Thursday, October 07, 2010

Livid

There is an enormous wrinkle in the plan that may mean that I cannot get surgery for 6 months.
At the advice of a benefit specialist who helped me to find out about MCHA and was coordinating my application, I cancelled MinnesotaCare, intending to get on MCHA. I was told by her that you can't get MCHA if you have another insurance, and I needed the certificate of termination in hand before applying.
BUT, it turns out that you can't get on MCHA If you voluntarily leave your existing plan, even if it doesn't meet your needs. MCHA is allowed to exclude me for 6 months based on pre-existing conditions.

The benefit specialist that I worked with now says she didn't realize that I'd only exhausted my *inpatient* benefits, not all of my benefits, though we *specifically* talked about this ad nauseum on the phone. She also specifically told me that I needed to cancel MinnesotaCare *before* applying to MCHA. She knew that I was covered and that I was leaving voluntarily.

It turns out she was dead wrong about having to cancel MinnesotaCare. A person *can* have both Minnesotacare and MCHA at the same time, and MCHA will make up the difference. This is according to MCHA. She admitted that she hadn't known this until today. A major ***ing oops.

Now I have but one hope of having this surgery done in the next 6 months: go crawling back to MinnesotaCare and hope that they'll take me. Of course, I have Cancer, so it wouldn't be in their best interest to do this, financially.

If MinnesotaCare takes me back (and I may need to reapply fresh all over again and wait a month or so to hear the decision) then I still need to get out of them something that I have been unable to get, since no one person feels authorized to give it: a letter stating that I have reached my $10,000 inpatient benefit. MnCare thinks it's HealthPartners (who administers MinnesotaCare for me) department.... and HealthPartners thinks it's MnCare's department.

Before hanging up on my insurance "advocate" at Gallagher benefit Services, I informed her that her oversight and misinformation, leading to a drastic delay in surgery, has almost certainly shortened my lifespan.

At my own hand, acting on misinformation, I currently do not have any health insurance whatsoever. I voluntarily cancelled the only plan I had.

11 comments:

emily said...

oh my fucking god. this is not a good day.

if you decide to have a fundraiser to pay retail, let me know. i'll do everything i can.

Anonymous said...

What about writing to elected officials for some help - that's what they're there for, right? I'd be willing to do that for you if you want me to. I got very good at getting in touch with elected officials in NV when I was helping my mom. Here in MN we have a much better system of care. Just let me know.

Mary Rohe

Deborah in MN said...

This makes me feel sick. I wish there was something I could do.

Kevin said...

So what is the retail cost of the surgery?

Eclector2 said...

I don't believe it. Our worst nightmare! Please see Matti's email and call the lady she recommends. You need more information and better advice.

FYI: I think you have a letter in your files that you received after the U of M surgery that says you have exhausted your inpatient benefits. It might be enough evidence.

Try to salvage some peace and quiet and quality time with J. this weekend. We'll get through this. You are not alone.

Love, Mom

Kelly McCullough said...

Fuck. Hang in there and know we're all pulling for you.

Anonymous said...

Presumably the woman who got it wrong has a supervisor, who might be able to help, and that supervisor in turn has another. Since this was a clear, and very grave, screwup by some entity, and not just this one person,there must be a make-good remedy, and not just, "Gee, I'm so sorry." Unless of course the advisor who gave you the bum steer was some sort of freelancer, which I strongly doubt.

--Dad

lsikora said...

I agree with your dad - I would not take responsibility for this snafu - benefit specialists are there to navigate you through just such a crisis, and it is directly because of her bad advice that this happened - I would start by making a loud noise first to her, and then to her boss, and then to her boss's boss - and contact an attorney right away for a free consultation or pay one for an hour consultation - this is NOT RIGHT!!!!!!!

lsikora said...

As a matter of fact, don't even bother making a loud noise to her - just start moving up the chain, immediately!!!

lsikora said...

Michael - please let me know if I can help make any phone calls FOR you or bug people for you. This makes me livid too.

M said...

Thanks all, this was a very unnecessary hassle for me (and everyone) to go through. I think it is resolved now, fingers crossed. Part of this process (and the reason for the tongue-in-cheek title of this blog) is that I don't know *what* I don't know. I'm reinventing the wheel here and figuring it out as I go along, learning more than I ever wanted to know about all of this stuff. All of the advice and suggestions are very helpful, truly. Thank you so much! Still, good thing I have anti-anxiety medication on hand!

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