First: January 20, 2012
Last: January 20, 2012
My mother is currently in the hospital (after being there almost straight through from 12/1/11 has undergone numerous bypasses culminating in a lower leg amputation on 1/10, had a heart attack on 1/13 and now has pneumonia. My father suffers from seizures and had one so bad in August he was in a coma for 3 weeks and is now moderately physically and mentally disabled requiring 24 hour supervision. My siblings and I - who have jobs and families (I have 3 kids under 6 and a full time job) are trying to help advocate for them the best we absolutely can but have run into some serious trouble.
My mother and father both have health insurance through NetBenefits which is part of the Fidelity Group that administers plans for Texas Instruments (where my mother worked for many years – and took an early retirement package from). In Oct 2011 mom turned 65 and I worked with her to transition her onto a plan offered through NetBenefits that would subsidize her Medicare and coordinate all of the benefits. This was the Secure Horizons United Healthcare plan. Essentially, TI was allowing her to stay on a plan that they offered and she would have to pay the full premium. They would also let my father stay on her insurance but because he was not eligible for Medicare he stayed on the prior plan that they had both been on through cobra and this was BCBS of New England HMO.
Because my mom was now on Medicare they were on different plans both being administered through Netbenefits and all was well. Open enrollment for the next year was in December and my mother received things from United Healthcare saying that the name was changing and they sent her new cards. She then spent most of the month in the hospital. On the Netbenefits website that I access periodically I saw that they were changing the plan name and the premium was going up slightly. Nowhere did I see anything that said that they were losing coverage.
On January 13th I went to the website to see what my father’s insurance card number was as I needed it to book him a very important appointment.The website said they had no coverage. That evening I called the NetBenefits center and had my father authorize me to speak with them on the phone and Sharon kept telling me that they no longer had coverage – but that she didn’t know why but that she could get them onto a high deductible plan so they at least had something.
She could not answer any of my questions like:
Why did my mom get new cards from UHC?
Why did they automatically deduct the whole premium from her bank account if they did not actually have coverage?
Why did they drop both of my parents if there was a hypothetical specific issue with just my mom?
Why do I have a document from UHC instructing them to do nothing as it seemed to be a passive enrollment?
Eventually – After 2 hours Sharon came back and said she put another set of eyes on the case and they discovered it was a system error (which I actually believe is the case) and they would clear it up and not to worry.
She then called last night and left a message saying the situation had been resolved but didn’t leave any details. I had my sister call her this morning because she was with my dad who could verbally authorize them to speak with her – and they told her that because my mother has Medicare Part D she is no longer eligible for this insurance. That makes no sense to me – and they kept telling my sister that my father was also on Part D but my father is only 64 so that is completely incorrect.
I also had a manager tell me on Tuesday that I needed to have a copy of the Power of Attorney notarized on top of the notary they lawyer did. Obviously – that is not possible – but an example ofthe level of incompetence I am dealing with.
Currently as it stands they have a PoA that was signed for this morning in their office but still they will not talk with me because they claim it takes 4 weeks to process. They are continuing to put us into a revolving door of “I don’t know – let me have a resolution specialist call you back in 3-5 days” and it is currently jeopardizing my parents health. Honestly, I administer health insurance plans at my work and this has been the least informed group of people that I have ever dealt with on this level. They all just read from scripts and put you on hold and no one can actually answer your questions. If I were a senior citizen that had to deal with this I would just purchase whatever high priced plan they were trying to sell – just out of fear and desperation. It is completely unacceptable and negligent as far as I am concerned.
I am not sure there is actually anything anyone can do – but my gut is that something shady and/or incredibly negligent is going on here it seemed appropriate to reach out to the AARP community because I am desperate, at my wits end and have no idea what else to do.
The NetBenefits customer service number is 888 – 660-1411