More Californians complain of plan cancellations

As Emily Bazar reported in a recent Ask Emily column, an untold number of people have been dropped from their Covered California health plans, without their consent and often without notice.

Some are getting pushed into Medi-Cal. Others are dropped outright.

Since the column appeared, more readers have reported frustrating experiences trying to restore their coverage.

Dan Shafer from Sacramento said he and his family were switched to Medi-Cal in July “out of the blue:”

I called Medi-Cal immediately. Their system showed that I had $0 income. After further checking into it, the representative discovered that my income was entered as a deduction. After re-entering my information into the system, seemingly correctly, it was still showing Medi-Cal eligibility even though I was clearly eligible for a Covered California subsidized plan.

Shafer believes the switch occurred because of a technical glitch between the Covered California and Medi-Cal computer systems.

Numerous subsequent calls to Covered California from July 17th through August 25th have been met with incredible frustration, but they did acknowledge a computer system interface problem between them and Medi-Cal that started back in May.

Covered California is “not aware of a ‘glitch’,” says spokesman Dana Howard.

“However, we truly want to help resolve any case where someone believes their coverage has been incorrectly terminated,” he adds.

Since writing in, Shafer says he has been working with the Medi-Cal office to be placed back on his original plan.

Unfortunately, other readers we’ve been hearing from have had trouble resolving problems with Covered California.

Melody Lewis, from Hemet, was dropped from her insurance entirely.

I only found out when I called my carrier because I noticed my premiums had not been deducted from my checking account. I was told Covered California had cancelled my policy and Blue Shield would not reinstate it until Covered California told them to. This was a privately purchased policy. What right did they have to tell my carrier to cancel and why did Blue Shield not contact me?

Melli Herrera from Garden Grove found herself without insurance after her daughter apparently experienced a life change that qualified her for a special enrollment period:

July 1 I called Kaiser Perm to reschedule an appointment. The appointment center told me my coverage was terminated as of midnight June 30. I had not received any notice of cancellation, I am certain of that. I spent three hours on the phone that afternoon with Covered California and Medi-Cal. Finally someone told me the reason for cancellation was because my dependent daughter turned 19 on March 9 and she would no longer be eligible for coverage under our Covered California family plan after the 90 day grace period following her birthday. Neither I nor my daughter had ever received any information regarding the pending cancellation.

The law currently allows young adults to stay on their parents’ plans until the age of 26. Herrera was told that her coverage would be reinstated on September 1st, but has yet to see results.

“While people may believe they have been improperly terminated, it is important to look at the activity on their account to assess what has taken place,” says Howard.

Consumers who believe they have been incorrectly placed in Medi-Cal can file an appeal through Covered California. 

Those who have been canceled without notice can file a complaint with the state Department of Managed Health Care (DMHC).

Hellesen assists Emily Bazar in researching topics for Ask Emily. 

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