A Morrisville man who had been a Blue Cross Blue Shield of North Carolina member for 12 years lost coverage for himself, his wife and his daughter after missing a single monthly payment.
Full story: In 12 years, Triangle man missed only 1 health insurance payment. He lost coverage
Here’s what happened:
- Cord Silverstein thought he had set up automatic payments with Blue Cross, but it didn’t work. Blue Cross sent a letter July 7 to tell him that his policy was canceled, but when he called six days later to ask about reinstating his policy, it was too late.
- Missing a payment isn’t a qualifying life event for a special enrollment period — a time outside open enrollment when you can sign up for coverage. Qualifying events include moving, getting married or divorced or having a child.
- Silverstein had a grace period of 25 days to pay his bill — longer than the 10-day period laid out in state law for individual plans that aren’t subsidized with a tax credit, Barry Smith, deputy director of communications for the state Department of Insurance, told The News & Observer in an email. Marketplace customers using the premium tax credit who have paid at least one full month’s premium can have up to 90 days.
- Caitlin Donovan of the nonprofit Patient Advocate Foundation said she didn’t know how common it is for customers to lose coverage after missing a payment, but noted the healthcare system is “so confusing and so complicated that people make financial mistakes within it all the time, and it costs them either money or their coverage or their future treatment.”
- Silverstein bought temporary insurance for emergencies, but it doesn’t cover pre-existing conditions. He canceled a transfusion he needs every three months because the out-of-pocket cost runs $15,000 to $20,000.
The summary points above were compiled with the help of AI tools and edited by Dave Hendrickson and Renee Umsted, who also reported, wrote and edited the full story in the link at top.…