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Need advice on health insurance

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hbarcat

Supporting Member
Aug 24, 2006
10,228
18,645
Rochelle, Illinois
I knew I was losing my employer provided health insurance at the end of 2016, so in December I enrolled in a policy through the government sponsored program at HealthCare(dot)gov. I filled out the application and got Blue Cross Blue Shield and it came with a subsidy so my monthly premium was reduced to less than $400 per month.

I paid my first premium and finalized my membership by filling in my information at the BCBS website. I was informed that my ID cards and packet of information explaining everything I needed to know would be arriving in the mail in about a week.

By the end of January I called BCBS to find out why I hadn't received anything. It was virtually impossible to talk to a live person because I would always be put on hold for literally hours at a time. I tried almost every day and at different times of day and it actually took me until late February to get through when I sat and read a book while I listened on speakerphone for someone to finally get to me after almost 4 hours.

The representative explained to me that I needed to create an account on the website before they could send me anything and I told them I knew that but I couldn't create the account because it wouldn't accept my information for some reason. He told me the reason whey was because my address didn't match what was on the original application from the government website. It was a simple typo where part of the street address was slightly different. The problem was they were unable to correct the information because what they received from the government was registered with the federal government as my legal address for the purposes of proving that I was conforming to the personal mandate.

So I can't create an account with the incorrect address and the insurance company can't correct the information. I have to go through the government website to get it changed there. In the meantime I'm paying monthly premiums for services that I can't receive.

Here's where I need help. I've tried to go through the HealthCare(dot)gov site to make the required change and I don't see where it's possible to do so. I've tried various phone numbers to try to talk to someone in person but everything I've tried comes up as a dead end. I desperately need to get to see my new doctor for a physical and to update my necessary medications but I have no idea what doctors are in my coverage plan or what facilities. I can't do anything until I get an account set up with BCBS and I can't do that until I get my address corrected by the government. And I've run out of ideas on how to make that happen.

It's been suggested that I consult a legal professional who specializes in health care issues but I'm just a poor boy living paycheck to paycheck. I can't afford to pay a lawyer to deal with this for me. I'm hoping that there is someone on this forum who knows how this stuff works and can give me helpful advice on how to proceed.
 
Since you're paying premiums, BCBS needs to help you. You have insurance so they need to fix it.

I would call back and speak with a manager.

What state are you in?
 
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Hey, for what it's worth, while I didn't have as many issues as you do, once I got changed over, I am extremely happy with the government blue shield insurance, and I have a lot of medical issues so I have been able to really review the quality of insurance. Very odd and specific problem you have though. Wish I could help. All I can do is say best of luck and you should be happy once everything gets corrected. Glad you defeated the multi-hour phone hold game. That one sucks.
 
H-Bar.... I cannot imagine the frustration. I do not have any experience with government healthcare. And I am surmising that when you use the government interface, you lose the convenience of an agent to run interference on your behalf. I can only offer this in hopes it will at least brighten this horrific experience you are going through. We use BCBS coverage for our employees and their coverage is exceptionally good. For what it is worth, I will PM you two numbers I have that have always gotten me to a person in a reasonable time frame.
 
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Contact your state insurance department. Somebody at BCBS compliance will end up getting a letter and they will solve the issue. Insurance companies really hate being contacted by the insurance department. Somebody will end up caring and solve the problem. Just tell them you signup and paid and now can't get cards or any information.

insurance.illinois.gov/main/contact.asp

(I work for an insurance company. We take contacts from state insurance departments very seriously.)
 
A couple years ago, I went through the Health Care . gov training and was registered to sell health insurance with the program and carriers in my state at the time. The entire online system was a problem for the agents and the consumers and got worse last year when several companies pulled out of the state. I never sold anybody through the program because they were so confused and it was not financially beneficial to them. Last year, I was to pay to go through new training and register for the 2017 plan. I decided it was not worth the time and effort for a system that does not work properly.
 
I am extremely happy with the government blue shield insurance

You do not have "government blue shield" insurance.

You have Anthem BCBS insurance, the same Anthem BCBS insurance as anyone can buy, only bought through a government channel so that you qualify for a subsidy.

God I wish there wasn't so much confusion and misinformation out there.

As for the OP, @hbarcat , I don't know what to tell you now, but at next open enrollment, please purchase your policy from a licensed insurance broker, with significant experience, who can sell both "on exchange" as well as "off exchange". You don't pay more, but you gain a qualified, experienced advisor, helping you make decisions (not just fill out paperwork), and who can assist in a situation like this in getting it sorted.
 
Hey @hbarcat, sorry to read of the hassles.
The advice from @gttim is what I'd do as well. Before you contact your state insurance commissioner, have all your paperwork, like payment receipts, handy and ready to submit if asked.

I'd also offer up calling your provider, if you haven't already, and ask them to run an eligibility check with your SSN at BCBS. If they come back with evidence of coverage, you can be seen without the physical cards in hand.

-Mike
 
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I have been on the exchange since it opened. They have had my address wrong since it opened, they have had my wife's birthday wrong since it opened. I have six copies of that app sitting in my ACA file each one saying it was corrected..even has the little "corrected form" box checked in the corner... because I have called them six times to tell them and to get it straightened out.

Every one of those six application is wrong just like the original and I really need it to be correct because they keep sending my 1095A form to a non existent address.

I don't know why they want to see that form so badly. That thing is even more incorrect than the application information. It lists my original insurer and subsidy form 6 years ago that has zero basis in reality since. I have about a dozen wrong copies of that even though I have begged them to fix it. They can't

Their inability to fix their own paperwork caused them to suspend my health insurance right as my wife was going under the knife for lung cancer and losing a lobe of lung.

That little incident and the resulting dust up caused the IRS to issue me a blanket pre-qualification and approval for the maximum time they are allowed to issue it ( 5 0r 8 years, I can't remember)

Which is a good thing because they STILL can't get my stuff right, still can't accurate income / subsidy figures into the system.

I have given up
 
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Sorry, was just being brief. Wasn't trying to misinform.

That's cool, glad you actually know. The amount of people who really do not understand part of, or any of, all of this is staggering to me. I think it's a big part of the reason we are where we are with it.

I'll just leave it at that, 'else I begin to wind myself up and get angry, and -

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I'm pretty sure it varies state to state. For me there was a tax issue that I still don't understand... I happened to get really lucky and got connected to the healthcare.gov 800 number in less than a minute. Pretty much they told me the easiest way to solve the problem would be to switch to a different plan, which I did and I haven't had a problem since then.
 
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