Thread by @KevinSenzaki

On September 1st, @BlueShieldCA cancelled my family’s health insurance without notice.

My wife is 8 months pregnant and was denied service at the doctor’s office last week due to lack of coverage.

All my efforts to get our coverage back so far have failed.

On September 14th, we received a pharmacy call saying my wife’s prenatal supplements could not be refilled due to a change in our insurance. I called Blue Shield (henceforth BSC) and was asked by the representative, “are you aware your coverage has been cancelled?”

I said no.

Our coverage was a COBRA plan, so I was told the issue had to be sorted out with my former employer and their HR company. My problem was news to them as well.

After discussion w/ my former employer (and many very stern emails to the HR firm), HR resubmitted my COBRA paperwork.

I was told it was in processing, which could take up to 21 work days, at which point BSC would reach out to me. On October 15th, I called BSC (as I had done several times by now) and the rep confirmed the paperwork was in their system (I had not been contacted about this).

But my former employer needed to verbally OK the documents. After the rep tried two people, she concluded that my former boss had to sign off.

So I texted him, had him call BSC, and on a group call, we reached BSC’s COBRA department.

“We can’t continue your plan,” the rep said.

It turned out that my former employer terminated all relationship BSC on September 1st, which voided my COBRA. Nobody I’d spoken to at BSC had informed me of this basic piece of information.

I was told to do a new application from scratch. The call ended.

I filled out an application online, but was unable to find a special enrollment option.

(I had received a letter from BSC later on in September stating that I qualified for special enrollment. The letter was dated September 1st, the date of my cancellation. Not advance notice.)

After speaking to 2 reps on the phone, who also couldn’t find a special enrollment option, I was told to simply submit my application for a January 1st, 2019 start, and email my letter to Eligibility Verification, which I did on October 17th - and have still not received a reply.

Meanwhile, doctors were calling me asking what was going on with our insurance. I explained that it was a temporary issue that should be resolved very soon. We bought my wife’s prenatal prescriptions at uninsured rates.

On October 30th, my wife texted me while I was at work - she’d been turned away by one of her prenatal doctors at their office for lacking coverage. We wouldn’t be able to reschedule until we were insured.

This was completely out of control.

I stepped out of work and called BSC, and was helped by Nigel (who did his best) in contacting the relevant departments to get my situation fixed immediately. During the nearly two hour call, Nigel filed a grievance on my behalf, and got my application in front of a live person.

My start date was changed to November 1st, the earliest they could do - I would have to email Eligibility Verification again, and hope they would approve retroactive coverage from September 1st. I did so, and have not heard back from them.

Nigel stated that my case was now in enrollment’s hands, but that I should be charged my November fee within 24-48 hours, and have active coverage by November 1st. He gave me my new ID number, which would be live as soon as the money was transferred.

Come Friday, November 2nd, nothing had happened. I called BSC again, and May looked into it. She said my billing account didn’t exist, so they couldn’t take my money. She would send the request up the chain, and call me back by Monday, November 5th at the latest.

My phone didn’t ring today.

At no fault of our own, my family is potentially looking at delivering a baby uninsured. Our other options aren’t great: I can try to apply for Medical for my wife only, which may force us to completely change doctors and hospitals at the 11th hour.

The other option is to leave the country. It’d be a logistical nightmare, and I would need to choose between losing my work next year or being with my family (I would absolutely choose family). My US-based grandparents would miss out on their second grandchild being born.

The way American health insurance works - is allowed to work - is a complete joke and a disgrace. All the worse knowing that my family’s experience is just a drop in the bucket.

I’m stressed and angry. What am I supposed to do when my wife says, “they won’t let me see our baby?”

I’ll pick up the phone again tomorrow, as I’ve done too many times these last two months.

And hope for the best. Hope I’m not crying out for help into an unsympathetic and incompetent abyss.

@BlueShieldCA

Adding @TeamShieldBSC

Update: May just called and said that my issue “has already been fixed,” but that it won’t show up in their system for another day or two. So it’s another wait. Still hoping.

I don’t know if raising a Twitter Grievance had any correlation, but thank you everyone! Updates soon

Just received another call - a rep is specifically assisting us in getting everything, including back coverage, sorted out as soon as possible. She specifically stated I was contacted because of Twitter.