Health Insurance Disaster!

[momw/ic]

I am posting this to find out if anyone has any ideas for where to turn next:

We had group health insurance through my hubby's job. He is a pastor and we found out about 2 agents in Tennessee who put together a group plan for all pastors in the U.S. The plan was underwritten by Aetna and was expensive but was good coverage. So, last September we were notified that Aetna was pricing us out and we would be changing companies. Within a month we received new cards etc and had coverage through a popula PPO. We were paying $980 a month in premiums!! In the last 6 weeks we have found out that our premiums (along with the other 400+ people on the plan) were never paid to the company and no claims since September of 2004 have been paid. Now when we tried to contact the agents their numbers have been disconnected. No one knows where our premiums have gone - but we all figure they are with the agents in another country. Now we have in excess of $20,000 in unpaid medical bills that of course everyone wants their money - yesterday. My uro is one who we owe over $6,000 and they are being awful about it. This whole thing is so stressful that I don't answer the phone at home during the day because of all of the calls from people wanting their money. We are trying to figure out what recourse we have and if there is a way to get our premiums back or something. In the meantime we were able to get on a group plan with some other pastors but we are now paying $1400 a month in premiums and have a $4,000 deductible. So, any ideas?? We have discussed personal bankruptcy but if we can find another way out we will take it. I have job hunting to see if I can get a job with insurance but the problem is I need my cyst w/ hydro so I can go back to work but can't afford because of the insurance problems so am not able to work. I have been virtually bedbound for about 2 months trying to get a hydro. Sorry this was so long. Thanks in advance for any ideas anyone may have!!

Pam

[Prinny Joy]

Hi, Sorry for your health coverage situation. Have the proper authorites been involved in this? Usually if there is some sort of fraud or something that isn't your fault I thought most times it is not your responsibility. I could be very wrong as I've not had any problems w/ healtchare costs regarding insurance. WOW so sorry about the problem. I did speak w/ someone andother IC patient who has catastophic coverage kick in after the costs hit a peak. Can you get some medicaid or other assistance? Have you looked under the I believe economic secirity assistance from your state. It may be worth checking into as you need your medical care. hope it helps. PEACE and JOY

[ICNJess]

Ohhh my god...I hope you have contacted somebody about this!!!!!!

Otherwise, there is a bankruptcy called Medical Bankruptcy (at least there is in WI) where you just claim all your medical bills.

How about applying for some kind of community fund, like maybe the clinic you go to has some kind of Patience Assistance? I hope you get things straightened out!

[ICNDonna]

Have you consulted an attorney? It sounds very much like you need to if you haven't. A letter from an attorney should get the bill collectors off your back. What happened to you is horrible and I hope they catch the "agents" --- hopefully, this whole thing can be resolved quickly so you can have your procedure.

Sending gentle hugs,
Donna

[K9wife]

I don't know what church affiliation you are with, but could the Conference or diocese ( or whatever governing body of your denomination) help? Imagine....now we are going after God's own workers, when drug dealers on the streets have all the rights. No wonder my hubby is frustrated with the legal system. Hang in there!

[tigger_gal]

Have you called the BBB? It really might help you and all the others that this has happened to.. I hope that you can get some type of help in finding these con artitists'.
Not to mention your money back that you paid in faithfully. You may consider a chapter 13.. this way every one gets paid a little at a time.. Also, if you just pay them 10.00 a month as long as your paying them there is nothing they can do....
hugs and best wishes
Brat

[momw/ic]

Thanks for your posts - you all are wonderful and caring which is very refreshing compared to the people I have been dealing with lately! We have contacted lawyers and part of the problem is that it is not a good "pro bono" case because more than likely the money will never be recovered so we need to pay legal services as we go - which is not an option. We talked about a class action suit but because of the HIPPA privacy laws there is no way to find out who everyone is thoughout the US who was on this plan. We did find out today that there is a state agency with the insurance commission that you can apply for a portion of you premiums to be refunded if you can show proof of bills that have not been paid (which of course we can). It is so humiliating to be the ones being treated like common criminals. My uro's business manager has been the worst. She told me that $25 a month payment was an insult from me to my doctor. Everytime I go now I have wait 30 minutes to check out while she "audits" my account and then she comes out and talks about it in front of other patients. My hubby and I are meeting with the doc this week about her and how inappropriate she has been. She has come into the exam room while I am waiting for the doc to talk about my account when she knows that unless we win the lottery nothing has changed! This has been a real learning experience for us. I will keep you all updated so that in case this happens to someone else you can learn from what we have been through. In the meantime I am still trying to figure out how to get my cysto w/hydro on Tuesday as planned.

Pam

[Prinny Joy]

You have been through so much! You need to make sure the lady is aware of Hippa, that is your privacy issue. I'd be switching Dr.s even if it wasn't his fault. I'm so sorry and I think the Dr. needs to know she said you were insulting him w/ the 25.00. The nerve of some people. So sorry! PEACE and JOY

[Dixiefireball]

I'm sorry I don't have any advice. I wish so much i had an answer for you.
I will be praying that this gets straighten out very soon and the sorry con artist get caught and put behind bars where they belong.
sending you hugs and prayers
Rhonda

P.S
My uros office had a lady like that once she came out in front of other pat. telling me about my balance and very much embrassed me. I also seen her do this to other pat. Needless to say. She wasn't there much longer.
sound to me as if this lady doesn't really want a Job or she would be asking you to come in an office with the doors close and clamly sitting down and trying to figure out something to help you and the office to get there money. Fussing at you and upsetting you isn't getting there money any quicker.
there is so many people out here who needs jobs and you get the onces who got the jobs who doesn't want them.
How sad!

[ICNDonna]

It is absolutely not legal for you to be asked about payment on an account in front of witnesses. I think you would be doing your doctor a favor by telling him that it's happening. Some day somebody will sue him if she continues.

Donna

[Sarojini]

This is an awful situation! I wish I had more advice for you, but... here are some :grouphug:s... that's about all I can do right now. I hope you are able to get this straightened out somehow.

[JaniceB]

How terrible! I don't know what to tell you on the insurance fiasco. We kept paying higher and higher premiums to until we finally had to decide whether it was pay insurance or eat!! (DH's job does not offer insurance) So now we are without insurance. :(

I have been getting my care through a low income program at the hospital. The larger the hospital, the better. I don't know what your situation is as far as your income, but even if you don't qualify for 100% write off, you may qualify for, say, 50%. This is something you may want to check into. This is why I am kinda "stuck" with the uro I have, as he is the only one that works through this hospital.

Also, for meds, check needymeds.com. Many IC drugs are on patient assistance programs, and most of the income guidelines are posted on the site. This is how I am going to get my pain medication that I otherwise can not afford.

I still owe lots of $$ to drs, radiologists, you name it, even though my hospital care is being taken care of. None of them have turned down or complained about my $10 or so per month! I would love to pay them more, but I can't pay them all the maximum they want, not when I have so many to pay on. That is terrible, the way the office mgr is treating you.

I feel so bad for you! :kissing: I really hope things improve. Let us know.
Janice

[cass2376]

Pam,
I am so sorry to hear about what has happened to you and your family. My husband is a Pastor too and I can't even imagine how you must feel!! First of all, I will keep your family in prayer, not only to resolve this whole situation, but also to help you with your pain and need for money to come to take care of bills. I know how it feels to be a Pastors wife who is sick, it's not easy, not to mention having all this other stuff going on on top of it.
I wish I could tell you what to do, (besides praying :) ), but I don't know. The others are right to suggest getting the athoritys and attorneys involved somehow, which you seem to be doing. You sound like you are doing the best you can, I give you credit for hanging in there and hanging on the Gods hand!! My husband and I could not afford our premiums any more for our insurance through Healthnet insurance so all the other Pastors and familys on staff at out church switched to Kaiser which was a lot cheeper monthly for us!! You might want to look into it in the future when you can. They have been great with us so far and I found a uro who is great. Hang in there and I REALLY do hope things get resolved fast. I feel sorry for these "agents" cause they were not only robbing from inocent people which is bad enough, but in the long run, they where robbing from God, you know what I'm saying? I would not want to be in there shoes(Vengance is Mine, saith the Lord....ect) :) If you need anything please write back here or PM me, please!!!! God Bless, Cassandra :angel: P.S. I'm glad you are meeting with the Doc regarding that "lady" who has been terriable to you at the docs
office, she had NO right whatsoever to do that to you!!!, it got me so mad when I read that. You don't need that right now with all the stress and of course not feeling well to boot. I hope she gets in trouble for it, she asked for it!! By the way, it is not an insalt to pay 25$ a month, it is your right and
legal to pay whatever small amount you can to avoid getting sent to collections. I once payed 5$ a month on a medical bill till we refinanced our home to take care of bills that were overwelming us. It is legal and they can not complain so you are doing a great thing by reporting her, who does she think she is, God :biglaugh: Sorry, couldn't help it!! Take care sorry so long. :)

[Mare]

Hi Pam, The behavior of the woman in your Dr.'s office is totally unacceptable. I know that it is hard for some patients to remember, but if it weren't for patients like you, she would not have a job. She may think that she only works for the Dr. but every time that you visit that office, she is working for you. And I would not hesitate to remind her of that the next time that she speaks to you like that. It really is OK and totally appropriate to stand up and tell her to stop the conversation unless she is willing to move into a private area of the office. If she refuses, you might think about walking out of the waiting room to put an end to the conversation. The only reason that she continues the behavior is because she can. If the Dr. is not available to stop her in the middle of the inappropriate behavior, you certainly have the right to stop her. We teach our children to move away from adults that make them feel uncomfortable. As adults, we have the same right to stop any behavior that we feel is inappropriate or abusive. I dealt with a situation at a Uro's office about 10 years ago by reminding the woman in the front office that without the patients neither she nor the Dr. would have a job. Then I told her to tell the Dr. that he had been fired, since he refused to talk to me in person. I received an ovation of clapping hands from the other patients in the waiting room as I exited the office. It was the best thing that I did for myself. It freed me to find a Dr. who actually acknowledged that IC was a disease and I was diagnosed and started treatment that has helped me to be able to work again. Good luck with the insurance nightmare. Maybe you could try to find out some of the other victims' of the scam by posting some info in one of your church newspapers or any websites that other pastors read. Best wishes for brighter days! Mare :bunny:

[Sherry5]

I don't know how it is in the city you live in, but here (phoenix, AZ) We have two networks that will publicly help with your problems. One is "twelve news for action" Where the news team at our channel twelve get your story, have it on the news, and basically shame businesses into cooperating with you. Anyone that reads your story can feel your pain and realize it is not your fault. The news team just sheds some light on the subject and shows the whole community how abominally you have been treated. Most businesses will cave under public ridicule. Because we have two of these stations, it is likely your town may have one. Let us know how it works out, and know that so many of us are praying for you! :grouphug: