronica "made a mistake" but that "there was nothing they could do about it".

Well, guess what that means to me, who has been unemployed since July of 2013? It means that I'm now stuck with two dental plans. I can't cancel Anthem plan, because Anthem says they can't cancel it because it was obtained through the healthcare exchange, and the healthcare exchange can't cancel it without canceling my medical insurance with it, thereby jeopardizing my health and well-being due to the timing of my yearly exams and prescription refill cycle. And I can't cancel the Humana plan, because I just saw the dentist, I don't want to wind up paying in full for that visit, and furthermore I paid a non-refundable $35 signup fee with Humana, which I would have to pay again in January should I cancel them and signup with them again in November.

So - again, I'm unemployed! - I'm going to have to dish out $120 to Anthem for the remainder of the year for ABSOLUTELY NOTHING. I can't tell you how disturbed and disgusted I am by this. I'm stuck paying due to the extortion also known as "going to collections and having my credit rating affected negatively", and apparently NOBODY CAN DO ANYTHING ABOUT IT. Anthem responds to my online requests with idiotic customer service replies that ignore the meat of my requests (e.g. I ask for them to cancel my policy, they reply with some polite mumbo jumbo about what phone number to call for customer service). The healthcare exchange people are similarly useless, repeating back the same verbiage about what they can and can't do, none of which solves this ridiculous situation that I'm in through no fault of my own (although I'm sure all these organizations have lawyers that will be able to find some sliver of "terms and agreements" text that "prove" otherwise).

Tell me. Is it reasonable that medical and dental insurance have be canceled *together*? Is it reasonable that Anthem bears no responsibility for their website information stating that my dental provider was in their network, when the dental provider itself insists otherwise?

Where is the sensible America I once knew? The ridiculous costs of the healthcare system, the mazes of "where is such and such an insurance plan good?", and the fact that someone who just wants the kind of health and dental care they used to have BEFORE A LARGE COMPANY (IBM) DECIDED TO USE WALL STREET EARNINGS PER SHARE TARGETS AS AN EXCUSE TO PRACTICE THINLY VEILED AGE DISCRIMINATION (WHICH OF COURSE THEIR LAWYERS KNOW HOW TO DEFEND AGAINST) can get themselves into a situation where they're UTTERLY STUCK with TWO dental insurance plans, with no way out except to either cancel their medical insurance and remain uninsured for several months, or pay dearly to just ride it out in order to avoid collection agency harassment and a tanking credit rating. I'm just sick over this.

I would appreciate it if you could do something about this that leads to my not having to suffer the cost and indignity of $120 out of pocket for NOTHING. Greedy Anthem and the apparently powerless healthcare exchange remain willfully deaf on this matter.


Regards,


[snipped contact information]

No comments:

Post a Comment