(WSVN) — When Obamacare was enacted, she was able to get health insurance at a price she could afford. But an automatic deduction from her checking account left her broke and no way to get her money back under the Obamacare plan. She was out of luck ’till she called Help Me Howard with Patrick Fraser.
They are words that will make the strongest person weaken; you have cancer.
Josephine Diaz: “I didn’t know what was in front of me with the cancer, if I was gonna have chemo, I had no clue.”
The good news: so far Josephine Diaz has beaten breast cancer. The bad news: she had to quit work and live on social security.
Josephine Diaz: “And it just won’t stretch that far. $1,298 is my monthly social security check.”
After battling cancer, Josephine couldn’t find health insurance even if she could afford it. Then Obamacare was passed.
Josephine Diaz: “Oh I jumped at it. We picked our option. I was happy with my coverage.”
Josephine is now paying $197 a month for health insurance and it’s withdrawn directly from her checking account. Then she went to a store to buy some food.
Josephine Diaz: “And I swiped my card thinking there was money and it shows declined. Wow.”
When she got home, she went online and discovered her insurance company under the Obamacare plan had deducted $697 instead of the $197 dollars from her account. She called them to get the $500 back.
Josephine Diaz: “‘Oh no, that is the regular monthly rate for your coverage under Obamacare.'”
The insurance company said Josephine’s rate had gone up because they never got her tax information that qualified her for the lower rate.
Josephine Diaz: “I did send my tax information but I did not send it certified. I didn’t feel I had to.”
Josephine sent the information again to prove she was eligible for the $197 rate and again asked for the $500 overpayment to be returned to her.
Josephine Diaz: “She said we don’t return money. No refund.”
The insurance company said an appeal could take three to six months. Josephine’s reply; without that $500, she had no money to live the rest of the month.
Josephine Diaz: “That is half my check, I need to pay for everything else. I had to ask my son to bail me out.”
Well Howard, when you are dealing with a government agency working with a private insurance company in Obamacare, can you quickly solve a problem?
Howard Finkelstein: “It doesn’t work that way yet. Obamacare is a new program and there are remedies to fix problems like Josephine has but they can take months. She doesn’t have months to get her $500, she needs that to survive this month. One day Obamacare may have that quick fix, but it’s not been implemented yet.”
We contacted the government agency called Marketplace which handles Obamacare. They couldn’t talk to us because of federal privacy laws but they told us they would look into it. We then contacted Humana, who insurance’s Josephine under Obamacare. Humana then resolved it.
A spokesperson told us although the marketplace would not go back to allow the credit, Humana agreed to an exception after taking the entire circumstance into account. Humana then sent Josephine her $500 refund.
Howard Finkelstein: “To avoid this with any government agency or business, send your paperwork certified mail. A few days later, call to confirm they got it and it’s everything they need.”
Josephine Diaz: “Thank you. Thank you.”
Josephine got her money and won’t have to worry about money being automatically taken from her account again. She will now make the payments.
Josephine Diaz: “I stopped the autopay because there went my confidence level. That is not going to happen again on my watch.”
Patrick Fraser: “As a rule of thumb, I never use autopay. I want to control when I pay. And by the way, trying to resolve Josephine’s problem was unusually frustrating for us. In part because we are dealing with a government agency working with a private insurance company and because it’s a medical issue. Under HIPAA, they really can’t talk about the details of a specific case.”
Having said that, if you have a similar problem, there is a website that oversees Obamacare and can answer your questions.
Getting no care in treating your problem? Wanna insure you get good help? Contact us. We will give you a healthy dose of support and try to automatically deduct the problem from your life.
With this Help Me Howard, I’m Patrick Fraser, 7News.
CONTACT HELP ME HOWARD:
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Reporter: Patrick Fraser at pfraser@wsvn.com
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Questions or Problems under ObamaCare.
https://questions.cms.gov/faq.php?id=5005&rtopic=1993