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Sapphire723

No Health Insurance?

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So, I got promoted and am now working in NY even though I live in CT. To make a long story short, I switched my health insurance for an HMO because it looked like it was going to be WAAAYYY more cost effective. Before I switched, I called to double check that all of my doctors and medical problems would be covered and listed them each and had them check.

 

Fast forward to the new year. Apparently the HMO only covers doctors in the five boroughs of NYC even though I don't even work in NYC, live in NYC (more than 2 hour drive away), and I specifically called to make sure that EACH ONE of my CT doctors would be covered. Not only that, they don't cover prescriptions or tests from my CT doctors (which I've racked up almost $1k already this year). The second I found out this I started frantically calling to see if anything could be done. The only thing that can be done is for me to submit a written appeal and wait at least a month for them to respond saying I can switch my insurance.

 

Meanwhile, I thankfully got my gyno to give me free samples of birth control so I don't have to pay full price, and I pushed back all of my checkups and appointments. But now something is out in my back and it's causing me great pain to move at all, but I don't want to go to the Dr or Chiro, because I don't want to accumulate any more expenses while waiting for a response!

 

Major sucky situation. I kinda want to just do a legal wedding now so I can update my (and FI's) insurance coverage due to a life change cause.

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I'm so sorry you have to go through this! As a person that works for an HMO insurance, I know how difficult it can/will likely be. Good luck with your appeal! Also, I'm not sure how 'traditional' you are, but FI and I did our legal recently for the exact same reason. His firm gives HORRIBLE insurance. Now he has full coverage on mine (not HMOwink.gif. No one knows, we have kept it to ourselves. If that's an option, I would say go for it. Having quality insurance is really a great peace of mind.

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I’m sorry you have to deal with this. My health insurance is horrible too, but thank god I don’t have anything serious to worry about. If getting legally married now will help the situation, then I saw why not? My FI and I are getting legally married before we go to Aruba and we both agreed that it is not our wedding and we aren’t married till the ceremony in Aruba.

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I think your health is something worth spending on. A small problem can become a huge problem in a short period of time. 1 month doesn't sound terribly long but maybe shop around for a "cheaper" chiro.

 

Can't really relate, with the free health care and all..

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I would definitely get legally married...I mean you have to do it anyway. Did they say when open enrollment was so you can switch your plan again? Every year you will have one.

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Quote:
Originally Posted by Jess View Post
I would definitely get legally married...I mean you have to do it anyway. Did they say when open enrollment was so you can switch your plan again? Every year you will have one.
Ours is in November and it takes effect in January.

Thanks ladies for your support! My back is feeling a lot better today and I have all next week off, so I can bum around and rest if I need to. It just really makes me really aggravated that I'm paying into this plan (and my employer is paying into this plan) that is now useless!

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You poor thing. That is a bad situation that you are in, no matter how you look at it. sad.gif I say that you do whatever is necessary to take care of yourself. You are a priority right now--Remember that!

 

I am actually a health insurance agent, and I was just having this exact conversation with some of my coworkers today (whether or not you should get married earlier to take your spouse's benefits). It's a very real possibility.

 

One thing that I wonder about your enrollment in the HMO is that you say you live in CT, and the plan only covers doctors in NYC. Normally HMOs only allow people to enroll in the plan if they reside within the service area. Have you tried arguing the fact that you shouldn't have been able to enroll in the plan in the first place since you live in CT and there aren't any providers there? (Or is CT still within their service area--as messed up as that would be?)

 

Good luck!

Ashley

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Quote:
Originally Posted by ashscho View Post
One thing that I wonder about your enrollment in the HMO is that you say you live in CT, and the plan only covers doctors in NYC. Normally HMOs only allow people to enroll in the plan if they reside within the service area. Have you tried arguing the fact that you shouldn't have been able to enroll in the plan in the first place since you live in CT and there aren't any providers there? (Or is CT still within their service area--as messed up as that would be?)
I think they consider me as being eligible because I work in NY (even though it's not NYC), but I argued that in my appeal... the response for which I received in the mail yesterday.

They denied me. I got almost 15 minutes of sleep in this morning before I had to schlep off to work. While I was getting ready, I spontaneously burst into tears about three times. Talk about being unhealthy... I think FI almost had me comitted.

The good news is that I think I'm getting married! Yay love!

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