Families forgo care because of Healthplanfinder issue




Posted on May 14, 2014 at 7:39 PM

Updated Wednesday, May 14 at 11:27 PM

The Washington Healthplanfinder is trying to fix a big invoice problem affecting about 8 thousand of its customers. In the meantime, families say they are forgoing doctors visits, even urgent care, because of the problem.

For Niki and Jim Fleetwood, health problems are a part of life. In 2003, Jim survived a horrible car crash that left him with extensive burns and breathing issues.

"Unfortunately as a result of my burns, I damaged my lungs," said Jim. "I require an inhaler."

He's been paying for that $180 inhaler out of pocket because of account issues with the Washington Healthplanfinder.

"Here we are in May, paying premiums, and I have nothing to show for it," said his wife Niki. "I can't go to the doctor. He can't go to the doctor. So we are paying for coverage we don't have."

The Fleetwoods signed up in November with Premera, and then switched to Lifewise in March. Even though their premiums are debited every month, Lifewise still no record of them.

They are among the hundreds of complaints that have come into the Office of the Insurance Commissioner regarding problems with payments and enrollment on the Healthplanfinder website.

Last week, CEO Richard Onizuka revealed they were trying to fix an invoice problem affecting about 5% of the applicants for Qualified Health Plans, about 8000 people.

"These issues may also result in customer notices from Washington Healthplanfinder requesting payment or insurance companies being unaware of completed payments," said Onizuka.

A Healthplanfinder spokesperson says the Fleetwood's case has to do with the way files are processed between the Washington Health Benefit Exchange and the insurance carrier. They have already implemented more than 130 data and manual fixes to fix the process, and they are reaching out to Lifewise to help the Fleetwoods.

"It scares me," said Niki Fleetwood.

It's not just her husband she worries about. She smashed her finger two weeks ago but fears the cost of going to the ER or urgent care without an insurance card.

"So I chose to tape them together and do the best I can and save money," she said.

After writing to the OIC and state legislators, the couple says they're finally seeing some progress with their case, but it is little consolation.

"It doesn't repay the anger, the frustration, the sleepless nights, the tears. I don't' get any of that back," she said.