The short version of this story is, “The squeaky wheel has gotten the grease.” My coverage is once again active (and retroactive). Now I can schedule a visit to a doctor….
Posts Tagged ‘Aetna’
Few things make me so damned angry that I seriously consider writing to my congress-critter about them, but the absolute travesty that is COBRA and health insurance is one of them.
As most people who know me or read my blog are aware, on Wednesday, May 28, 2008, I resigned from my previous full-time job as the editor of SCIFI.COM to become a full-time freelance writer.
One of the key decisions I made at that time was to exercise my rights under COBRA (Consolidated Omnibus Budget Reconciliation Act) to continue my GE Health Care Preferred medical and dental insurance. That has proved to be one of the most frustrating undertakings of my life.
First of all, there is the general sloth of all the parties involved in this process. Rather than provide me with the necessary information for COBRA on my last day of employment, my company makes me leave empty-handed and wait for them to notify the COBRA administrator, a company called Ceridian.
During the 10 days that I had to wait for Ceridian to get in touch with me via snail-mail, I had no health insurance at all. At last, I receive the benefits-election paperwork. I read through it and was dismayed to find that, while you can log on to their website and apply for benefits online, you can’t pay online, and your benefits won’t be processed until they receive your money. The only forms of payment they accept are paper checks and/or money orders — no credit-card payments, no electronic fund transfers, no automatic payments.
This was my first “WTF?” moment with this process. We live in an age of e-mail and online payment, so why am I being forced to cope with a stone-knives-and-bear-skins payment model?
Still, I perservered, filled out the paperwork, read the fine print (or so I’d thought), and sent it in with a check for my first payment-in-full. Being an Internet-savvy guy, I monitored my bank account online and verified when Ceridian had cashed my check. Then I logged on to their site and again confirmed that they’d received my payment and had marked my account as “paid in full” and its status as “active”.
What I didn’t realize was that this didn’t mean jack-shit, because it can take up to another two months for them to get this information to the companies that actually provide my medical and dental benefits. I found this out when my wife tried to get a prescription refilled and was turned away at our local pharmacy.
I made some calls to my COBRA administrator and asked them to kick my prescription, medical, and dental benefits providers in their figurative collective backside and get my coverage restored. Ceridian said it would send out “urgent medical bulletins” to those companies to expedite the process. That was in late June.
Come early July, our prescription benefit had become active, but we still had no medical coverage. I called Aetna, my medical insurance company, and they claimed to have never heard word one from my COBRA admin company. I called Ceridian, who sent another “urgent” notice.
More delays, more runaround, more excuses. In the midst of all this, I get a rejected claim from Aetna for a doctor’s office visit my wife made on June 16 during the “blackout” period in our coverage. Attached to it is a bill for roughly $1,300.
Finally, on Wednesday, July 2, while I was in the grips of a non-fatal but excruciatingly painful malady, I called Aetna again and spoke to a rep named Kevin. Kevin worked his way up the chain of command at Aetna and finally spoke to an “eligibility representative” who confirmed receipt of the message from Ceridian and told me that my medical benefits would once again be active the next day, Thursday, July 3, and would be valid retroactively to May 29, 2008.
Thusly reassured, I resubmitted the rejected claim with a letter explaining that the charges should be treated as valid now that our coverage is active and valid retroactively to May 29, 2008.
Great, right? Wrong. As of today, July 7, I still have no medical benefits, and the computer system at Aetna continues to say only that my coverage is terminated. And if we don’t get this sorted out before Aetna receives the resubmitted claim for benefits, they’ll reject it again and I’ll be unable to resubmit it — meaning I’ll get stuck paying the whole thing out of pocket.
So I’m on the phone again today, talking to Frank, yet another Aetna customer-disservice representative, who checks with Kevin, who now claims he told me that my benefits “might be active as soon as July 3″ but that he never promised any such thing. Bullshit, Kevin.
So, in case anyone Googles this, if you worked for NBC Universal, General Electric, GE, or SCI FI, and you want to claim COBRA benefits, here is the skinny on what it will cost you: $922.94 per month. And you will probably have to shell out at least three months of these payments before you see even a moment of coverage, if even then.
Someone explain to me why this is fair and legal: Why is a COBRA administrator such as Ceridian allowed to take thousands of dollars of my money and extort me for near-instantaneous payment month after month, while it and insurance companies such as Aetna drag their heels, fail to update critical information, deny my coverage, and provide me no services and only excuses?
To my eye, this looks like robbery, pure and simple. They’re taking huge sums of my money and providing no services in return. And if this isn’t sorted out by this time tomorrow, the next step is a flurry of letters to my U.S. Representative Carolyn Maloney and my senators, Chuck Schumer and Hillary Clinton. Nothing will get changed in time to do me any good, but maybe I can make these bastards at Ceridian and Aetna miserable in the future.