COBRA Hiccup

Satomi’s medical benefits officially stopped on October 17th.  It is now November 3rd and we just had our medical coverage reinstated.  While it is true that this 17-day period is well within that specified in the DoL requirements, Satomi’s condition makes it a lifetime.  Remember that we have many appointments every week and she takes many medications every day.  Medications can’t wait and re-scheduled appointments can mean weeks of delay-All of which are unacceptable.

I needed this conversion to be as quick and easy as possible so I arranged a meeting with Satomi, her boss, and her HR manager.  They were very helpful and answered many questions.  Basically, I had to wait for the “COBRA package” to arrive in the mail from the COBRA administrator.  In it would be all the necessary forms and a fee schedule to facilitate payment.  I shouldn’t worry about anything because the coverage is “retroactive”.  I don’t do well with “waiting” so I planned to continue an active involvement.

Satomi was running low on certain medications so we ordered them over the phone at our local Walgreens.  Satomi called our insurer to verify coverage and supposedly “got us active” so I went to pick them up.  “No Insurance-Cash Only” was printed on the packages so I told the Pharmacy people to call the insurer again in the morning.  We also called and determined that we were not only inactive but completely removed from the insurers system.  I was a bit upset and we started calling everyone to figure out what was the problem.  We had enough medication to last until the end of the month.

Several days and many phone calls later, I was told by the COBRA administrator that there was an eligibility date discrepancy on the documents so the entire package was on hold until it could be resolved between our HR and the COBRA administrator management.  I explained our situation and emphasized that this could not sit in someone’s In Box.

More days passed and calls made and we were advised to watch our mail.  We found nothing so I continued my calls.  I spoke with the COBRA administrator at the end of the week and was told that the package was mailed on Tuesday October 27th from their offices in Rhode Island and we needed to immediately fill it out and send it back.  I again explained our medication situation.  With the representatives help, I was instructed to write a fax containing all pertinent information and provide them a check over the phone in lieu of returning the package.  Finally, some progress! 

After exchanging 2 separate faxes and speaking with 5 different people, they had the proper information and over $1,300 of my money; but they were in Rhode Island and it was 4:30pm.  There wasn’t time to contact our Insurer or get confirmation of the re-activation of our policy.  We had no choice but to wait until the following Monday.  What the…?

The package arrived on Saturday October 31st. 

I spoke with the COBRA people again on that Monday and confirmed that our Insurer was contacted.  It had to be processes into their system but should be official by end of business…Tuesday.

Satomi ran out of medication so I had to get a partial prescription filled.  It cost me $1,000 for a 2 week supply of medication and I had to pay cash for my Tuesday Dentist appointment-$395.  Holy Crap. 

Let’s see how the reimbursement process goes.