just got a letter 12/24 telling me my insurance coverage terminates on 12/31/09

lisa42
lisa42 Member Posts: 3,625
edited March 2014 in Colorectal Cancer #1
Hope you all had a Merry Christmas! I did, but I did get a frustrating letter in the mail, which I didn't see or read until Christmas Eve around 6 p.m. The letter was from my insurance company, Aetna, telling me that effective 12/31/09, my insurance coverage will be terminated based on the fact that my group coverage from my former employer (I'm on Cobra) is being terminated 12/31/09. My former employer is a school district and they are closed for the holidays until Jan 4, 2010, which is the week after my insurance will be terminated! I only found out what's going on because I called someone I used to work with who told me the district is changing from Aetna to Health Net on Jan. 1st. No one told me anything at all about this! Shouldn't they be required to give me more than a week's notice, especially a week's notice over the holidays when everyone is closed?! I'm freaking out- I'll have no health insurance as of this coming week and I can't even talk to anyone about it for over another week! It was literally just 2-1/2 weeks ago that Aetna told me they're covering the interferon I'm now taking. I wonder if that Aetna dept. even knew anything about me being dropped soon- I can't believe they would have if they would have known. I think all the blame lays w/ my former employer- I am so mad at themm and I can't even do anything about it. I will be contacting Health Net Monday a.m. to see if they can do anything for me to add me without having to wait for my former employer Vista Unified school district to reopen on Jan. 4th. For any of you who pray out there, this is a prayer request- that this can be solved without too much difficult and/or stress. I supposedly still qualify to pay under CalCobra status for another 16 months. It's no longer the federal Cobra status, but the state level under California law, I can pay the insurance company directly for an additional 18 months & I just started paying Aetna directly under CalCobra status Nov. 1st. ****Anyhow.... my question to you guys is to anyone who has or has experience with Health Net. I think it's called the Healthy Families program & it would be the HMO plan. Has Health Net been difficult or easy to work with, and do they routinely deny things, or do they cover most things? I had pretty good luck with Aetna, and so I'm nervous about changing companies. I just got Aetna to cover my "off label treatment" interferon & had just submitted to see if they'll cover my visits to Dr. Cantrell in Tennesee, who is out of my network. Obviously, I would't have even bothered to try to submit it to them if I had known I'd be changing insurance companies.
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Comments

  • dorookie
    dorookie Member Posts: 1,731
    I will say
    a special pray for you Lisa that things go smoothly and that there will be no lag time in your coverage. I am so sorry to hear this is happening to you. I dont have any experience with Health Net, as I have AETNA. But wishing you all the best.

    Good Luck
    Beth
  • tootsie1
    tootsie1 Member Posts: 5,044 Member
    Goodness!
    I don't have answers, but I sure can pray for you. I hope it all works out well.

    *hugs*
    Gail
  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    BCBS
    Never heard of these guys, but if its an HMO, that concerns me - they will be able to dictate which doctor you will see, and referrals would probably be needed, and coverage can be limited.

    HMO's put me in the bind I was in many moons ago, and I could not get a referral or determine my treatment - the rest of my story is well known.

    And I think the big thing is will they pay for Dr. Cantrell's treatments because they are an HMO.

    Sounds like a cost saving measure by the school district to move off of PPO and over to HMO.

    I'm sorry that they allowed this to happen to you - someone dropped the ball around the holidays leaving you with limited recourse for action.

    Hopefully, you will still be able to see your doctor and continue with your new treatments - these things should not happen to people in a modern society, but it always centers around $$$.

    I'm glad your Christmas was good anyway - have a safe New Years.

    -Craig
  • snommintj
    snommintj Member Posts: 601
    Sundanceh said:

    BCBS
    Never heard of these guys, but if its an HMO, that concerns me - they will be able to dictate which doctor you will see, and referrals would probably be needed, and coverage can be limited.

    HMO's put me in the bind I was in many moons ago, and I could not get a referral or determine my treatment - the rest of my story is well known.

    And I think the big thing is will they pay for Dr. Cantrell's treatments because they are an HMO.

    Sounds like a cost saving measure by the school district to move off of PPO and over to HMO.

    I'm sorry that they allowed this to happen to you - someone dropped the ball around the holidays leaving you with limited recourse for action.

    Hopefully, you will still be able to see your doctor and continue with your new treatments - these things should not happen to people in a modern society, but it always centers around $$$.

    I'm glad your Christmas was good anyway - have a safe New Years.

    -Craig

    Intentional
    You know the timing was intentional. I seriously have no idea what to make of your situation. I will pray that you are given the patience and wisdom to deal with your upcoming debacle. I hope you have a prescription for some nerve and high blood pressure meds. You're probably gonna have to foot the bill for as long as it takes to get your insurance squared away. I wish you the best of luck with your treatment and finding insurance.
  • HollyID
    HollyID Member Posts: 946
    I'm saying big prayers for you...
    I hope there isn't a lapse of coverage, and really, there shouldn't be. I just hope they continue to cover you as well as Aetna did.

    We had Aetna ins. at one time and it was really great.
  • JDuke
    JDuke Member Posts: 438
    dorookie said:

    I will say
    a special pray for you Lisa that things go smoothly and that there will be no lag time in your coverage. I am so sorry to hear this is happening to you. I dont have any experience with Health Net, as I have AETNA. But wishing you all the best.

    Good Luck
    Beth

    I too
    am so sorry that on top of everything else you are having to deal with this. I know it is so frustrating. I am a Humana customer, so I don't know anything about your new potential insuror. I hope that the transition is smooth and that the coverage will allow you to continue your current treatment.
    Warmly,
    Joanne
  • ittapp
    ittapp Member Posts: 383
    I just said a prayer for you
    I just said a prayer for you Lisa. God Bless, patti
  • grammadebbie
    grammadebbie Member Posts: 464
    HollyID said:

    I'm saying big prayers for you...
    I hope there isn't a lapse of coverage, and really, there shouldn't be. I just hope they continue to cover you as well as Aetna did.

    We had Aetna ins. at one time and it was really great.

    Similar situation
    So sorry Lisa,

    I was in a similar situation. We were on Cobra when my husbands previous employer changed companies. It was a mess but we worked it out. We went with an HMO and paid the extended Cobra until it ran out. I'm now on a medicare/medical coverage thru the same HMO. It was really scary to be in treatment and lose my insurance. The social worker at the hospital was very helpful in getting everything to work out.

    I will be praying for you.

    God bless you and give you peace.

    Debbie (gramma)
  • idlehunters
    idlehunters Member Posts: 1,787
    ittapp said:

    I just said a prayer for you
    I just said a prayer for you Lisa. God Bless, patti

    Hey Lisa
    GEEEEZ! If ya didn't already have enough to deal with!!! Just when everything seems to be going smooth it just figures something had to screw up..... I will definately keep you in my prayers and hopefully this will get resolved quickly. Good luck

    Jennie
  • k1
    k1 Member Posts: 220
    link
    This is a link to a website with lots of information about CAL-COBRA and federal COBRA including relevant phone numbers in case this info would help you in any way. Maybe someone will answer one of these phones if government offices are reopened before your school district. Just trying to help -- you may already have some of this info.

    http://www.hmohelp.ca.gov/dmhc_consumer/hp/hp_cobra.aspx

    I'm sorry for the stress and anxiety these types of mail cause. And how they seem to come at the worst possible time ever. I got a letter the eve of my colon resection surgery saying that I was being rejected for the continuing coverage of life insurance I was guaranteed when I lost my job. The reason the insurance company gave was they said I did not mail my premium in time, although I mailed it within less than a week of receiving the paperwork for my former employer and they had the power to accept it if they wanted for up to another month by their own stated terms. I appealed and even provided copies of the postmark etc. to show that my former employer was late sending it out and sent it to the wrong address, causing a five day delay in delivery to me, but still got denied something that was my right and didn't require health documentation to receive as a benefit.

    Of course, it wasn't the mailing date that caused them to reject my application and premium payment - it was cancer diagnosis; they just aren't going to say that. I got totally screwed on something that was my legal right. I had to have surgery the next day after receiving the letter and since then have been trying to recover and am also taking care of others in my family who also have cancer and another terminal illness and just haven't even had the energy or time to try and consult with a lawyer to see if there is anything else I can do. It caused me many sleepless nights because I had counted on the life insurance to take care of financial issues like medical and funeral expenses for me if I don't survive my cancer and my recently laid off husband is left holding the bag on thousands of dollars worth of expenses.
  • KathiM
    KathiM Member Posts: 8,028
    I'm sending strong vibes!!!!
    Nuts!!! I HATE when they do this!!! Almost makes me WANT the health insurance being proposed!!!!

    Yes, call Aetna, and HealthNet. And, if you have a number, your underwriter for your COBRA (I'm guessing that's Aetna....). I always played nice at first (BTW, HealthNet is large...so keep trying to wade thru THAT mess...I have that insurance!!!!), asking for their help, explaining that 'I am an active patient right now...what should I do?????'...THEN, if that doesn't work, well, I got sort of pushy...lol...threw around insurance commission, etc....although, it's really the school district's boo-boo...sigh...maybe call the district office????

    Hugs, Kathi
  • PhillieG
    PhillieG Member Posts: 4,866
    Lisa
    First, Merry Christmas. Second, the news you got sucks but I did a quick search and saw this:
    "Q24: Am I eligible for COBRA if my company closed or went bankrupt and there is no health plan?
    A:If there is no longer a health plan, there is no COBRA coverage available. If, however, there is another plan offered by the company, you may be covered under that plan. Union members who are covered by a collective bargaining agreement that provides for a medical plan also may be entitled to continued coverage."

    I found the info here.

    I hope this has some helpful info for you Lisa
    {hugs}
    -phil
  • thready
    thready Member Posts: 474
    So Sorry
    Lisa,
    I am so sorry about the insurance stuff. You also need to contact the California Insurance Commission. They have an omsbudsman that might beable to help.

    Also I will be praying for you, you bet!
    Jan
  • Hatshepsut
    Hatshepsut Member Posts: 336 Member
    Ideas

    Sorry this is happening to you. Nothing can rival the stress of fighting cancer, but the struggle with insurance companies is certainly a strong stressor.

    As a former school employee, you might try to contact CTA or your local association. There is a CTA regional office in San Diego. Also, if you don't otherwise resolve your problem, you might consider filing a complaint with the California Insurance Commissioner. Another idea: your Congressperson or Senators Feinstein and/or Boxer may have an ombudsman who could help you navigate this issue.

    I hope this works out for you.

    Hatshepsut
  • KathiM
    KathiM Member Posts: 8,028

    Ideas

    Sorry this is happening to you. Nothing can rival the stress of fighting cancer, but the struggle with insurance companies is certainly a strong stressor.

    As a former school employee, you might try to contact CTA or your local association. There is a CTA regional office in San Diego. Also, if you don't otherwise resolve your problem, you might consider filing a complaint with the California Insurance Commissioner. Another idea: your Congressperson or Senators Feinstein and/or Boxer may have an ombudsman who could help you navigate this issue.

    I hope this works out for you.

    Hatshepsut

    GREAT idea!!!!
    I used my Congressman to straighten out a trouble I had with Social Security. When no one else could...

    Hugs, Kathi
  • lcarper2
    lcarper2 Member Posts: 635
    Aetna sucks
    they did the same thing to me but I got a 30 day notice and signed up for another to take over as of Jan 1 and then aetna listed me as closed when I went for a 7000.00 chemo and I almost had a heartatack called them and thay said it had been done in error and they would have to reinstate me and it would take 2 weeks which would have been the 31st I fought like crazy explaining that they were not keeping me from getting an asprin they had me fax some stuff over to them and got it done fast I think so I would quit calling them every 15 min. anyway I got my treatment and got a 90 day supply of any meds I needed while I had them. They are the worse ins. company around and they have been in business for years. It really suprised me when I got the letter...I will pray that you get this handled fast I wish you the best..
  • Fight for my love
    Fight for my love Member Posts: 1,522
    Hi dear Lisa,all your
    Hi dear Lisa,all your concerns is understandable.If I were in your position,I would have the same concerns too.Sorry that I don't know anything about insurance companies.You are in my prayers and I have just prayed that everything will fall into places for you.Best luck with everything.Take care.
  • ADKer
    ADKer Member Posts: 147

    Hi dear Lisa,all your
    Hi dear Lisa,all your concerns is understandable.If I were in your position,I would have the same concerns too.Sorry that I don't know anything about insurance companies.You are in my prayers and I have just prayed that everything will fall into places for you.Best luck with everything.Take care.

    social security disability
    Lisa -

    I am just wondering whether you are receiving or have considered applying for social security disability. If you have not worked for more than a year, I believe that you are eligible. You also become eligible for Medicare 2 years from the date of disability, which would be the last date that you worked, or the date of diagnosis if you have not worked since diagnosis. My husband's job was eliminated at the end of last year, probably because of my medical bills (he worked for a governmental unit that was self-insured). We have COBRA for 18 months but I will become eligible for medicare before that expires. Insuring the rest of my healthy family should be easier without me.

    Just an idea. Let me know if I can help.
  • dianetavegia
    dianetavegia Member Posts: 1,942
    Praying!!
    Lisa, I prayed before answering and hope you can get some answers and peace of mind first thing tomorrow!

    We have an HMO and I've not had to have referrals for specialists. Of course, we're in Po-Dunk, USA :o)

    Diane
  • AnneCan
    AnneCan Member Posts: 3,673
    Lisa,
    I am sorry for this;

    Lisa,

    I am sorry for this; you don't deserve this! I hope you are able to resove this without too much trouble. I will be thinking of you.