By skyforbes Background: I am a licensed practical nurse, 26 y/o male from NY & I was recently laid off for the first time (I take full blame, it was a very stupid mistake on my part that I should have prevented but I’m taking it as a lesson & moving on, I needed to take some much needed time off honestly anyway to focus on improving my mental health, I suffer from BPD – borderline personality disorder & it makes my life way, way, way more difficult and messed up than it should be). Anyway, after being laid off my first concern was getting on Medicaid asap because I take several medications & obviously with BPD & my several other mental health issues it isn’t exactly an option for me to go entirely without insurance. The medications are only the half of it, I also am doing an outpatient mental health program that provides me with therapy I cannot afford to miss out on.
Situation: After being approved for medicaid, and being assigned Healthfirst as my managed care organization, I have been able to get everything I need medical-wise & they even have provided transportation which is crucial for me at the moment as I do not have a car at this time. I called them the other day because I needed to check whether I had been approved to have medicaid backdated by 3 months before I signed up (as I had a ton of claims then but my primary wouldn’t cover it but waited to tell me til months later when it amounted to $7k… like what the hell??) & I indeed had been, but the rep i was speaking with notified me of an issue that I was entirely unaware of — I had received zero mail regarding this, zero emails to my knowledge, absolutely no texts or phone calls — essentially I had no idea that Healthfirst’s benefits were going to cancel in 15 days if I didn’t provide proof that my prior insurance policy’s coverage has ended.
I assumed this wouldn’t be an issue and that I would be able to just call my previous insurance provider (1199SEiU) & ask them for a letter of determination stating that my insurance policy was now terminated, as well as the date at which my policy’s benefits stopped providing coverage on. I speak to a rep from 1199, only to find out that my previous employer has not cancelled my insurance policy nor put in my last date of work & as a result my prior insurance policy from the job I was no longer working is somehow still active. The benefits tier did drop from wage class one to wage class two due to number of hours worked, so the benefits were reduced, but the policy itself is still active. So I find out I have to contact my previous employer’s HR dept (which btw is one woman who forgets everything & took 3 months to get me a freaking name badge AS A NURSE!!) and have her write a letter that states my last date of employment & that my employer would like to terminate/end the benefits from the policy.
After all that I still need to send that letter ending my coverage from my last job’s HR via email to 1199, I have to allow 7-10 days for them to process the letter and apply the termination of benefits, & finally then am I able to ask for this damn letter of determination. Of course I then have to fax the letter of determination from 1199 to medicaid & Healthfirst, they both have to process the document & finally then, am I able to prevent my Healthfirst coverage from lapsing.
Problem is — this HR lady is never going to type this damn letter for me that’s required for me to even move to the next step of this BS process. Is there any other way for me to obtain such a letter? I texted the HR person and she is saying that “I don’t have 1199 coverage” on account of “she never saw my name on any of the papers for 1199.” I explained to her I had completed an internal transfer of my 1199SEIU benefits because I had the same benefits and policy at my job prior to this one, so I completed paperwork for the internal transfer and rather than submitting it to HR I had submitted it directly to the representative from 1199 assigned to my facility. In other words — she is right that she never saw my name on any of the papers & that I never signed up through her, because I already had the benefits from job 1.
I have no idea what I am supposed to do now because medicaid is already denying the filling of my adhd meds on account of “I have a primary insurance.” In half a month I have a ton of other monthly psych meds I have to pick up that I really cannot go without. So I try to put both insurances on file at my pharmacy & tried to see if that would work but it’s still saying insurance will not cover it even though it always has covered it fine in the past prior to this issue. I am going to end up having to pay for this one prescription out of pocket with no insurance just a coupon, but I cannot afford to do that with all of my meds.
Which leads me to the question that is the whole point of this post: Is there anything I can do in this situation aside from praying she does her job? Is there any kind of action I can take or other route I can go if the HR person from my last job keeps ignoring my request? I’m at a complete loss as to what to do. I really can’t have my healthfirst/medicaid terminate their benefits, but I also am unable to provide the letter of determination that is required by medicaid because to do so I would first need this HR person from my last job to provide me with a letter that states my last date of employment as well as a request to terminate my 1199 coverage — & I would have to submit that letter to 1199 in order to even get them to terminate my policy, & only after all that would I be able to provide medicaid & Healthfirst with a letter of determination from my previous provider (1199).
I can’t move forward without this lady’s cooperation & it is so frustrating & I am so scared that I will lose my benefits as a result of her negligence.