When one consumer fights for ethical trade and fairness, it helps the whole pack of us consumers.
If you get your health insurance through your employer, your personnel department probably interacts with your health insurance company for you. Lucky you.
We insured individuals are on our own. After several ugly tussles with health insurance, I’ve picked up some important tactics.
Before listing them, I must thank Obama Care, for your past help. Here its implemented as Covered California. Officially, ObamaCare’ name is the Patient Protection and Affordable Care Act (PPACA), or Affordable Care Act (ACA) for short.
ObamaCare does two things. First, it makes it illegal for insurance companies to discriminate on the basis of gender and pre-existing conditions other than tobacco use. Second, it ensures that everyone has health coverage.
Most people know that Covered California subsidizes health insurance for individuals with low incomes. (Medi-Cal helps those with zero income.)
Few know that Covered California can help people who make enough money to not need financial assistance. Covered California is also a formidable insurance broker for individuals. When things go awry between individuals and insurance agencies, they’re a compelling powerful mediator.
1 Be solution oriented and tenacious.
2 Be emphatic about what you need and why. Even the nicest people seek to do what’s easiest for them, unless they’re pressed.
3 Phone when they’re least busy: early on weekdays. Barring that, after 7pm. If they answer phones on weekends, most decision makers are off.
4 Don’t waste time. I’ve been given runaround regarding health, billing, and tax filing issues. I’ve been told to dial elsewhere, wrong information, and false promises. I’ve been put me on hold countless times and cut off after holding for eons. The moment that begins: fill out their online grievance form.
5 If your grievance isn’t rectified within 30 days, file a lawsuit with the state.
6 Stay focused. For everyone but you, its just business.
7 Refuse ‘no.’
8 Keep notes:
•Name of whom you spoke with.
•Number you dialed, date, and time of day.
•Transaction/case ID number.
•Phone conversation ID number.
After all the above, my health insurance came through with the exact things they swore were impossible.