Problem with healthcare.gov marketplace

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Hi,

I am having some problem with healthcare.gov marketplace and your suggestions/ advices would be very appreciated.

​For the year 2016, I had the health insurance (for my wife, son) bought from healthcare.gov marketplace. I was covered by my employer. 

For the year 2017, I informed healthcare.gov that I would not be renewing. My wife and son are now covered by Aetna since January 1, 2017. However, yesterday I got two months of bill from the old insurance company for ($2048.46). When I called the insurance company, I was asked to call healthcare marketplace instead. Initially, the customercare at healthcare marketplace told me that she could not do anything about that and I had to pay. Then, on my request, she forwarded the call to her supervisor. The supervisor told me that someone renewed it on January 24. I told him that it was not me or my wife and also, I could produce proof of insurance coverage by AETNA. He then registered my complain and told me that a case worker will have a look at my complain and her decision would be final. 

I called healthcare.gov thrice in December to ensure that my plan was not renewed and I have the proof of these calls. So, this whole episode is depressing for me.

I am interested to know if you know of someone having similar experience. Could someone please suggest what else I can do or, where else I can complain in case of an adverse decision? 

Regards,
Dushyant

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I'm not sure how ACA healthcare is billed. Do you owe for coverage in December and it was billed in January? It seems like your proof of insurance from AETNA should clear up any question about continuing coverage.

This probably needs to be unbeloited to Finance to get help from the bigger brains.

I had this exp with auto-renewal. It looks like some of the crooked insurers (like my ins co) are auto-renewing from their side and mailing invoices for due premiums. I had subscribed to a new employer provided plan in Nov, and told them to terminate the plan....they did not....they even went one step further and auto-renewed in Jan for the 2017 year and sent me invoices in mail......so I showed them the middle finger....they had no choice but to terminate plan after 3 months of non-payment of invoices.....

OP - If you truly have no outstanding claims for the disputed period, then you can ignore the premiums. In other words, you paid your premiums till 12/31 and have no claims after 12/31 routing to this company then you are all clear and can ignore them. These are not your typical bills where they get reported to collections if you don't pay. These are premiums for insurance coverage for a specific time frame (like a calendar month) and if you don't pay they reject all claims for that period and they terminate coverage.

OP , what date did you call Healthcare.gov? After Jan? Then yes you owe at least 1 month.
Feb 1st? Ouch then you could owe 2 months.

And only Healthcare.gov can handle it, the way the ACA works is the insurance company is just a 'servicer' and takes no money upfront, so cannot administer policies.

forbin4040 said:   OP , what date did you call Healthcare.gov? After Jan? Then yes you owe at least 1 month.
Feb 1st? Ouch then you could owe 2 months.

And only Healthcare.gov can handle it, the way the ACA works is the insurance company is just a 'servicer' and takes no money upfront, so cannot administer policies.

I did call Healthcare.gov thrice in December: Once in the beginning, then in mid December and then in the end of December. I was assured that everything is cancelled and there would not be any renewal.

dealgain said:   I had this exp with auto-renewal. It looks like some of the crooked insurers (like my ins co) are auto-renewing from their side and mailing invoices for due premiums. I had subscribed to a new employer provided plan in Nov, and told them to terminate the plan....they did not....they even went one step further and auto-renewed in Jan for the 2017 year and sent me invoices in mail......so I showed them the middle finger....they had no choice but to terminate plan after 3 months of non-payment of invoices.....

OP - If you truly have no outstanding claims for the disputed period, then you can ignore the premiums. In other words, you paid your premiums till 12/31 and have no claims after 12/31 routing to this company then you are all clear and can ignore them. These are not your typical bills where they get reported to collections if you don't pay. These are premiums for insurance coverage for a specific time frame (like a calendar month) and if you don't pay they reject all claims for that period and they terminate coverage.

  
I do not have any outstanding claim. Also, I have proof of insurance from Aetna.

Hopefully, Healthcare.gov would rule in my favor. But, if it does not go this way and I do not pay, would it go to my credit history. If yes, can I dispute there?
 

dushyant said:   
forbin4040 said:   OP , what date did you call Healthcare.gov? After Jan? Then yes you owe at least 1 month.
Feb 1st? Ouch then you could owe 2 months.

And only Healthcare.gov can handle it, the way the ACA works is the insurance company is just a 'servicer' and takes no money upfront, so cannot administer policies.

I did call Healthcare.gov thrice in December: Once in the beginning, then in mid December and then in the end of December. I was assured that everything is cancelled and there would not be any renewal.

  Hmm, wonder why they denied you then.
Most of those calls are recorded for legal purposes.

dushyant said:   I did call Healthcare.gov thrice in December: Once in the beginning, then in mid December and then in the end of December. I was assured that everything is cancelled and there would not be any renewal.

...The supervisor told me that someone renewed it on January 24. I told him that it was not me or my wife....
 


Why did you call them 3 times about the same issue, each call being 2 weeks apart, if you would normally have every reason to believe that one phone call would be enough?

Did they tell you on the first and second calls that you'd have to call them again, for some reason?

If you called them so many times in December about the very same issue because you were so worried that it wouldn't be recorded properly, why didn't you write them an email or a letter, to document your cancellation in writing?

Who renewed your insurance on January 24th? Very few people would be able to do this, beside you and your spouse. Can they not tell you exactly who renewed it on your behalf?

If it was only renewed on January 24th, then your Marketplace insurance for 2017 would only come into effect on March 1st of this year, and you would not even have been covered for January and February. Therefore I do not understand why you already have received a bill for 2 prior months of coverage for the year 2017 (presumably the months of January and February).

It does not make sense.



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