Thursday, November 18, 2010

Insurance debacle

This post is going to be very confusing because the whole thing is still confusing to me.

As much as I love being able to get insurance through the state, I am finding that it is truly a nightmare.

We can all remember my issues with getting coverage in the first place (if not check out the posts labeled insurance) and how glad I was that I was finally approved.  Well it turns out there was a huge snafu somewhere along the line and I have the wrong coverage...twice.

In April I was approved for Health Safety Net.  This being basic hospital coverage in case something happened I would be covered at a hospital and all all community health clinics (i.e. those places you see on TV where anyone with out insurance can go to, a breeding ground for germs, ewww).

In May I submitted forms to show my disability to get covered under that insurance.  I was still not covered for anything else and paying out of pocket for my meds.

In June, a decision was made (though I have no paperwork on this, I found out by calling on Tuesday), though what I still don't know.

In July I was officially granted insurance with MassHealth Standard, Neighborhood Health Plan.  Cheap co-pays on meds, no premiums, no co-pays on doctors.  Perfect.

Fast forward to November when I receive the letter stating my MH Standard is being dropped because I make too much money.  And that I am being switched to CommonWealth Care.  Have to pay a premium, which is still cheap and co-pays on everything, including doctor visits.  No biggie.

Then comes this Tuesday when I hear from the Social Worker at clinic so we can figure out my impending hospitalization.  Apparently I am not supposed to be on CommonWealth, but I am supposed to be on CommonHealth.  Yes really one letter difference.  CommonHealth is for those disabled and premiums are based on a sliding scale of income.  I was supposed to be informed of this, through MassHealth, but never was (letter lost in the mail perhaps?).  There is a qualifying clause in order to start the coverage.  Either meet the $5688 deductible or have a letter written saying you work for at least 40 hours a month.  THANKFULLY I just started that consulting work and can get a letter from them.  This coverage will be backdated to October 25th, so my appointment yesterday will be covered.  However, I am still unsure about the hospitalization (which starts today at some point).

So that is my insurance dilemma in a nutshell.  I have insurance, just don't know how active it is.  I paid my first months premium on the insurance I am not supposed to have, so I don't know what will happen with that money.  And I have no idea how long my IV stay will be.

But hey, on the bright side....I will still get my meds in there and be covered by SOMETHING!


  1. Holy crap, I would have pulled my hair out. And possibly my eyelashes. Glad everything seems to have kinda-sorta-maybe worked out, and that you're not COMPLETELY without coverage. Hope you feel better soon, and that IVs now means a healthy, happy Christmas for you! :o)

  2. Oh Amy, Don't you just love insurance run-arounds!?!? ....NOT!!! I hope it all works out for you... and most importantly, FEEL BETTER! {{{hugs}}}