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!

2 comments:

  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)

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  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}}}

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