Health Care Website Still has a Lot of Fixes to Make

Steve Michaelson wants us to get down to business.

The Las Vegan emailed us about the spate of stories we’ve written on locals who’ve been unable to get medical coverage or care despite paying months’ worth of premiums to Nevada Health Link.

“Since the only people who ever see any results getting untangled from their insurance companies’ declarations that they have no coverage are the people who are featured in one of your stories, I suggest you call five insurance companies every day from the list of people who contact you regarding coverage and payment issues. Then print the names of those five companies — EVERY DAY — along with the people who reported their problems. Set the list of names and insurance companies in a box with a big border around it so it stands out.”

Steve, profiling consumer woes definitely gets results, sometimes in a matter of hours — even for people who’ve languished for months on end without a fix. But we’ve been inundated with requests for help. We can’t run the names of everyone who has a problem.

Still, we’re going to take your suggestion, with some tweaks. We don’t think we need a box with a big border around it, for one thing. We’re also calling out the state exchange and website contractor Xerox, since they’re responsible for getting member details to insurers in the first place.

Forthwith, below is a very incomplete list of locals who have paid for a plan through Nevada Health Link and say they have little but frustration to show for it.

Consider this roster a guide for the state exchange and its contractor, Xerox, whose officials we know want to get this stuff sorted out. We’ve included enough identifying details that the cases should be easy to track down and patch.

In the interest of transparency, we’ll circle back to these folks in the next few days to be sure their coverage is finally in place. If it’s not, expect to hear more about them soon in these pages.

And if anyone else out there thinks a little sunshine would move along their case, give us a shout.

Here we go:

■ Ellen Schwarz of Las Vegas bought a Health Plan of Nevada policy that was supposed to take effect June 1. Her monthly premium was set at $110.49. Ellen sent in a $178.42 payment in May, and followed that with payments of $110.49 on June 3 and July 28. But the health link’s software figured Ellen’s federal tax credit wrong, and she overpaid on some premiums to avoid cancellation after the system “lost” two of her payments. Today, she says she’s due a $100 credit. Yet, Health Plan of Nevada canceled Ellen’s plan in August for nonpayment after none of her money made it from exchange to insurer. Despite four months of payments, she was covered for all of a month and three days in midsummer. Now, Ellen says she can’t see her doctor for recurring melanoma checkups and treatment. She needs help, stat.

■ Larry and Yvonne Usher of Las Vegas signed up and paid for a plan for Yvonne in December (Larry is on Medicare). Nevada Health Link deducted the first payment of $311.77 from the couple’s debit account in December. Then the exchange took a second, unauthorized payment in the same month. The Ushers have sent in checks every month since, and the exchange has cashed them all.

Despite never missing a premium and being double-billed in December, the exchange tells the couple they owe $1,200. There’s already been one cancellation notice from Health Plan of Nevada, and Yvonne’s prescriptions to control her asthma and high blood pressure are not being covered because of “lack of payment,” Larry said.

The cost out of pocket: $100 to $150 every three months.

To add insult to injury, the exchange inexplicably changed the Ushers’ mailing address in August, so their September bill went to the wrong household.

■ Paul Hardwick. Paul and his daughter, Amaunie, bought a Health Plan of Nevada policy in February that took effect in April. They paid monthly premiums of $292 in March and April. But before long, the exchange was billing the Hardwicks for coverage in January, February and March — coverage they never had. The Hardwicks couldn’t afford the nearly $1,000 in additional premiums, and some of the money they paid never made it to the insurer. Their coverage was canceled.

Paul called the exchange in May about the billing mix-up, and a supervisor told him he’d call back with an answer in 72 hours. Paul’s still waiting for that call.

Today, the exchange continues to bill the Hardwicks. Their latest invoice was more than $2,000.

It’s too much of an expense for Paul, a retiree on a fixed income. Meanwhile, he can’t get surgery for a pinched nerve in his hand. His doctor won’t see him to schedule the operation unless he can pay for the $107 visit out of pocket. He’s paying cash for his blood pressure medications, but he’s had to forgo his pain pills and stomach medications, which total nearly $500 a month out of pocket without coverage.

Worse still, the Hardwicks’ insurance isn’t even paying $1,500 in medical costs Paul incurred visiting doctors and getting treatments in April, when he actually had a plan.

“My quality of life is just miserable right now,” he said.

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