Health Insurance Confusion 2019-2020-

Neglecting to click one button leads me to a health insurance bill of over $1,200, and there wasn’t even a doctor’s visit or prescription or consultation involved. I called my health insurance company to clear up a lost $90 payment, and found that I owed them >$1,100, and stumbled into the fact that they double charged me months ago, at least once. The consequence of one frustrating phone call and two helpful (or at least diplomatic) phone calls is a bill that arrived today. I owe them $1,202.16. So, the $90 isn’t resolved, the tax credit isn’t being applied, and there’s no agreement about their overcharging. This is not healthy, and it isn’t over, yet.

Let’s start with my mistake. Check back through some of my posts and find my journey through Obamacare, Washington State Health Plan Finder, and my distaste for bureaucracy. For the first time, I didn’t contact the State’s marketplace because it seemed unnecessary in recent years.

The first year of Obamacare was confusing. I struggled through, and was glad for the subsidy. The task was tough enough that I chronicled it in One Confused ObamaCare Applicant. It turned out to be a useful post for thousands, and remains this blog’s most popular post. Each year after that I dutifully called the State’s support number, usually because I couldn’t remember the username and password. It seemed that every time I called the response was something like; “Everything is fine. Your coverage has been renewed.” I wrote about it for a while, but that seemed unnecessary.

This year was different. I recall receiving letters and emails saying that my coverage was renewed, so I decided to put the topic aside, and simply keep paying my bills. Then, the adjustment came. No surprise. It was a new year so I expected a new premium. But, the bill came in late. I didn’t want to be late with the payment, so I blindly paid the most recent amount, and then paid the difference when the bill arrived. That was about $90.

They received it late, and considered me delinquent. Hence, the call to them. It was probably just a case of bills and checks passing each other in the mail. But, I knew they received both payments. My bank told me so. I called, bounced through phone menus, and began talking to someone who couldn’t find the $90, and informed me that I owed them over $1,000. My reaction was not healthy, but I tried to remain diplomatic. I’ll save you the description of the frustration, but imagine talking to someone who can only respond with what they have on the screen in front of them. After asking to elevate the conversation with a manager or a supervisor more than once, I was connected to a boss.

The boss/manager/supervisor (a distinction that was important to them) took the time to listen, ask questions, and start untangling the mess. Remember my mistake, that button I didn’t click? That was the button on a web site that I was supposed to click. Clicking that button was necessary for renewing my tax credits (~$700 per month). (That number is startling when I think of how much health care that health insurance money could buy, but this is how much the insurance company gets monthly for a service I can’t afford to use.) OK. After a call to WA Health Plan Finder, I realized my mistake, they reinstated my tax credits – which will start in February. Better late than never, but if it never happened I’d simply cancel the insurance out of necessity.

As for the $90, it turns out that my insurance company won’t accept electronic payments from my bank. One mega-corporation and another regional large financial institution haven’t figured out how to transfer money any other way except by printing and mailing a check. That explains the delays in some of the payments. It doesn’t explain how the insurance company lost track of it. Sure enough, the manager encouraged me to find images of the cancelled checks, and the bank helped me find them online. So, it was my job to find copies of the cancelled checks via the bank because the insurance company couldn’t find them. Weird, but I was able to do so. Also unsettling that they’d lose something as basic as a payment.

If they lost that one, did they lose any others? I looked back through 2019’s payment history and found two times when they sent me a delinquent bill notice. I dutifully and embarrassingly paid them as double payments to get ahead of the next month. Just like the recent bill that showed up too late to pay on time, something similar happened earlier that I assumed they rectified with my payments. From what I can tell, they may have done so in one case but not the other. While tracking down their lost $90 check I may have found one or two lost $650 checks.

Nods to the manager who took each item separately. I think the $90 check is now ‘found’. The manager thought I might be able to get the tax credit retroactively applied to January, but no. (Though I should get the difference back when I file taxes in 2021. 2021!) The manager also tried to reconcile the doubled payments, but seems to have counted some of the double payments as single payments. That’s unresolved, at least from my perspective.

I am fortunate enough that this is all happening after closing a real estate transaction a few days earlier. If I began the investigation at the start of the month my anxiety level would’ve spiked at a time when I was already overwrought with another issue.

How many people is this happening to, and how much worse does it get when treatments are involved? The corporation has the money, can demand more, and can degrade someone’s credit rating while the consumer has to counter without teams of lawyers or the funds to pay. Cases that include tax credits involve people without sufficient funds by definition. Asymmetric power multiplied by millions.

When I called back to double check on the tax credit I heard something real. The insurance company’s customer support person sounded new. While clicking through the screens they had a question. Without putting me on hold or putting them on mute, they called over their boss/manager/supervisor. I got to listen to the conversation. The company probably has recording or the transcript or both. When the new person saw how much I owed without the tax credit they said something like, “How can anyone afford that?” I suspect that person has more empathy and understanding than most because they’re probably making an annual salary close to mine. Call centers aren’t known for big paychecks. The supervisor/manager/boss may not be in a much better position.

It is easy to feel assaulted and dismissed when confronting a corporation, especially one that can represent a person’s largest monthly expense that provides no benefit, and yet requires time and effort to maintain at best a neutral relationship. It is harder to not take out frustrations on those who have the job to be the public face for the corporation.

I am glad for the help I received. I am dismayed that the corporation is so poorly run that they can’t keep track of the money I send them. Other corporations impress me with carrying forward credits, and working through payment issues.

I have a similar frustration with mortgage companies. (Yet Another Mortgage Story)

Healthcare and housing are major issues in the US. Both are backed by major corporations. Yet both seem to be inefficient and, in some cases, unresponsive. Healthcare and housing are also major issues for humans. These are fundamental issues that will take more than one competent manager/boss/supervisor to patiently untangle. These two issues are also entangled at the personal level. I am considering refinancing my mortgage, but refinancing a mortgage is tied to having an acceptable credit rating, and poor practice from an insurer can damage my ability to obtain new financing.

On a personal level, without teams of lawyers or a community of politicians working on near-term solutions, it becomes necessary to make more money to feed their machines. Making the extra money to pay for health care or improve personal finances results in unhealthy life choices. So much for ‘do no harm‘ and ‘fiduciary responsibilities.’

In the meantime, I do have the best health care I can recall. My local naturopath operates from a subscription service. For one monthly fee I get monthly doctor appointments that are long enough to have real conversations, and care options that fit my lifestyle, finances, and values. They are sensitive enough to their patients’ situations that they apologized for a $10 or $20 monthly increase. Even with that, I get a year’s treatment from them for the price of one month’s (basically worthless) health insurance (not health care) payment. There are solutions, but I’m not finding them in corporations.

My health insurance bill arrived today. Despite things being resolved or unresolved, they are billing me $1,202.16.
“PLEASE NOTE YOUR ACCOUNT IS CURRENTLY PAST DUE AND SUBJECT TO LOSS OF COVERAGE.”
I intend to pay because as an optimist I hope things will be sorted out, but I also know that if they cancelled my coverage, I and the State would save over $1,000 every month. (Yeah, yeah, I know. There are fees and fines, but they’re starting to look very attractive.)

About Tom Trimbath

real estate broker / consultant / entrepreneur / writer / photographer / speaker / aerospace engineer / semi-semi-retired More info at: https://trimbathcreative.net/about/ and at my amazon author page: http://www.amazon.com/-/e/B0035XVXAA
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1 Response to Health Insurance Confusion 2019-2020-

  1. Scott says:

    Next time I would recommend making your life simple by using an insurance consultant if you continue the ACA. As a bonus, it will not cost you anything.

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