"Insurance" Companies..Can't Stop Crying

Discussion in 'Fibromyalgia Main Forum' started by nina_and_me, Jun 30, 2008.

  1. nina_and_me

    nina_and_me New Member

    I am truly at the end of my rope with insurance companies. They have no right calling themselves that - they don't insure - they make you crazy.

    In late May, after almost a year of waiting, I finally received approval for LTD at work. Since I was out of money and had to sell my house, I moved in with my mom temporarily - we'll see if it's really temporary.

    My mom lives a 3.5 hour drive from my doctors, and the LTD company requires that I remain under "constant care" for my conditions, and in order to receive disability past April, I needed to see my doctors.

    Since I was planning to move in less than three weeks, I went to three of my doctors in one day last Monday - 7 hours on the road, siting in waiting rooms. I was just beginning to recover from that.

    Today, I called my pharmacy to request refills. The pharmacist put me on hold to check to see if the insurance company would cover one that was filled on 6/5. A few minutes later, she came back on the line to tell me that my insurance company replied that my health insurance was terminated effective 6/11.

    I called HR from the company I used to work for. The lady who used to handle people on leaves is gone. The new person in charge said that I have to pay for COBRA. I know that, and I've been trying to pay since last year. I called so many times and left so many messages with no reply that I gave up and since my insurance was still active, I stopped obsessing about it. The lady said that she doesn't know if she can get me on COBRA and that my insurance might be permanently terminated. Someone was supposed to return my call today, but no one called.

    When I was on disability before (I should never have tried to go back to work), I received monthly notices of my COBRA premiums, and they took the money right out of my account. I have received nothing from this company...nothing. Not only can I not get my rx's filled, the three doctors I saw last Monday are not covered. I need to have these prescriptions filled and I need to see these doctors in order for the LTD company to consider continuing my coverage.

    Maybe if I were living with my mom and receiving disability, I would be able to pay my doctors and rx's out of pocket with my disability money...maybe. But that's not even an option, because my mother is moving, and the closing is in 2 weeks. That's when we're supposed to move to the house we bought with money from the sale of my old house.

    I am sick to my stomach. I feel like I'm losing my mind. I've been crying most of the day, and now it's after 2:00 in the morning, and I still can't stop. I don't know what to do.

  2. frosty77

    frosty77 New Member

    From what I've read in your post, it's not the insurance company's fault, but the fault of your employer.

    LTD is usually something offered as a bonus by your employer, but from what I've read and learned, it's not a great coverage and you have to jump through hoops to maintain it once you are on it.

    Why were you trying to pay Cobra since last year if you were insured? If your employer was still covering your insurance, then you would not need nor be eligible for Cobra.

    If your last employer had more than 20 employees and you were terminated for other than gross misconduct, you are eligible for Cobra.

    If the above is true, then your employer should have notified your plan administrator of your termination and you should have been sent an election notice for Cobra within 14 days of this notification.

    So, if your employer has more than 20 employees and meets other guidelines for Cobra (such as maintaining a group health plan), then you need to contact them as they appear to have failed to send you the Cobra election form.

    Since your health coverage has been terminated and your employer is now unsure if they can get Cobra, you may want to also look at buying insurance on your own (I've been on Cobra a few times and actually sometimes found it less expensive to just buy my own insurance). Plus Cobra is only short term insurance - if LTD does not include health insurance, then you'll need a long term solution for this.

    But if your former employer does fit the criteria (>20 employees, maintains group health plan...), then they screwed up - and should fix it!! Good luck!!!!!

  3. PVLady

    PVLady New Member

    In addition to the information you have received, you just need to get to the bottom of this with your employer.

    1. Did they offer you Cobra? If so, you need a copy of the letter (which should be in their files) and the date it was offered.

    With Cobra, you only have a certain time period to elect coverage and if you do not take it in either a 60 or 90 day time period, they are off the hook and do not have to provide coverage.

    2. I am pretty Cobra coverage follows the same coverage you had while employed. I was on Cobra for 18 months and tried to reduce coverage to save money and was told that was impossible - I had to keep the same coverage as when working.

    You said your health coverage was terminated on 6/11 - was that the date you stopped employment at the company? Was your employer keeping you on their health plan after you terminated? or were you still a employee on disability?

    There may be a major problem if you did not sign up for Cobra in the time period required. When the HR person said she may not be able to get you on Cobra it may be because the time has expired for you to enroll. It is either 60 or 90 days from the time of the offer.

    I would ask your employer the date they offered you the Cobra and get a copy of the letter.
  4. nina_and_me

    nina_and_me New Member

    Thanks to all of you for your support. I've been off the computer for awhile straightening this out. I am now on COBRA. I received a letter the day after I posted this which was dated 6/28 that stated that my health insurance was terminated effective 6/11. On Saturday, I received a separation notice stating that I was terminated on 6/21, which is one year from the date I last worked. I called HR the day after I called them last week, since I didn't receive a follow-up call as promised. I called every hour until the person in charge of leaves of absence called me back. The receptionist finally pulled her out of a meeting, and she gave me the name and number to someone at the health insurance company.

    I called the health insurance company, left a message for the person I was trying to reach and expected another delay. Much to my surprise, she called back five minutes later. She e-mailed the forms I needed, and I got them in the mail that day, with my payment.

    I called again yesterday, and again, the lady from the health insurance company called me back within 30 minutes. I asked her when my health insurance would be reinstated. She said it would be no more than a week, and she asked me what the problem was. I told her that I was running out of 3 meds (zoloft, clonazepam, and tizanidine) and that they wouldn't last another week. She said that I could pay out of pocket and submit the claims. I asked her if she could call me when the coverage was reinstated, and she said that she would.

    An hour later, she called back, and told me that she had called the bank to clear the check, called the provider network and the pharmacy network and I was officially reinstated. I was so relieved that I nearly cried. This is the first person I've talked to who has actually helped me.

    As nice as the person with the health insurance company was, I am in shock that the company I worked for, who empolyees more than 4,000 people, waited so long (after coverage was terminated) to mail that letter concerning insurance coverage. The woman I spoke with from HR told me that I should have known that I needed COBRA. It's over now, and hopefully, I will never have to speak to anyone at the company I used to work for. My mom used to work for a law firm and she was all set to pick up the phone last week.

    On the plus side, I received a packet from the Social Security Disability Law Firm, who was hired by the LTD company, and I signed those papers and sent them back. I still haven't heard about my next check from LTD, and my caseworker has been on vacation. She will be back today, and I plan to inundate her with phone calls.

    I cried for two straight days last week, my stomach hurt constantly, and I basically was in a meltdown. It was so bad that I couldn't get on the computer. Then, after the tears stopped, my eyes and head hurt for a few days. I'm doing a lot better now. I'm still worried, scared, frustrated, and distrustful, but I'm not crying anymore, my eyes don't hurt, and the headache is better.

    Thanks to all of you. The information was very helpful, and I really appreciate it. I'm sorry it took me so long to reply - I haven't been on the computer since I typed that message on July 1. The support from this board always amazes me. The empathy, the help, the information, and the support helps so very much. Thank you.

  5. frosty77

    frosty77 New Member

    Nina, glad it all worked out! And sorry you had to go through all that!! What happened to you is just wrong! I hope your former employer does not make a practice of screwing up like this!!!!

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