Tag Archives: Cobra

And as if you haven’t heard enough…

My friend Casey—aka Mighty Casey Quinlan, interviewed me for this week’s Healthcare is Hilarious installment and we discussed my Cobra debacle. One more time. Happy, shiny, glittery ending and all.

Support Casey (a formidable individual and advocate too) and give a listen here.

The naked truth about losing health care coverage

I learned a thing or two from my now-you-have-it-now-you-don’t insurance debacle.

First, that individuals with expensive conditions like a cancer that’s turned chronic are sitting ducks. We represent one of the worst case scenarios for the health insurance industry—someone who requires costly long term care, effectually increasing burden to other policy holders as well as reducing company profits.

As keeping us alive is so very expensive, we are inherently vulnerable. No insurance company actually wants us on their policy and, if pre-existing conditions were still a valid reason to deny coverage, people with cancer would be shit out of luck.

Because we are incredibly vulnerable, we have to make absolutely certain we never provide a valid excuse for booting us—like I just did.

Which is why I was so terrified. Given that I’d missed a grace period, I understood all too well that no one was legally compelled to restore my coverage. From a business perspective it made perfect sense to deny my appeal. The fact that the denial was overturned underscored an exceedingly important point: this was not a legal victory–it was moral.

I also learned the importance of having multiple plans of approach. Not just A, B, C, but rather A, B, C, D, E and F.

When I first realized I’d missed a payment I called WageWorks and, after confirming that my coverage had been suspended, overnighted an appeal. It took multiple phone calls, a second faxed appeal and a full week before I learned that my appeal had been denied. Scratch plan A.

Plan B was to send an email to my oncologist as well as the director of the cancer center–as Dr. Shaw is my personal goddess (yes, I do understand that I have to share her) and the cancer center is my home away from home.

I also initiated plan C, posting a clarion call beseeching everyone I know to contact WageWorks on my behalf.

Plan D was reaching out to LUNGevity; an organization I’ve worked closely with.

And then plan E, F and G happened organically as a result of my multiple requests for assistance, as various people reached out to the trial sponsor, LUNGevity hooked me up with Patient Advocacy Foundation and some pals on twitter introduced me to Medicaid Matt.

Well my friends–it really does take a village. And it was you, the villagers, who made this happen. Plan C, as it were.

Astounding. Heartwarming. Empowering.

The big surprise was who offered little help: Massachusetts General Hospital. My oncologist was prepared to provide documentation per my side effects but aside from also offering to have her reach out to the insurer, MGH came back with this response ‘ We don’t have any other solutions at this time, but let us know how things pan out.’

Not a no but also not the ‘don’t worry, we’ll work this out’ that one would hope for from the folks (second family?) ensconced in my home away from home.

Or, if you discard the warm and fuzzy stuff, the institution that I have faithfully patronized for thirteen years and counting–making me one of their best customers. The cancer center where I served on the Patient Family Advisory Council for four years. I’m on the Wall of Hope, in a permanent display in the museum, have been honored at The One Hundred and, along with Dr. John Iafrate, was a calendar girl. And, of course, I’ve been a source of much positive publicity. Just the sort of patient, who, from both a moral and business perspective, you might want to provide support to.

The take away? Don’t give up, don’t ever give up. Have not one plan but many and don’t be afraid to use them all. If I’d stopped at B, I’d be screwed now. And finally, it’s not necessarily who you know, it’s how many you know. Because we/us/you are a force to be reckoned with.

xo

FAITH IN HUMANITY & COVERAGE RESTORED

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In a word

Yesterday I received a phone call from the appeals manager at WageWorks. They had been inundated with letters/faxes/emails on my behalf. And, she said, it was slowing down my case. Because each time a new communication arrived, it had to be open, read, and filed. I couldn’t help myself and simply burst out laughing. “Yeah, I have a lot of friends.” To my great relief, the manager chuckled as well.

But then I asked her what she meant when she said ‘slowing down my case.’ I had been led to believe that I was now done with WageWorks, and that my second appeal, which I was hard at work on, would be going to UFP Technologies. The manager than explained that it was a two tier process, that my case was not decided by one entity alone. And then she said she would call me as soon as my second appeal had been reviewed.

We were in the weeds here, in a way I hadn’t anticipated. However, for the first time, the banter was friendly. And that made me hopeful.

In the meantime, I had reached out to UFP Technologies simply to confirm the mailing address. The woman I spoke to was also the person who would be making a call on my appeal. She reminded me that I had been late on a payment one other time, back when I’d first gone on Cobra. But she was also incredibly kind and seemingly understanding. She urged me to get the materials for my second appeal in as quickly as possible, so that we could bring this to resolution.

My second appeal was ready to go, barring a letter from Dr. Shaw per my cognitive challenges–she was going to send it to me last evening. I had been working with Gayle Petrick, a case manager from Patient Advocate Foundation, as well as Matthew Cortland, an attorney who believes that healthcare is a human right and who can be found on twitter under the handle MedicaidMatt. Gayle and Matt were (without charge) helping me to prepare my second appeal and Matt was also advising me as to options when and if it was denied.

The folks from LUNGevity and Bonnie Addario were working on my behalf behind the scenes. Chris Draft kept checking in, a representative from the American Lung Association called to see if they could be of assistance, and I was also contacted by the sponsor of the trial, Pfizer. At least one media outlet was interested in doing a story. Countless numbers of you reached out to me both for support and counsel. As I said at one point, I was turning over every stone possible. And if that didn’t work, then I’d just pick those stones up and start throwing them.

Fortunately, that wasn’t necessary. And I have to believe it was because of all of you and your constant stream of messages.

Half an hour after my first phone call from WageWorks (these people don’t call you—that in itself was a wonder), I received a second call. They had spoken to the plan administrator at UFP and my termination had been overturned. Furthermore, if I had any issues in the future, the manager urged me to call her.

I then received email confirmation from the woman at UFP–reinstatement for nonpayment is not something they do but they were making an exception for my, well, exceptional circumstances. And, that if I was to run into any more trouble or difficulty, ‘call or email me so I can help you.’

From here to hell and back. Just like that. Two of the longest, most stressful weeks ever have come to a close. Victorious. A crowd-sourced, group effort with an overwhelmingly positive result. At the end of the day, my coverage has been restored, but so too, I hope, is your faith in humanity. Together we really can overcome.

Thank you.

 

A fresh concern and it’s a whopper

Sent by a straight female friend 🙂

A lot of you are friends with me on Facebook so you’ve already seen the splendid offer I received. However, too good not to share with a broader audience.

And….so very many of you have leapt into action and sent letters/faxes/emails to WageWorks on my behalf. Thank you thank you thank you.

All of your comments and suggestions have been welcome/helpful as well. One recent comment made me realize I might be in a bigger pickle than I thought if my coverage is not reinstated. Open enrollment for Affordable Care Act policies is in December. However, the end of Cobra is a qualifying event, meaning I could enroll at any time. Termination from Cobra for nonpayment is a non qualifying event, which might preclude me from getting any sort of coverage (I do not qualify for medicaid or medicare) until the end of the year. If I am misunderstanding this, please apprise me.

My rapidly developing ulcer just increased in size. As well as my determination that there is only one way this can end—so very much is at stake. So please, keep those appeals coming. I shall be sending a fresh one off later today (thanks for the tutorial in how to send a fax for free from home, Miss Kimberly).

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

Frosted

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Yesterday I had two slices of chocolate cake for lunch. And yet another for dinner. This is so not my usual behavior, but then again, desperate times call for desperate measures.

Sigh. Desperate is surely an exaggeration but then again, this is undoubtedly an interesting moment in history.

2017 started off with a bang when I tried to pay my health insurance premium for January. To great consternation, I found myself locked out of my own online account. Never, ever, a good sign.

It was a holiday weekend so I had to wait until January 3rd to speak with a representative at BeneDirect, the company that manages my health insurance through COBRA. The pleasant young woman on the other end of the line confirmed that due to non payment in December my policy had been terminated.

Isn’t that an awful word–terminated? Right up there with terminal. No good has ever come of either one of them. Were I Queen they’d both have their heads lopped off.

Speaking of heads, what’s inside mine is nowhere near as sharp as it once was. I’d never knowingly miss a COBRA payment, understanding only too well how much is at stake. I am undoubtedly any health insurance company’s worst nightmare–having been in treatment for lung cancer for almost twelve years now. And being denied health insurance is my worst nightmare.

Fuck, fuck and more fuck. My only option was to file an appeal. Well of course I got right on that and faxed if off that very afternoon. And just to make sure nothing fell through the cracks, I call BeneDirect when I returned home to see if they’d received the fax. Confusingly, this representative told me that no, I had not in fact been terminated. That due to the holiday weekend lots of people had been late with their payments. And if I overnighted payment for December and January, my policy would remain intact. One more trip to FedEx and a big sigh of relief.

Until two days later when I received an email from the human resources representative at my ex-husband’s place of employment (they administer my cobra) informing me that in fact, my policy was kaput.

Many phone calls, emails, a few tears and several days of additional anxiety later, I logged on to see that my policy had been reinstated.

Man oh man oh man. I only have one more year of COBRA before being thrown to the free market (or the wolves, depending on how this administration sorts things out) but I’d rather not have to deal with that shit yet. Of course that doesn’t mean I can relax either. Like everyone else dealing with a chronic condition, I am nervous as hell that preexisting conditions and lifetime caps will in fact be reinstated.

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And if that happens, we can always just eat cake.

xo