Sunday 4 June 2017

The day I lost my health care coverage

In 2011, when I retired, I was allowed to "roll over" my health care coverage. I was able to continue getting the exact same coverage I had while I was employed by simply continuing to pay the premium myself.

If I hadn't done this, I would have had to find another health care provider, go through medical checks to establish insurability -- and risk being denied coverage or limited in some way. Being a partially decrepit old guy with arthritis and chronic crap, this could have been bad.

So in April 2011, I signed a contract with Sun Life to continue my benefits. Six months later I moved to the mountains (the trouble began here, though I didn't know it at the time).

Since 2011, I have had a number of occasions to contact Sun Life to clarify claims; some dental, some physiotherapy, and some other stuff. No issues; they have sent me stuff, and I send them stuff. Other than being a bit of a pain in the neck to break through their telephone defence system, all has been OK.

Until May 23rd, 2017, the day I lost my health care coverage.

Karen went in to get a prescription filled, and the pharmacy said the insurance coverage was denied as my insurance had been cancelled.

Huh?

I checked my records -- which I don't really have. It's not really my fault; since 2011, I have never received any correspondence from Sun Life. They bill me on my MasterCard. My MasterCard records said they stopped billing me in February 2017.

I immediately got on the phone with Sun Life -- or I tried. I broke through their telephone defence system (a 15 min exercise) and spoke with a representative. I told them my insurance appeared to have been cancelled, and they stopped billing me for some reason. I didn't want to be cancelled; could they explain what happened and get me un-cancelled?

The Nice Lady I spoke with told me I was talking to the wrong department. She apologized, patched me through to the "right" department, but that put me back in the phone queue.

Once again, I broke through their telephone defence system (a 15 min exercise) and spoke with a representative. I told Nice Lady #2 my insurance appeared to have been cancelled, and they stopped billing me for some reason. I didn't want to be cancelled; could they explain what happened and get me un-cancelled?

And once again I was told I was talking to the wrong department. Nice Lady #2 also apologized for the problem and for the fact I was put through to her. But she couldn't patch me through to the "right" department; however, she could give me their number (Sun Life has about 10 toll free numbers to contact various departments).

I called the new "right" number. Once again, I broke through their telephone defence system (a 15 min exercise) -- only to find all the agents were busy and I could only stay on hold 2 min before I was cut off.

Again, I called the new "right" number. Once again, I broke through their telephone defence system (a 15 min exercise) -- only to find all the agents were busy and I could only stay on hold 2 min before I was cut off.

Again, I called the new "right" number. Once again, I broke through their telephone defence system (a 15 min exercise) -- only to find all the agents were busy and I could only stay on hold 2 min before I was cut off.

This repeated for about 2 hrs before I finally made it through. Yipee!

I told Nice Lady #3 my insurance appeared to have been cancelled, and they stopped billing me for some reason. I didn't want to be cancelled; could they explain what happened and get me un-cancelled?

As usual, it was "my fault".

Problem #1: I got a new MasterCard that activated March 1st. They stopped billing me because they couldn't bill my MasterCard. They sent me a letter in January warning me it was going to happen, one in March when it happened giving me 45 days to update things, and one in April as a final warning that they would cancel my insurance on May 22nd unless I gave them new card info.

But the letters were pointless, because...

Problem #2: I had moved and "not told them". While Nice Lady #3 could see my "new" (last 6 years) address in the system, the "primary" address on file was my pre-2011 move address. I noted that I had worked many times with the Claims department in the last 6 years, and had corresponded with them; they had the correct address (and phone number) on file. Nice Lady #3 told me that Claims has its own system, and she was in Account Administration. I never reported my move to Account Administration, so my account has had the wrong address. For six years.

Six years? My guess is I have missed a LOT of mail from them, like, say, annual statements and premium changes. But... they had the correct phone number. Go figure.

Nice Lady #3 apologized for the problem and for the fact I was put through to two wrong people before finding her. But...

She also told me I didn't have any insurance. To get my insurance back, I would have to file proof of insurability as if I was applying again. Eeek (not that I'm not insurable, but you never know). And I wouldn't be insured until I was accepted again. More eeek.

But we talked. She could see in the Claims department records that I changed my address there in 2011, and she scolded me that I needed to change it with Administration. We agreed I was a dolt. We agreed I really should have told them I got a new MasterCard with a new expiry date. We again agreed I was a dolt.

And so recognizing she was dealing with a dolt, Nice Lady #3 reinstated us effective March 1st -- though she did warn me there would be an "administrative charge" to do so. Can't wait to see my June MasterCard bill.

Is there a moral to this story?

Probably not. Or, maybe...

Don't be a dolt. But if you do run into troubles with Sun Life, tell them you're a dolt.

I should turn that into a Motivational Poster.

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