ejpritz Posted October 18, 2004 Share Posted October 18, 2004 I posted about this about 6 weeks ago, and we still are having the worst time.. My mother has been living with cancer since last October, she made it the year that her oncologist told her was not going to happen!! I am going to call that woman and let her know that my mother had surgery and just had a CAT scan that shows she is all clear. Imagine if we listened to that Dr. But on a negative note, she has no health insurance. She wokred for a large corporation for 23 years, and with her illness went out on short and then long term disability. About 6 weeks ago we found out that her Company cancelled her, retroactive to January 2004. Mind you the surgery was in April 04, so this is bad. I have an attorney helping, but he is my boss and to be honest is not spendning enough time on this like usually happens when you have a friend do work for you as a favor. Anyway, these are the facts. they told us she should have been paying cobra. a coba notice was never sent out. After several requests for the copy of the cobra notice, they finally admitted to the Attorney one was never sent. The fisrt correspondence was a HIPPA Cert. I called upon recieving this and this is when we found out it was cancelled. Well her file has been in appeal for 6 weeks now, and I call once a week and every time and told they will have na answer in 5 days. this has been going on for a month and a half. Has anyone ever had a similiar situation?/ And can I name the corporation so maybe you guys can boycott them?? Quote Link to comment Share on other sites More sharing options...
Wendy Posted October 18, 2004 Share Posted October 18, 2004 I am sorry that your mom has had such a bad time. I wish I could be of more help but I really don't know the ins and outs on Cobra The company I work for is really small and we did have a situation where someone went on medical disability and the company paid for the employees health coverage until she was terminated with the company (1 1/2 years after going out on disability). Unfortunately I don't know if the company was required to pay the premiums while the employee was disabled or if they did it out of the goodness of their heart. I am sure that someone on the board will have good information for you. I am glad your mom is doing good and good luck with the insurance. Wendy Quote Link to comment Share on other sites More sharing options...
ejpritz Posted October 18, 2004 Author Share Posted October 18, 2004 See as far as we knew, her company was paying her premium. We knew nothing about her paying Cobra. She is still with the company and stil considered an employee, so we jsut do not know what is going on Quote Link to comment Share on other sites More sharing options...
Ry Posted October 18, 2004 Share Posted October 18, 2004 Well I am not an attorney but I do believe there are fines involved for violations of COBRA. So if they did not send your mother a notice to pick up the insurance, it is going to be bad for them. I can't believe they made the cancellation retroactive either. It would seem to me that she has the makings of a good lawsuit there. Have you researched the COBRA Act for the requirements of the employer? Sorry I am not much help. Quote Link to comment Share on other sites More sharing options...
kimblanchard Posted October 18, 2004 Share Posted October 18, 2004 American Cancer Society Navigator 1-800-227-2345 or try 1-800-688-0147. I called them over disability issues, they have all kinds of resources to help people with cancer, including insurance and discrimination problems. They said they "couldn't give me legal advice" but they sure did tell me what the law was and exactly what we could do if we wished to pursue it. You might also contact the Insurance Commissioner for your state. I am not sure what that title would be - or even the Attonry General's office. Raise a fuss. They must send you an initial notice of rights and information about signing up. They do not have to send you monthly notices, though ours does. We had complications, I raised a fuss, it worked. Good luck and keep us posted, we want to know what you find out and if it worked. It may help someone else. Margaret Quote Link to comment Share on other sites More sharing options...
Lyn Posted October 18, 2004 Share Posted October 18, 2004 When you leave employment or go on an unpaid leave of absence, your employer has to offer you health coverage under the COBRA law for 18 months. They have to notify you in writing of this. You are able to continue your health coverage and pay for it at the company rate. You will have to pay the premiums for all of the months she was not covered, but it sure will beat the hospital/surgery costs! They can make your coverage retroactive back to when she was uncovered and the insurance should pay for her medical bills. Lyn (Human Resources Employee) Quote Link to comment Share on other sites More sharing options...
ejpritz Posted October 19, 2004 Author Share Posted October 19, 2004 thank you guys. I ahve researched the COBRA Laws and they definatly violated them. They are just being so difficult. Even though the Attorney sent them a letter or representation and my mother isgned a Power of Attorney for him to dealw itht hsi issue, their policy is "Not to speak to an attorney or any third party." Problem is, the last thing my mother needs to do is sit on the phone with 800 numbers all day. In have consulted several attorneys and many feel we have a good lawsuit here. I am just trying to figure out who to use and what action to take. My mother had a pancoast tumor, so when they removed it they had to cut some nerves. Now her left eye droops and her left hand and arm suffered damage so that she does not have all of the use. She was supposed to star physical therapy two months ago, and had to cancel it and has not been able to go. nOw form what I read and form what her Dr. told us, the longer she goes without the physical therapy the worse her arm and hand will become. He called it "Claw Hand", and said without therapy there is a chance she will end up with that permanantly. So this is just one fo the reasons it is so important for her to get insurance. Not to mention the obvious. We did ask if it was an option for her to pay back all the payments she was supposed to be making, that is what the appeal is. Its been 6 weeks and no answer. I am getting so frustradted. I hate this Compnay. Everything was fine until two months ago when her Company got taken over by this enormous corporation. once the merger went through, everything got all confused. Quote Link to comment Share on other sites More sharing options...
Ry Posted October 19, 2004 Share Posted October 19, 2004 What about calling her congressman to intervine? May be worth a shot. Quote Link to comment Share on other sites More sharing options...
ejpritz Posted October 19, 2004 Author Share Posted October 19, 2004 You know, I never even thought of calling a congressman. Has anyone ever taken this road and received help from their congressman? Quote Link to comment Share on other sites More sharing options...
kimblanchard Posted October 19, 2004 Share Posted October 19, 2004 PS on Cobra. If Social Security rules her disabled, the Cobra can be extended to 29 month. With Social Security, Medicare kicks in in 24 months so between Cobra and Medicare, she would be covered from now on. Also, on the Cobra, I think they have 60 days from termination to send you the notice and it is retroactive to the date of termination, once you pay. For us, they terminated him almost without notice, caused billing problems but indeed the coverage was retroactive and I just had everyone resubmit the bills. Medical providers are very familiar with Cobra problems. If it goes past 60 days, they are fined something like $100 per day. It could be 60 days from the date they actually sent you the termination letter. I haven't used a congressman but I have heard of others who did and in every case they got quick results. Just make sure you tell him it is urgent. Margaret Quote Link to comment Share on other sites More sharing options...
ejpritz Posted October 21, 2004 Author Share Posted October 21, 2004 Thaks guys. Well this Company apparantly has no idea what they are doing. We were told that her insurance as been reinstated through april 17, 2004. We recieved a HIPPA Cert saying that date as well as a letter. That is positive, since her surgery was in Macrh, and all of her chemo and radiation was prior to that. Quote Link to comment Share on other sites More sharing options...
ejpritz Posted October 21, 2004 Author Share Posted October 21, 2004 I got cut off in the middle of that last one by my boss. Anyway, things are looking up, if worst case scenario is paying the bills since April, we will be OK. It is a lot of $ but nothing compared to what I thought we were in for. So the plan is to sue them for her insurance back, and if we lose then we can get her put on the insurance my father is on through his pension, though its a little pricey. But in any event, today is great. GO SOX!!! Any fans out there?? Quote Link to comment Share on other sites More sharing options...
Eileen Posted October 22, 2004 Share Posted October 22, 2004 I am very glad things are looking up insurance wise ---money worries are the last thing needed at this time but---I am very sorry the curse of the bambino seems to be suspended---just wait till next year!!! regards Quote Link to comment Share on other sites More sharing options...
lindseysmom Posted October 22, 2004 Share Posted October 22, 2004 You may want to check out www.patientadvocate.org I'm not sure if they can help but it is worth a try. Best wishes, Dee Quote Link to comment Share on other sites More sharing options...
ejpritz Posted October 22, 2004 Author Share Posted October 22, 2004 Thanks guys. I am looking into all of these places. (And I am starting to think Boston deserves the curse after the way these idiots celebrate. A 21 year old girl gets killed after Game 7 vs the Yankess in the riots and a 21 year old got killed during the riots after the Superbowl.) Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.