Health Care Act

3 stories: Problems start small but prove tough to solve

The Affordable Care Act helped B.J. Welborn of Charlotte pay for expensive medication that keeps her leukemia in remission, but an error in her 2015 renewal cut her off.
The Affordable Care Act helped B.J. Welborn of Charlotte pay for expensive medication that keeps her leukemia in remission, but an error in her 2015 renewal cut her off. dlaird@charlotteobserver.com

A variation on a name. A delay in activation. Miscommunication between a bank and an insurance company.

These are the kind of things Charlotte-area residents say triggered problems with Affordable Care Act coverage that left them in limbo for months. Here are their stories.

Name flags citizenship challenge

After Hardie Steitz of Charlotte was laid off from a communications job early last year, he got a subsidized insurance policy.

Last summer he got a letter from the federal government saying he would lose that aid unless he could document his citizenship. The problem, he says, was that his application was filed under W. Hardie Steitz, while his birth certificate and Social Security number are under William Hardie Steitz.

He thought he could call the exchange and explain. He was wrong. “The marketplace is a call center. That’s all it is,” he said.

The federal government stopped his subsidy. Coventry Health Care of the Carolinas, the company that issued the policy, started telling him he owed more money. His policy was canceled in October, “while I was trying to rectify it.”

The state insurance department told him how to file an appeal with the government. After a telephone hearing in early March, he’s waiting for resolution. With less than a month before income taxes are due, he’s not sure whether he’ll be penalized for going without coverage for part of the year.

Meanwhile, he signed up for a similar Coventry policy on the exchange for 2015 and is hoping for the best. “The only thing I’m thankful for is I didn’t have any medical bills,” he said.

She kept trying to pay

Deborah Frye, 62, doesn’t get health insurance from her job as a veterinary assistant. Last year, she signed up for a subsidized Coventry policy, got her insurance card and set up a bank draft to pay the premium.

But in February 2014 she started getting notices that she hadn’t paid.

For months, she went in circles: The bank said the payment was working. Coventry said it wasn’t. The state and her health care providers tried to help, but in June her policy was canceled for nonpayment.

This year Frye went to a Blue Cross agent. The nurse practitioner who provides Frye’s medical care is in the Blue Cross network. But Frye chose a new plan that includes only Carolinas HealthCare providers – and her nurse practitioner doesn’t work for that system.

State insurance officials say helping customers understand the complexity of insurance networks is the biggest challenge this year.

“I just wish I had known more going in,” Frye said. “I just have to try again and do better next year.”

Delay creates confusion

Early last year Sandy Banks quit her job in South Bend, Ind., to care for family members in Charlotte. In February her husband, John, filled out an application for her on HealthCare.gov.

She was approved, he said, but the new policy couldn’t start until her workplace coverage ended. Her company extended it through March 31, so the couple tried to activate her Coventry policy in April.

They spent five months working the phones. The exchange said the application for subsidized coverage had been approved while Coventry said it hadn’t received that information. Later, John Banks says, Coventry said the application was under review.

In August, after contacting the Department of Insurance and a health insurance navigator, Sandy Banks got her policy, backdated to June 1.

Now there’s a new challenge. John Banks says even though their income estimate was within $200 of what they actually made in 2014, the IRS says they got too much in subsidies and owe more than $1,000. “We’re trying to find out who made the mistake,” he said.

To their relief, Sandy turned 65 in December and switched to Medicare.

Related stories from Charlotte Observer

  Comments