A one-digit mistake in the insurance policy a Nevada family bought and paid for on the Nevada Obamacare exchange is leaving them with $1.2 million in medical bills that the insurer won’t pay.
Kynell and Amber Smith purchased an Anthem Blue Cross insurance policy for themselves and their five children on Nevada Health Link last October and are still struggling to get their coverage worked out 10 months later, the Las Vegas Review-Journal reports. Despite making a $1,300 premium payment every month, their claims are still being denied due to a typo in their policy.
Amber Smith’s birth year is listed as 1978 on the insurance identification card, when it should be 1979, causing her claims to be denied. Even worse, the couple is unable to get their newborn daughter Kinsley added to their insurance plans, although they’ve made “dozens of calls” to both the Nevada Obamacare exchange and Anthem Blue Cross.
The couple’s coverage began in January, when they made their first premium payment. So when Amber delivered the couple’s daughter Kinsley five weeks prematurely in February, the pair’s hospital stay should have been covered. Kinsley spent 10 days in the neonatal intensive care unit and Amber required a 40-day hospital stay and several surgeries.
On top of the extensive hospital stay, the Smiths are paying for Kinsley’s ongoing follow-up care out-of-pocket, as the exchange is failing to add the newborn to the insurance policy. The Review-Journal reports that Amber’s specialists left the exchange coverage’s provider networks as well, sticking the Smiths with even higher out-of-pocket costs.
All told, the Smiths are stuck with a $1.2 million bill, incurred while their claims should have been covered.
“I have spent countless hours on the phone trying to get this resolved,” Kynell Smith told the Review-Journal. “I have contacted and pleaded with elected officials to help and was told I may have to sue to get this resolved. What kind of answer is that?”
Xerox, which was the lead contractor for Nevada’s erstwhile Obamacare exchange, is already facing a class-action lawsuit from exchange customers who were denied care or delayed it due to the endless technological failures in the state exchange. The exchange fired Xerox in May and opted to move to HealthCare.gov for 2015. (RELATED: Nevada Obamacare Exchange Considered Dumping All Customers)
One woman who was part of the lawsuit, Linda Rolain of Las Vegas, passed away in June after delaying treatment of a brain tumor while waiting for her insurance enrollment to be straightened out. (RELATED: Woman Suing Obamacare Exchange Dies)
Another man, Larry Basich, had a heart attack several months after he began making premium payments for his Nevada Health Link coverage, but was charged over $400,000 when it turned out that Xerox hadn’t communicated his enrollment to the correct insurance company. The Smiths are considering joining the suit.
After a recent switch by the insurance exchange, the Smiths can’t see their policy details or billing information at all. Nevada Health Link contacted the Smiths in March to inform them that they were overpaying on their $1,575 per month insurance policy and that they needed to switch. But since they switched to a policy with a lower $1,296 monthly premium, they’re unable to access detailed information about their policy online.
“All I know is, I am sending checks and they are cashing them,” Kynell Smith said.
Anthem Blue Cross told the Review-Journal that the Smiths’ dilemma “illustrates the frustrations we and the health exchange have had with Xerox.” A spokesman for the Obamacare exchange said they’re “working very quickly to solve it.”