Mailing Address Change Automatically Cancels Obamacare Subsidy – Story
March 1, 2015
A new health insurance policy with Blue Cross Blue Shield of NC (BCBSNC), subsidized by Healthcare.gov begins. The subsidized rate is $257.83. This replaces my policy with BCBSNC that, on Jan 1, increased from $295 to $405 due to me turning 50.
April 23, 2015
I called the Marketplace 800# (Healthcare.gov) to correct my mailing address. They did not have the suite#. However, the street name and number as well as the city, state and zip code were correct.
May 18, 2015
I receive a new health insurance card and info from BCBSNC in the mail. The subscriber number is the same, but the group id and the account number have changed. It says I have an increased rate of $495.83 a month (effective as of April 23, 2015). An additional amount of $132.22 was added (prorate from April 23 – 30). Invoice total was $628.05.
May 20, 2015
I call the Marketplace 800#. I was told that because correcting a mailing address is considered a ‘life change’ by Healthcare.gov my subsidy was automatically cancelled and I was given a new policy, without any subsidy, and with higher deductibles across the board. I am told by the first representative that she is aware of this ‘life change’ problem and internally the other reps are upset about it as it happens all the time.
My call is escalated to a supervisor who matter-of-factly says that I should have known that a mailing address correction would cancel my policy. She directs me to the ‘appeals form’ on the Healthcare.gov website and says it would likely take 3 months to be looked at. She said that if I don’t pay the current higher premium of $495.83/month from BCBSNC, I cannot reapply for insurance through Healthcare.gov until the following year.
• I was originally never told that correcting the mailing address over the phone would automatically cancel my subsidy.
• My new rate of $495.83/month is $90/month HIGHER than my old policy that was replaced by the Healthcare.gov policy on March 1st. And my deductibles are higher and my benefits worse.
May 21, 2015
I mail in the appeals form and all required paperwork to the address in London, KY. I subsequently was told to pay the $628.05 to keep my changed policy in effect.
May 23, 2015
I went online at BCBSNC.com to register the new policy but it would not accept it even though they already sent me a bill and the insurance cards with the updated subscriber number and group number. I went to the pharmacy to get prescriptions drugs refilled. They said the policy is in the system but not ‘activated’ by BCBSNC yet. They told me to call BCBSNC. It is the Memorial Weekend and nobody in that department of BCBSNC would answer the phone.
May 26, 2015 (Tuesday, day after Memorial Day)
I called BCBSNC and they said ‘registration’ of this newest policy – aka: getting it into the system – would take about 10 days and that I could not pay the premium due, $628.05, until it was complete. The rep said she would escalate it but it would likely take another 5 business day. I was told to pay the cash price for the drugs and I would be reimbursed later. So now the premium invoice states that the policy will be canceled if not paid by May 31st and the good people at BCBSNC of NC say I can’t pay the premium until it is completely ‘in the system’ which may not happen until AFTER May 31st.
May 27, 2015
Tried repeatedly to contact BCBSNC via phone. It kept saying they were having technical errors and it would auto end the call. This happened ALL day.
May 28, 2015
Called BCBSNC and waited 22 minutes for a rep. She said the “first” system was telling her that my new policy was terminated by HealthCare.gov and to call them. After additional questioning by me she asked her supervisor and they looked into a “second” system – which told them that the policy WASN’T canceled but was still not fully built into the system. She said that even though my issue was already ‘escalated’ it would actually take about 10 business days to fix. I was instructed to mail in a check for my premium payment and it would be applied when the policy was fully active in the system. I was also told to pay cash for my drug prescriptions, which now are a week into not being filled, and I would be reimbursed. Lastly, she said she would call me on June 4th to update me on the status.
Often with stories that center around complaints there is some good reasoning or advice that we can offer. Often it’s a matter of the person not understanding how to leverage all their new rights and protections or how to take advantage of cost assistance correctly. In your case this actually just sounds like a nightmare. The idea that correcting ones address, while remaining in the same exact region but simply correcting suite / apartment numbers would result in any type of plan change just makes no sense. Also, it makes sense to auto renew someone in a similar plan when the situation calls for it, but giving them no choice in the matter and declaring a plan that costs nearly $200 more as similar is mystifying. At the end of the day you should simply be able to change to another plan (but that may be more trouble than it’s worth at this point).
Both BCBS and HealthCare.Gov are correct in theory, you should be able to appeal and be reimbursed… but of course not everyone has an extra couple hundred dollars to simply keep the ball rolling while paperwork is done.
Not sure this will help you, but it is worth pointing out: You always have the option of projecting less income, if you reasonably think you will make less than originally projected. In a state that didn’t expand Medicaid, like NC, one can project to make a little 100% of the Federal Poverty Level or more and still get subsidies. The subsidies at near 100% FPL are generous to say the least. Subsidies are always estimated and can be paid in advance to be corrected on tax returns at the end of the year. In other words if one thought they might make less money than originally projected this year, for any sensical reason (such as projecting to be out of work for a month), and thus projected a lower income, they would be able to take advanced tax credits based on their projected income. At the end of the year they would owe back tax credits, but not cost sharing reduction subsidies for lower out of pocket costs… So, for most people this would mean a messy tax season, but for some people the flexibility of the way tax credits are offered in advance could mean the difference between being able to pay a premium or not.
The above being said, it’s pretty important to understand how much you are getting in tax credits. A bigger base premium can mean more tax credits, that can mean more tax credits owed back if your income is higher than projected. Doesn’t sweeten the deal you are in to say the least, but it’s important to understand.
Also, if you are being reimbursed for prescriptions you may still be able to use a “free RX card” (google it) and get discounts that way. Should double check with BCBS first, but this could help you save money while your insurer figures out how to actually provide you with the insurance they are charging you for. Yeesh.
I was asked early on by Marketplace to provide proof of my citizenship and annual income. I provided both by sending a copy of my passport and our income tax filing. I was then sent a letter from Marketplace, dated May 4th informing me I had satisfied their request and that I needed to take no further action, as my coverage would continue as initially explained. I recently received an envelope from Assurant Health, dated May 24th, “welcoming” me to the Assurant Health Care Family, and explaining the details of my coverage. Today, I attempted to have a prescription filled and it was denied by Assurant who claimed they were told by Marketplace that I hadn’t paid my premiums. My original premium was around $400.00 per month and was automatically paid each month through our bank, but unbeknownst to me, they raised it to $917.00 per month, claiming I failed to send them the documentation they requested with respect to my annual income, even though they previously informed me they had received it. I spent 2 hours on the phone today with the Marketplace geniuses. The first gentleman I talked to (Daniel) was doing his best to help me and was very kind and knowledgeable. Unfortunately, we were disconnected. I called again and was told I could not be reconnected with Daniel, and I would have to explain my situation again to this new person. Suffice it to say, she claimed they had not received the documents they requested, therefore, my eligibility for the discounted premium was terminated. I was invited to appeal this decision, of course, but meanwhile, I have no health coverage. My husband and I are retired and I didn’t expect this kind of complete incompetence from Marketplace.I’m ashamed, appalled, and fed up with the way Marketplace takes no responsibility for this. I think these people cause more problems than they alleviate. They need to stop being part of the problem! Not sure what to do now.
They are right, you can appeal all of this. You may even be able to switch to an insurer that doesn’t randomly double it’s rate after people have already enrolled for the year (seems like a great business practice on behalf of the insurer there). That being said, it’s unfortunate that there is no “in the meantime” solution for people dealing with extended issues like this that prevent them from having coverage or prevent them for getting cost assistance on their coverage. Aside from appealing this decision you could try talking to the insurer themselves and seeing if their is a solution on their end. You may be able to pay the full amount of your coverage until subsidies are worked out again. As long as it’s a Marketplace plan (you enroll through the Marketplace with or without the help of the insurer) you can simply claim subsidies on form 8962 at the end of the year when you file taxes. You don’t need Marketplace approval to get tax credits in retrospect, just in advance. Claiming tax credits in retrospect is primarily based off claimed MAGI income and whether or not you have access to Medicare or employer based coverage.
Unaccountably is the cornerstone of the US government and the insurance industry. I was treated at least as badly by insurance companies before obamacare. Our culture is too corrupt and apathetic to offer national health care. There was no reason to expect better, based on how our other public programs operate. Getting more red tape into the mix can’t improve quality and any improved affordability will come with an exaggerated price tag for the country.
Obamacare has to disappoint.But Obama was the best man for the job and I would vote for him on a third term if I could.
As of today, March 18, 2016 I changed my address and plan over the phone without issue. The bigger issue for me is the lack of training of the representatives who give out wrong information constantly, or do know now how to answer questions or where to find the answers. I spend 2.5 hours with the rep in tears because he could not make corrections to my account.
I need to change my address, with Dean Care, they told me i had to do it through the Market Place I am not sure were to go, to change my Address
If you need to change information in the marketplace, the simplest thing to do is call healthcare.gov and have them walk you through it. There are also instructions on healthcare.gov for this sort of thing. https://www.healthcare.gov/reporting-changes/how-to-report-changes/