Why New York State of Health is an Epic Fail

I cut New York State of Health lots of slack. The first year, I was unable to get signed up in time to have health insurance. I was told that it was just too bad and I would have to do without for a year. I figured it was my fault for not staying on the phone long enough.

I learned my lesson. When enrollment opened up in 2014, I signed up right away. I got health insurance that was somewhat expensive, but the coverage was pretty good. I had a reasonable co-pay and no deductible. I was happy.

In December, I suddenly got a phone call saying I haven’t renewed yet. I had not received any notice that I had to renew, but hey, whatever. The call came on December 13th. The man on the phone says, “You have to renew.”

I reply, “Well then, renew me.”

“I can’t do that. You have to call New York State of Health.”

I reply, “What is the point of your calling me if you can’t help me?”

So, the next day at work, I spend over an hour on hold with New York State of Health. I finally get through and get cut off. I called back and was told that I would have to start all over again.

I called my husband and told him what happened. He called the local Affinity Healthcare representative (Affinity Platinum is the plan I had in 2015) and she said she could help. She called me at work and I explained that all I wanted to do was continue with the same policy that I already had, Affinity Platinum.

She said, “Ok, I’ll take care of it.”

We got another call from Ms. Affinity (I won’t mention her real name) saying she needs pay stubs from me. I asked her why and she said “That’s the way it works.”

I don’t hear from her again until JANUARY when she called to tell me the options I have. None of them are the Affinity Platinum plan that I had. It turns out that instead of renewing my policy, she started a brand new application. So now I’m no longer covered by health insurance. She says that I will be covered as of February first.

Not great, but it’s only one month. I told her go ahead with that. This happened on about the eighth of January. We don’t get a bill, they don’t take the money from our checking account, so we call her back. I finally got to talk to her yesterday, January 27th. What did she tell me?

“You won’t be covered until March 1st. I told you that.”

I say, “No, you told me February 1st.”

She, of course, denies it. My husband is also on the phone (and had been on the phone when she told me February 1st.) He says, “Yes, that is exactly what you told us.”

So basically, she dropped the ball and I’m going to suffer for it because she won’t admit to having screwed up. The issue has not been resolved. I’ll post again when it is.

There is so much wrong here. But mainly, there are two changes that need to be made here:

  1. Make it possible to sign up for healthcare at any time in the year. Now that healthcare is required, you should be able to sign up for it year ’round. It would take a lot of the pressure off of them as well as us.
  2. Allow people to say, “Keep it going.” If I’m happy with my plan, and I don’t cancel it, the plan should continue as it is. If I don’t want it, I’ll surely let the know immediately.
  3. Oh, and at the risk of sounding like a Monty Python skit, why should I have to prove my income before signing up for healthcare if I’m not asking for assistance paying for it?

Come on, New York, fix this mess!

If you agree, here is contact information for our New York State senators and the representative for the city I live in:

Member NameDC PhoneDC FAXContact Form

Senator Charles E. (Chuck) Schumer (D- NY) 202-224-6542 202-228-3027 Email Chuck
Senator Kirsten Gillibrand (D- NY) 202-224-4451 202-228-0282 Contact Kirsten
Representative Sean Patrick Maloney (D – 18) 202-225-5441 202-225-3289 Contact Sean

 

UPDATE: When I got my mail this morning, there were two letters from Affinity Healthcare. First, I received a letter saying that my policy had been cancelled. The second letter was a bill for January and February. Really? So I called Affinity and was told that yes, if I pay the bill, I will covered from January 1st with no gaps. I paid the bill, and that part is all set.

However, I still have to manage to talk to NY State of Health and make them aware that I am actually covered so that they don’t report any gaps to the government next year. Shouldn’t that be automatic?

On one hand, I am grateful that the confusion and misunderstandings have been cleared up. On the other, it shouldn’t be this difficult to get and keep health coverage.

UPDATE 2: Apparently I spoke too soon. After putting me on hold for an hour, the NY State of Health representative said that it doesn’t matter that I’m covered. Because I didn’t do it through them, New York State considers me as without coverage until March 1st. So I said, “What do I have to do to prove to you that I’m covered?”

He wouldn’t give me an answer, but after going back and forth for about five minutes, he said he would transfer my call to someone in Account Review. After another half an hour, I’m still waiting…

After 2 hours and 5 minutes on the phone altogether, I finally go to talk to someone who was not reading off a script. He looked into my account and said that what seems to have happened is that I have two accounts, one with Affinity that hasn’t lapsed, and another Affinity plan through New York State of Health that doesn’t start until March 1st. He suggested that I confirm that I have a separate plan with Affinity and, if so, call back the New York State of Health and cancel the second plan.

Is the end in sight? We’ll see.

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