Insurance Got Terminated - PLEASE HELP!

[ACAScrewedMe]

Nothing further.

Well that's unfortunate

I can't help you on the overall situation... but since it sounds like you technically don't have coverage then you would be considered a self-pay. As a self pay you can negotiate the bill cost down with the provider. They typically cut between 30-50% off what is owed for self pays. If in the end you have to end up paying them, maybe at least you can get the amount reduced.

I'm going to check into this. If it works, that's awesome news, since it'll save me about $1000. This whole situation sucks.

 

[ACAScrewedMe]

Hi everyone - I've been pretty busy lately, so I haven't had much time for an update. After the DOI appeal failed, I pretty much lost faith in the process. Either way, I filed an external (MAXIMUS) appeal, so I'm waiting on the results of that now.

I also plan on writing about my situation to: Andy Slavitt (Acting Administrator, CMS), HHS headquarters, and President Obama. I doubt writing Congress will do anything for me. Hopefully for me and everyone in my situation, the new administration will fix this horrible system. I don't care what ACA is replaced with; I doubt it could be any worse than this.

UPMC has been calling me about the outstanding "uninsured" medical bill, but I've told them that I'm planning on exploring my legal options and that I had coverage at the time of the bill. Assuming I can stick it out the next month & a half, I'll probably stop fighting after the last batch of letters go out. Unless something crazy happens, this experience will cost me around $2500 (fine + bills - 7 months of premiums).

 

[ggbh]

I purchased a UMPC (Pennsylvania) plan on the Marketplace, and my coverage was just terminated for non-payment. I got the termination letter on 7/20 that says my coverage was canceled effective 5/31. After doing some research, I found that my May payment was short (I accidentally only paid about 40% of the bill), but I didn't know about it until the next bill came out. I never received a warning letter or phone call, although my provider says they did both.

I have electronic billing set up, and I never got a notice in my plan message box nor in my email. I paid my bill in full (including outstanding charges for May) in June, then I paid my bill for July. I also saw several doctors due to an unfortunately timed problem with my leg. I did all of this under the assumption that I had healthcare. Which makes sense, because UPMC kept accepting my payments.

I already filed an escalation with the Marketplace, and UPMC denied my request for reinstatement. They said that I fell outside the "CMS guidelines" for payment grace period. Even worse, they're going to cancel the payments for all of the healthcare I received in June, so I'll need to pay for that now. I called the Marketplace for assistance, and they told me that I don't qualify for a Special Enrollment, but I can appeal the decision or apply for healthcare in January.

I'm already technically without healthcare for the past 2 months, so I'm guessing I'll get a tax fine for that? If I appeal, they said it could take up to 3 months, so that's probably 3 more months of fines. With my income, that's over $1500 worth of fines.

I'm completely at a loss, and my leg is still injured. I thought ACA was supposed to make getting healthcare easier! I'm not sure whether I should appeal or get a lawyer or sign up for a cheap health plan & pray that the tumor in my leg isn't cancer. PLEASE HELP!!!!

And this is where, you need a good agent. Intelligent/Learned agents are just as good as lawyers. You got a shitty one, or you decided to do it on your own. This is what makes my agency the best. But, we are not in your state yet, and the law may go away.

God bless people when we go back to 80/20 percent health, etc. With no stop-loss on MOOP. Americans had no idea what they had. Even better than socialism.