Terminal & Terminated

Terminal and Terminated.

I realized yesterday that I have had continuous health coverage from the moment I was born until just now–fifty eight years of buying into the American Dream of health and happiness. And it’s hard to believe that one missed payment was the undoing of this longterm relationship–me and my coverage. And given the fact that they cashed the check, I think we can call this a late payment instead. *However, it is important to note (for the sake of accuracy) that I missed the grace period by a few days, not the due date. The due date was May 31st for June coverage. The grace period ended on June 30.

Yesterday I was most concerned about the bills I am now going to face for care, procedures and prescriptions that were procured under the assumption that I had coverage.

Today I am more worried about what lies ahead. If I am not able to reinstate coverage and/or scramble to be picked up by a new insurer by August 1st, I will have to cancel my CT scan on the 2nd. Ditto for the appointment with Dr. Shaw on the 7th, when I would have labs and also pick up my three month supply of trial drug.

This can’t happen.

I am going to get to work on figuring out where I will get future coverage from but in the meantime, I believe it is essential to have my Cobra coverage, in which I have already met my deductible, reinstated. And I am going to ask your help in doing so.

If each of you could send a letter to WageWorks in which you ask them to reinstate my coverage, I would be much obliged.

Say what you like in your letter but here are the facts. Although the termination notice is somewhat confusing, I missed my June payment. The way Cobra works is you have the month of coverage as your grace period but if you do not make that payment by the end of the month, your coverage is automatically terminated.

In my case, I thought I had paid. Because of my short term memory challenges, I keep a ledger of my bills as I pay them and I had checked off my Cobra payment for June. I pay my bills electronically and there are lots of steps to go through for WageWorks and I must have failed to push submit at the very end.

I got home from Montreal late on the 3rd of July and on the morning of the 4th, went online to pay my July premium, only to discover that I had missed June and was now locked out. I immediately called WageWorks and overnighted my appeal the next morning. On the following Monday I called to make sure they had received it and even though the P.O. showed my letter had been delivered, WageWorks could not locate it. I then faxed my appeal and called yesterday to ask about the status which is when I was told my appeal had been denied and that I had been terminated.

If you have access to a fax they can be reached at:

8335146416  ATTN COBRA APPEALS DEPT

If not, please mail to:

ATTN COBRA APPEALS DEPT, WageWorks INC PO BOX 2998 Alpharetta GA 30023-2998

Reference me as Evalynn Linnea Olson, ACCT #22234499. Let them know that this is a matter of life and death. That if I am forced to stop therapy my lung cancer will jump on this opportunity. And so should they—an opportunity to do the right thing.

xo

42 responses to “Terminal & Terminated

  1. Deborah DeBarr

    You should go thru your states ins commissioner to get this done quickly. I had to do that not with my lung cancer but with an accident I had years ago and they had cancelled my cobra as I was late on the payment but I was in the hospital for a long time and missed it. The Ins Comm got it taken care of immediately. I was sent a hospital bill for $185k and told I didn’t have ins. I was very firm when calling the states (I am in Va) commissioner insisting and not settling for less than her and telling everyone I talked to first what had happened to me. They all felt terrible so by the time I finally got her on the phone the entire office was talking about it. I was in sales all my life and when doing this you have to paint a vivid picture because you want successful results. Good luck but please try this. We pay these peoples salaries sometimes they need to do a little extra.

    Sincerely,

    Deborah DeBarr

    • Deborah, I wish I’d had sales training—I might have handled my call with the supervisor at WageWorks with more aplomb. I can only hope that they will reconsider and I will get in touch with the Insurance Commissioner on Monday–thank you.

      xo Linnea

  2. Linnea, is there a possibility that Dr Shaw could help with this matter? A letter or fax from her to Wagework explaining the side effects of the therapy- how important it is for you to be able to continue the trial etc.
    If it does get resolved in your favor, which i fervently hope it will, why don’t you have your payment automatically taken out each book by bank. That way having to remember to do it
    and no damn submit button.

    • Mary, I have contacted Dr. Shaw as well—I am going to have to get my account beefed up before I can do auto-pay on a bill as large as health insurance—I end every month with only a couple hundred in my acct. And yes, damn those submit buttons. I swear WageWork sets you up for failure—with so many steps to do something relatively straightforward. And I never dared mail the check because we all know what can go wrong that way as well.

      xo Linnea

      • How about asking your grown kids monitor your bank account for missing recurring payments (in either direction)? They might even pitch in to help you make basic ends meet and get whatever support is available?

        (FWIW, my cousins rallied around their mentally-impaired father paying for years of nursing home care in excess of what Medicare would pay. I don’t have kids or relatives to pitch in for me, but I’m sure my brother would be glad to keep tabs on my bank account activity from halfway across the country to protect me from myself.)

        Best hopes,

        Craig in PA

  3. I meant month not book

  4. I will write a letter. You don’t know me but I follow your posts and feel like I know you. Healthcare in this country is an embarrassment and a failure unless you are rich.
    You are an awesome woman!

  5. Linnea, it break my heart that you are going through this. The wealthiest country in the world and we do not have universal healthcare. So sad.

    Have you ever heard of Prescription Hope. I have been getting my Tarceva for $35-50 a month for over a year now. They don’t get great reviews but have been a godsend to me. I don’t know if this will help you but worth a phone call
    Prayers always
    Jayne

    • Thank you Jayne—I will look into it. My therapy has not yet gotten FDA approval, so I must go through the clinical trial in order to receive it.

      xo Linnea

  6. Linnea,

    I follow you on your blog. I will write a letter also. I will tell you that Wagework took money out of my bank account without me pressing the submit button
    last month. I called them about the error and I did not like their response. There may be some internal issues happening that may need to be addressed to help you. In the meantime, I will send a letter.

    I am on Lorlatinib too and following your same journey, but only 31/2 years in and four TKI generations(Xalkori, Alectinib, Brigatinib, Lorlatinib, plus chemo Carbo/Gem) medications used. Keep Strong! Have Faith! Know that others around you are on your journey with you!

    Julie

  7. The state consumer advocate through your attorney general’s office should be able to resolve this for you very quickly. In Iowa you complete an online form. Let me know if you want help doing this.

    • Thank you Judy—I will call the office on Monday to see if I can expedite but I shall lean on you if I need assistance.

      xo Linnea

  8. I’ll gladly write a strongly-worded letter of support, but I would guess that you’d get more effective help from:
    1. getting an attorney (pro-bono one?) (maybe Alice knows someone connected to Harvard Law School who could help?)
    2. calling in TV news reporters (local & national)
    3. calling your U.S. Senator & Congressperson
    4. calling your state’s department for health insurance matters.
    If anyone can help they can. (The last thing an insurer wants is an hot attorney sending them legal letters, TV reporters scandalizing them, and government leaders threatening them with heavy-handed legislation and being expelled from doing business in your state.

    Best hopes,

    Craig in PA

    • Craig, I shall likely do all of the above. And thank you.

      xo Linnea

      • P.S. — And (forgive me if I mentioned this already) don’t forget to ask if the sponsor of your latest drug trial would cover the cost of a scan or test that you could not afford (or waive their requirement of it if they prefer) until you get insurance again. Since it’s only a temporary coverage problem and they want you in the trial, they might be willing.

        Best hopes,

        Craig in PA

  9. alpharetta GA? that’s a PO in my backyard Is their co out of GA? I’ll go open up a can of some whoop ass if so. I’m serious as hell.

    >

  10. Good luck to you. I am a king cancer survivor. Wagewairks fired my husband from his job with them while he was hospitalized from an accident. They are heartless.

    • Cindy, that was my impression and I guess I didn’t hold back on telling them so. I don’t imagine the supervisor I spoke to will easily forget a terminal cancer patient who has had coverage terminated asking her how they sleep at night. I’m sorry that happened to your husband and congratulations on being a survivor.

      xo Linnea

  11. Cecyle Rexrode

    If you’re still denied afterwards, called your Congressional rep. US senator. State rep and senator. And have family and friends and strangers in your district and state call too. No results? Offer your story to advocacy groups and online. Squeaky wheel….

  12. My worst nightmare – Hope you get it sorted out Linnea

  13. Michele M Taylor

    Readers, please also email Wageworks CEO Edgar Montes: Edgar.montes@wageworks.com.

  14. For anyone like me, who has a minor panic attack at the though of going to the post office… you can write a letter and fax it for free from your computer. Go to https://faxzero.com/, enter the fax number and information that Linnea gives in the blog post, and either write your letter write there in the text field, or attach a word doc. You can send up to 3 pages per day for free. When you are ready to send, they will send you an email confirmation link; click that link and your fax will be sent. They will send you a success message when your fax has been sent. I just got my success message!

  15. Just sent a email to my new friend Edgar Montes…

  16. Hi-I do not know your financial situation but for now, ACA policy may be available. After I met deductible they paid great. Also, the hospital may have a financial assistance program.

    • Thanks Janet. I will be getting an ACA policy next. Sadly, my deductible for the year was already met so I have to start over on that.

      xo Linnea

  17. Dear Linnea, my letter is written and will be faxed tomorrow. I will also email my letter to the Wageworks CEO. I know this is going to work out for you. You are one phenomenal woman, and I expect you to stick around for a very long time.
    Hugs,
    Kate

  18. I suspect tweeting @WageWorks is not an optimal way to protest, but what do I know. I don’t tweet.

    • I don’t know that there is an optimal way and someone suggested twitter so I went after that too. Yes, it is public shaming but then again, I am not sure that is out of line and certainly not nearly as concerning as my not having coverage.

      xo Linnea

  19. I am an insurance agent in California and one of my friends/clients told me about your situation. I’m so sorry to hear about this! My first immediate thought is they accepted and processed your payment, which is a strong arguing point. I have been on COBRA myself and I know that they can work with you. My monthly payment was just shy of $900 prior to the ACA and after working out a payment plan, I ran about a half a payment behind.

    Whenever I do not get the results I need for my clients, I immediately file an appeal and I keep calling. Continue to climb up the chain until you get to someone who listen. The problem is, they CAN reinstate you. You just have to find someone who actually cares about their job and about the person on the other end of the phone- you. My next suggestion would be to contact the department of managed healthcare. They make things happen. I’m lot certain if they can help in a COBRA situation but it is worth trying. I’ve seen them force insurance companies to pay for claims they refused for months.

    I wish you the best of luck. Open Enrollment for the ACA starts December 7th for a 1/1/19 effective date. In the state of California, you can only apply for insurance during this open enrollment period, unless you have had a loss of coverage through no fault of your own or have had a qualifying life event. Unfortunately non-payment does not create a qualifying event here, but it is possible it will there.

    In the meantime you can apply for state Medicaid and if you have not already done so I strongly suggest you look into being declared disabled so that you can qualify for early Medicare. My client is now on a Medicare with supplements and her coverage is excellent.

    I do sincerely wish you the best. I do not see myself as strictly a health insurance agent, but in an also an advocate for my clients. If you do not have someone who can advocate for you, you must be your own advocate and do not take no for an answer! I will follow your story.

    • Jennifer, that is really useful information, thank you. I hadn’t considered the fact that my non payment may preclude me from ACA coverage now as well. All the reason to push hard to be reinstated. And you are right, just as they can terminate me, they can choose to accept my appeal.

      xo Linnea

    • FWIW, I recall that under certain special circumstances Medicare for persons on SS Disability can be expedited rather than having to wait for 2 years of SS Disability. I never knew what the circumstances were, but you might want to look into that. I was told that under the special circumstances it can be just a couple of months.

      And regarding SS Disability, although Social Security Disability support is meant for people too disabled to work, it might be more like being too disabled to earn a living because recipients are allowed to earn a small income while collecting. The first couple or few thousand earned is ignored, and at some point there is a trade off of some kind (e.g., $1 less SSD for each $2 earned or something like that). You’ll have to contact them for the particulars, but for some people where SS Disability (either based on your own earnings or a % of a past husband’s, I assume) is too small for their expenses having a way to earn a couple or few thousand extra is a good thing. Of course, a person earning many thousands would no longer be eligible for SSD because they’ve proven they can earn a living on their own.

      Best hopes,

      Craig in PA

      P.S. — I sent off a physical letter to the company educating them about the resources of all kind that can be activated in your support by the thousands of people who consider you the preeminent injured hero trailblazer of bleeding edge research that is saving lives. I urged them to make a “reasonable accommodation” for a person with a documented medical impairment along the lines of the ADA (Americans with Disabilities Act of 1990).

  20. It looks like Linnea is getting fabulous advice from better informed people than me – but FYI I’m writing from London UK (where I now live) to WageWorks and to Linnea’s congresswoman. I’ve emphasised too that Linnea is a trail blazer and renowned for her advocacy. Surely surely surely this can and will be resolved. Linnea, you’ve long been one of my great, great heroines. We will get you through this. xxLiz

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