Wife's health insurance dropped all dependents

[mark_in_denver]

Hello,
For years our kids and myself got health insurance from my wife's employer (government). We were recently notified that our kids and myself have not been covered since July 1. They stated they never received the signed form saying we were her dependents. My wife swears she mailed that in, like she does every year. We only found out from a large medical bill after one of our kids went to the doctor and we called about it and found the apt wasn't covered.

So now we're not covered under her insurance. I'm not sure what this means, I'm assuming we won't have insurance until the new year after open enrollment starts again? My wife is calling her HR department, but I'm not sure what they will do. Any advice?

[delamer]

No option to get it through your job? There are short-term policues that you can get, if not.

If your wife pays part of the premium, didn’t you notice a change in her paycheck?

[Tdubs]

No option to get it through your job? There are short-term policues that you can get, if not.

If your wife pays part of the premium, didn’t you notice a change in her paycheck?

Does her coverage have an open season in the fall?

[000]

If everything else fails, COBRA?

My recollection is one has 60 days from the time the COBRA informational packet is delivered to enroll.

[Kenkat]

It would be good if she had a copy of the form that she mailed, but that ship may have sailed. If she thinks she mailed it in, I would push pretty hard on the angle that they lost it on the other end, especially with all the disruption with Covid-19, etc. I would at a minimum see if you can get reinstated prior to the next open enrollment period given, you know, that they lost the form and all.

[Katietsu]

If everything else fails, COBRA?

My recollection is one has 60 days from the time the COBRA informational packet is delivered to enroll.

Unfortunately, I do not think this qualifies. I would ask though.

[MP123]

This is a case where a short term policy would make sense if you can't get reinstated.

Also, losing insurance is a "qualifying life event" that might enable you to get on an ACA plan. But I'm not sure that your circumstances would qualify. It might be worth checking with your state's exchange if all else fails.

[Katietsu]

Yes. Argue that she returned it. Our open enrollment is done in May for a July 1 year. Around the first of August 1, we get a form showing what we signed up for and which family members. We are told to contact a number immediately if any of the information is wrong. I can only assume that means that they have a mechanism to fix a mistake.

I do not think this would qualify you for COBRA. I believe this would be a qualifying event to sign up for other insurance. The problem is, you just passed the 60 day special enrollment period.

If you really do need insurance, you should be able to get a private temporary policy until next July. I believe it will not cover pre existing conditions and does not comply with the regular ACA guidelines. You will need to be careful evaluating the plan as there can be significant differences between them.

[mark_in_denver]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

[000]

If everything else fails, COBRA?

My recollection is one has 60 days from the time the COBRA informational packet is delivered to enroll.

Unfortunately, I do not think this qualifies. I would ask though.

Why not?

[Katietsu]

If everything else fails, COBRA?

My recollection is one has 60 days from the time the COBRA informational packet is delivered to enroll.

Unfortunately, I do not think this qualifies. I would ask though.

Why not?

Because the insurance was, in theory, lost by choice not because the family members no longer were eligible for insurance under the workplace plan. The assumption is that the wife chose not to cover her husband and kids. I realize that this is not true in this case from the wife’s side but it is the current operating assumption of the employer.

According to CMS, COBRA qualifying events are: “ The following are qualifying events: the death of the covered employee; a covered employee's termination of employment or reduction of the hours of employment; the covered employee becoming entitled to Medicare; divorce or legal separation from the covered employee; or a dependent child ceasing to be a dependent under the generally applicable requirements of the plan.“

I do not believe that a COBRA packet would be generated in this case. However, these things can be complex enough that I would pursue every possible. I am definitely not an expert on whether this could be qualifying for COBRA.

[mark_in_denver]

My wife and I never received any document that we were going to be dropped from Anthem. I get much better notification when our XM is going to expire than our own health insurance. We weren't covered for a little over two months.

[000]

I wonder if OP should also start contacting the USPS about this.

[MP123]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Ask if they have a discount for cash payments for uninsured patients. Many facilities would rather have some money now than have to mess around with trying to collect it.

If your bill is unadjusted for insurance negotiated rates realize that the provider would only get a (very) small percentage if the insurer was paying it rather than you as an uninsured patient.

And be extra careful until midnight...

[Katietsu]

Congratulations. I am glad to hear this worked out.

My experience with a couple different health care providers is that they will give you a discount, 20% seems routine, if you are ready to pay in full.

[Watty]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Push harder to get it backdated. Try to get her HR department to help you.

It is very possible that the insurance company actually got the needed paperwork and and they dropped the ball and lost it or did not process it right with their staff working from at home.

Paperwork also gets lots in the mail. I would think that you should have also gotten a final letter too when they dropped the kids coverage.

[feehater]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Push harder to get it backdated. Try to get her HR department to help you.

It is very possible that the insurance company actually got the needed paperwork and and they dropped the ball and lost it or did not process it right with their staff working from at home.

Paperwork also gets lots in the mail. I would think that you should have also gotten a final letter too when they dropped the kids coverage.

+1
Backdating is absolutely possible and I've gotten my employer to do it in a similar situation. Although, you would then be on the hook for those two months of premiums, which may or may not be more than the bill you owe.

[KlangFool]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Asked them to re-instate you back to 2 months ago. They can cover you retroactively up to 2 months.


KlangFool

[stan1]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Asked them to re-instate you back to 2 months ago. They can cover you retroactively up to 2 months.


KlangFool

This is the best choice. Blame the USPS. Issues are well known. It's an administrative issue.

[Shikoku]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Asked them to re-instate you back to 2 months ago. They can cover you retroactively up to 2 months.

KlangFool

This is the best choice. Blame the USPS. Issues are well known. It's an administrative issue.

Lesson learned. Sometime after mailing important paperwork, I should call and verify if it reached to the destination.

[KlangFool]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Asked them to re-instate you back to 2 months ago. They can cover you retroactively up to 2 months.

KlangFool

This is the best choice. Blame the USPS. Issues are well known. It's an administrative issue.

Lesson learned. Sometime after mailing important paperwork, I should call and verify if it reached to the destination.

If you can, fax it. Then, call them. You can get a $10 fax modem that works with Windows 10. Or, use one of those free online fax services.


KlangFool

[RetiredAL]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Asked them to re-instate you back to 2 months ago. They can cover you retroactively up to 2 months.

KlangFool

This is the best choice. Blame the USPS. Issues are well known. It's an administrative issue.

Lesson learned. Sometime after mailing important paperwork, I should call and verify if it reached to the destination.

My company, before I retired 4 years ago, always sent out confirmation letters, until the last 2 years, when it went on-line and they sent us an email when the data was ready for us to check. And I always checked the first pay (on-line) so as to make sure all the deducted amounts were correct.

[FIREchief]

Thanks everyone, wife called and we are reinstated now, as of 12AM tonight. However there is still that doctors bill to pay, I'll see if the medical center can reduce it somewhat? What is your suggestion on that?

Asked them to re-instate you back to 2 months ago. They can cover you retroactively up to 2 months.

KlangFool

This is the best choice. Blame the USPS. Issues are well known. It's an administrative issue.

Lesson learned. Sometime after mailing important paperwork, I should call and verify if it reached to the destination.

That and using certified mail, which provides proof that a letter was delivered. That said, I feel sorry for the OP. Megacorp tends to be awful in these types of matters. They don't keep anything. It seems like I had to send them a copy of my marriage certificate about five times over the years. Same wife. Same name. Same everything.... But good 'ol Megacorp just needs me to recertify and recertify and recertify. Fortunately, my last connection to Megacorp expired yesterday, so I'm experiencing a whole new kind of freedom.