The only readily available help for someone in NYS who buys insurance under the Patient Protection and Affordable Care Act (which can only be purchased at the ineptly run New York State of Health Marketplace) is the Attorney General’s Consumer Health Bureau. I reached out to them when I had my health insurance abruptly terminated without notice last week. The woman I spoke to was very kind. She sadly got back to me to a couple of days later to tell me that the company that had screwed me had responded to their query and had not changed its mind.
New York State’s Commissioner of Insurance position was abolished in 2011 along with the Department of Insurance. The regulation of insurance companies in New York State was assumed by the newly reorganized Department of Financial Services which also oversees banking, finance and commerce. Makes sense, no? As of a few years ago this agency had no ability to help consumer victims of insurance company fraud or abuse. It only took complaints against consumers who the insurance companies accused of fraud. Makes sense.
When the Attorney General’s consumer health bureau gave me the sad news that there was nothing further I could do to get my insurance for 2020 back, I continued my online research and round of phone calls. I eventually found a new online consumer complaint form at the NYSDFS website. That form is here: https://www.dfs.ny.gov/complaint.
Within two business days I had a call from the insurance company, Healthfirst, informing me that my insurance was in full force and effect. They apologized for their “mistake” and acknowledged that the DFS complaint had caused them to “escalate” the appeal process they’d previously told me didn’t exist. Cool, now I can reschedule the appointment with the cardiologist I had to cancel for today.
I emailed to let the kind woman at the AG’s office know that, after only a week of indescribable stress and aggravation, my complaint had been quickly resolved by the DFS complaint process. She wrote back to tell me she was happy for me and asked if I wouldn’t mind helping a consumer who’d been screwed as I had been, could she give her my email address? I opted to write to the screwed citizen instead. Here is what I advised her (and anyone else in NYS sodomized by an unaccountable, constantly feeding artificial “person” of eternal life):
I was given your email address by the overwhelmed woman at the AG’s help desk, who asked if I’d be willing to help you. I am a private citizen who was recently screwed by my health insurance company. Not sure why the woman at the AG’s help desk couldn’t help you, and I’ll be writing to the assistant AG in charge of the sympathetic but unhelpful help desk (will not mention any names, the woman I spoke to was perfectly nice and really tried to help), but here is my advice.
I can’t go into the details of how you were screwed, believe me I know how many ways the virtually unregulated private insurance companies — and the accursed NY State of Health “Marketplace” — have to screw us. I’m sure thousands are similarly abused. Here are my recommendations:
1) contact the NYS Department of Financial Services today. They are the agency that oversees health insurance in NY State. Their NYC phone number is 212-331-6266 * (I don’t know what county you live in). They are open til 8 pm today. Wherever you live: Go to their website https://www.dfs.ny.gov/complaint and submit your complaint today. You can do it on-line.
If your complaint is complicated, write it out before you work on the on-line form, since you have only 30 minutes to complete the complaint once you start. Cut and paste the complaint you’ve already written, if you think it will take a long time to put your concerns in order.
Keep it brief and to the point. I was cut off health insurance for 2020 without notice when I called to pay my premium last week. The AG’s Health Bureau Help Desk called Healthfirst and was told my termination was done properly and in compliance with the “guidelines” and that nothing more could be done. Within 2 business days of filing my complaint at NYSDFS I had my insurance restored, Healthfirst told me it had been a “mistake” and they were sorry. I’m sure they were very sorry… corporations always say they are, when they are caught and there is no consequence to them for apologizing.
2) If the NYSOH Marketplace screwed you (as they have screwed me twice in the last few years) file a formal appeal over the phone (this cumbersome process will take about 3-4 months for a determination that will likely be in your favor). I’d recommend also writing directly to the unaccountable political appointee who runs it. Include a copy of your NYSDFS complaint. Here is her contact information (as best I can determine it, she keeps a very low profile):
Executive Director, New York State of Health Marketplace
New York State Department of Health
Empire State Plaza
Albany NY 12237
We are victimized in a state with virtually no protections for health care “consumers” who are screwed. Call NYSDFS, that’s your best first stop, and hopefully your last.
Best of luck to you, be direct, give ’em hell, and don’t take this abuse lying down! Many of us are similarly screwed, take courage from the new help now available at the Department of Financial Services.
* This is actually the telephone number for the New York City Human Resources Administration, Public Engagement Unit. I’m told the NYSDFS 800 number is as useless as it was the last time I entered their administrative cul du sac several years ago.