(C) Daily Kos This story was originally published by Daily Kos and is unaltered. . . . . . . . . . . Dealing with Cancelled Health Insurance (Rant) [1] ['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.'] Date: 2023-09-22 I don’t normally write stories, but this is something that I’ve been dealing with for several months now, and I really need to vent. Also, this is a good opportunity to point out how messed up the US healthcare system is. Basically, my health insurance was cancelled back in April. Before this, everything was going just fine. I had made every premium payment, I had reached my out-of-pocket limit, my claims were being processed without any problems whatsoever. Then one day my insurance was just gone. I didn’t even know about it at first. My insurance company didn’t give me a 30-day notice. They did send a termination letter, but it was sent the day AFTER my coverage was cancelled. I actually have a report from my insurance company that says outright that the termination letter was sent the day after my plan was terminated. Still, I didn’t need to wait for the letter, because I managed to break my nose not long after my coverage was cancelled. I go to urgent care, and they tell me my insurance is no longer valid, and that they couldn’t do anything for a broken nose and that I would need to go to the ER. This was quite a surprise to me since I had literally just picked up my insulin less than two weeks before this, and my insurance worked just fine. It took a couple months, multiple calls with both my insurance company and the Marketplace, and a complaint to the Department of Insurance to figure out what happened. When I enrolled in my plan, I went through the enrollment application on Healthcare.gov, exactly like I did for my insurance the year before. I had been receiving daily emails from the Marketplace telling me to make sure I enrolled so I had coverage for 2023, so I did. However, unbeknownst to me, they had already submitted a passive enrollment file to renew my existing coverage. I would think that this would be a simple problem to fix, and that the new application would override the old one, but that would be too logical. Apparently, in the esoteric world of health insurance, this is an absolute disaster that can only be resolved by terminating the offending applications as thoroughly as possible, scorching the earth and salting the land until no sign of their disgraceful existence is left. You see, my plan wasn’t just “canceled”. It was rescinded, which is a retroactive cancellation that basically denies my plan ever existed in the first place. They refunded my premiums, and said that I owed them for all the claims I had under the plan. Did I mention that I am a type I diabetic, and that insulin is expensive? So in addition to the ~$2,400 hospital bill from breaking my nose, and having to repay my out-of-pocket limit for the new plan I got, I am a bill for $19,998.77 for medication that they covered when I had insurance. That is more than I make in a year. I asked for an itemized bill, because I thought that was complete bullshit, and yep, around 90% of it is for goddamn insulin, which I need to fucking live. I’ve spent the last several months trying to get my old plan reinstated, but to no avail. My escalation to have my plan reinstated was denied, and the decision is unappealable. I’ve tried to figure out what exactly happened, and on what legal basis my plan was rescinded, but everyone gives me a different story. My insurance company tells me that Marketplace cancelled my plan, and that is why they didn’t give me 30 days notice. Marketplace tells me that my insurance cancelled my plan, and that they can’t cancel a plan unless I specifically call in and request for it to be cancelled. I can’t see whatever information they look up, so I have no idea what the actual facts are. I would be willing to accept that I made some sort of mistake when reapplying for health insurance. I am only 23, and this is my second year having my own insurance, and I am new to all of this, so I would be willing to accept that I made a mistake when I reenrolled for the new year. But they let me believe that I did everything right for 4 fucking months, and then pulled the rug out from under me and said “whoops, nvm”. I had no opportunity to correct any mistake, or to find new insurance, or any clue that there was anything wrong in the first place. I can’t help but suspect that this wouldn’t have happened if I wasn’t an expensive customer. To lighten the mood a little bit, let me talk about how thankful I am for the Affordable Care Act. For someone like me, who has an incredibly (and unnecessarily) expensive illness, Obamacare is an absolute lifesaver. I could never afford the plan I have now without it, they are covering like 90% of my premiums. I have a fairly low out-of-pocket limit, and since insulin is so stupidly expensive I will be guaranteed to reach it every year (I literally hit it in January), so I am not overly concerned about other health problems I might have. Also, the fact that I can’t be financially discriminated against for my illness means that I am not facing extortionately high premiums for my plan. Another thing the Affordable Care Act did is put a prohibition on recissions except in cases of intentional fraud or misrepresentation, so what happened to me might be illegal, and I may have a fighting chance yet. www.law.cornell.edu/… I am not a lawyer, and I don’t know if this would apply to my cancellation (cancellation is not defined as recission if coverage was terminated by the Exchange, and it is still unclear to me who initiated the cancellation), but I am trying to consult a lawyer to see if there is anything I can do about this. As an aside, let me say that the free market doesn’t work in healthcare. I can’t pick what type of insulin I get, I am limited by what my doctor prescribes and my insurance accepts. I can’t boycott insulin to demand lower prices, because without insulin, my blood will turn to acid (seriously, it’s called diabetic ketoacidosis and it horribly painful, I know from experience) and I will fucking die an incredibly painful death. So I am forced to put up with whatever bullshit prices insulin companies give, and have no ability to apply economic pressure to force better pricing since I kind of need it to live. There is no real competition or market pressure, so they can charge whatever they feel like and I have to pay it or die in agony. Government regulation of pharmaceuticals is needed to prevent predatory price gouging; market pressure simply does not work when the customer has no choice in the matter. Anyway, that is my story, I feel better writing that and getting it off my chest. If anyone else has their own bullshit insurance story, or has insight into my own situation, or has their own interesting takes on the American healthcare system, or can explain to me any horrible mistakes I’ve made, I would be glad to hear them. I hope anyone who reads this has an absolutely fantastic day, and I appreciate them for caring in spite of this overly-long rant. 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