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Urgent Health Insurance Question!!!

CaveCanem's picture

Ok. So you know my situation sucks. ROYALLY.

Well, I cover the "skid" under my health insurance. I am the policy holder. I call today because we still had not received the name of the PCP for the kid, and I am blocked from his info! Apparently "someone" put a password on his name/part of the account, and they wouldn't tell me anything...the name of the PCP, where his claims go to, NOTHING. Just that the account is password protected. I asked WHEN did this happen as I (the policy holder) didn't authorize ANYTHING like that. They tell me that they can't tell me anything. WTF? I told them that I was told that any changes to the skid's info, etc. could only be done by me (or I would have to sign a form allowing BM to have access), since the BM isn't on the account...that it doesn't matter that she is the CP, the BM, etc, that only I could make changes. But whoever I talked to on the phone today said that "certain" forms had to be submitted in order for this to be done. I'm trying to tell her that I DID NOT authorize ANYTHING. So bascially at any given time a parent who is NOT on the policy can make changes to their kid's information (as long as they can legally prove they are the parent) if the kid is on the other parent's health insurance info?!? Essentially block the policy holder from info on the kid?!? HOW do I know she's not committing fraud? For the record, the ONLY thing on the court order is that my DH is to provide health insurance, and since I carry the policy for our entire family, he was added to mine. Because of this password protection I cannot even access my OWN family's info online now!!! How in the hell am I paying for something that now I have NO say in?!?

HOW does this work? I'm thinking she may have forged my signature or pretend to be me to authorize this? Or would the insurance company give her full access to her kid's stuff when she isn't on the policy or is the policy holder, and I didn't allow access?! I didn't even get a phone call, letter, or email from the insurance company that this happened!!! I only found out because I just happened to want to check our account online and it wasn't working. HELP!

somerg's picture

i never password protected anything but i changed stuff on my x's policy all the time for my dd...nothing illegal about that, all she has to do is claim or send in papers proving who she is and they cannot stop her.

CaveCanem's picture

Are you serious? How do I know she didnt access our info? So what recourse do I have as the policy holder? Just oh well take it and thats that?

somerg's picture

as far as setting up password info i would call them back and ask them what documents do you need to submit to prove that you are the policy holder and would like the call pulled number traced and press what ever legal charges you can on the caller (setting up the password i would think should be illegal)

the insurance company shouldn't have given them YOUR info, however if she knows YOURS theres no way they would've known it wasnt you.

reasons like this i WILL not sign my skids on my insurance. bm is crazy enough to do shit like that....too much of a headache

12yrstepmonster's picture

Personally I would drop him from my insurance and had DH pick him up or if BM is solely responsible for unpaid medical (which I highly doubt it), I would get a shitty plan.

CaveCanem's picture

So any parent at any given time can change things to block the policy holder, make authorizations, change things, etc.? I just don't want fraud or anything to come back on me since I'm the policy holder.

somerg's picture

i agree with the other posts, and she shouldn't ahve been able to make changes to the policy itself that affect money, but info and stuff directly with the kiddo, there shouldn't have been a problem

i'd remove the kid altogether and let dh worry about it

12yrstepmonster's picture

I didn't even know I had the ability to do this as a CP! I usually can call about my DD's information and get only general information. They won't go into any specifics.

And didn't the insurance company tell you that you couldn't put a password on just your information? Or do I have the posts confused?

somerg's picture

i called in on x's insurance all the time and got specifics all the time on things that pertained directly to my dd. if he never gave me insurance cards, i'd call and have one ordered and mailed to him, if i STILL didn't get it, they'd mail one directly to me but didn't like doing that way

CaveCanem's picture

We put the skid on my insurance because it was cheaper in the long run, since if my DH picked up a policy from work, not only is it crappy (his is high deductible, mine is a really awesome HMO), he only gets a partial credit. Since I have a family plan, even if I cover myself and our kids I am still paying the same price. So I pay the same price, my DH pays more, only gets half credit. Plus the kid has state aid as the secondary insurance (BM is unemployed and is also on state aid for healthcare) so the state aid would pay out anything the insurance doesn't cover. Which is good on us, but we would still be out more money. AUGH...I can't do anything or find out anything until I call my benefits office tomorrow.

CaveCanem's picture

The insuance company offered to put a password on the entire account before...i should have...but i didnt because they reeassured me something like this wouldnt/couldnt happen. They said all authorization for ANY changes had to come from me unless I signed that BM can. Tehy did say he could be password protected but that again I would have to authorize it. When anyone is password protected it automatically disables access to the account online, and I like to check our things online. Plus I have it set up with our health info.

12yrstepmonster's picture

Wow, that is truly amazing. I know that BM put the kids into counseling and kept it from DH. Then we got the mental health evaluation slip. DH called and asked, and she blew a gasket, asked how he found out that he wasn't supposed to know it was the only way the kids would agree to go to counseling is if he didn't know. WTF????? He called his benefits rep the next day who said that he was entitled to know everything that hit his benefit package.

I would love to know if indeed a non dependent could block the policy holder from information.

I'm also surprised that state aid would cover your skid since there is already insurance coverage.

somerg's picture

on state coverage, yes they will pick up any child but if there is another form of insurance as well, the other form is primary, and state covers what ever the primary wont.

my dd is on both, that began because x's insurance SUCKS royally. i needed to get her in counseling and EVERY SINGLE ref the INSURANCE company gave me would not take the ins....so i signed her up on medicaid and havn't paid a dime towards any of hers or my counseling..

thank GOD she's back on MY insurance and he's paying the out of pocket expense in child support calculations

CaveCanem's picture

The court awarded her full legal and physical (we think because of the nature of the situation, DH had a crappy lawyer who didnt fight that). We actually think something is wrong with the kid and she doesnt want DH to know. I just dont see how as I am the policy holder I cannot access his info if I am paying for the policy.

no1smaid's picture

Welcome to my line of work.

1) talk to your HR department, alert them that someone has fraudulently accessed your (their) policy and has blocked you the policy holder from accessing your account.

2) Call the insurance company and ask for their fraud department, report the same thing, they will request a certified letter from you and your employer that you are the only one that should have access to the account and information on it. You want the account CLOSED, and new cards issued for a completely new account. They can do this, they will not want to, but they can. As soon as you get the new cards, YOU password protect it.

3) Contact your state insurance board and do the exact same thing.

Your employer will care, as they pay a far larger portion of the premium for that policy than you do. Additionally, every fraudulent claim that (potentially) is filed will increase their future premiums exponentially. The insurance company will care, once it is proven that you ARE the policy holder, not the person that put the password on the account, insurance commissioner will not give a sh*t, however, imagine the fear striking BM's heart when she "finds out" through casual conversation with your DH that you involved a state agency, which could potientially (in her mind) lead to her arrest.

CaveCanem's picture

Thank you, I appreciate the responses. I can't help but feel...a little violated by this. I will definitely be calling my benefits office in the morning and I KNOW they will investigate/be pissed because this is a pretty pricey policy that they pay 75% of! I am boggled that this has even happened (on top of all the other crap we are dealing with).

THANK YOU!

FedUpFallon's picture

Don't you mean HIPAA Laws? HIPAA deals with health laws such as privacy. FERPA is Family Educational Rights and Privacy Act.

disneymom78's picture

That is why i refuse to put SSs on my insurance at work. BM agreed to cover the insurance on her end with xxx amount of CS paid a couple years ago.

Over the last year she has been B*tchin about it, and saying that DH is supposed to be responsible and since his company dosent offer benefits wanted me to put them on my insurace here, NO WAY! I dont want her to have any access or information of mine.

sorry but you agreed to xx amount of CS WITH covering the medical insurance.

CaveCanem's picture

Actually my DH didn't have a say in covering the medical insurance. Yes, we both agreed mine would be used in order to save money, but he didn't agree to anything. He basically had the book thrown at him due to the nature of the situation (we are so certain), and whether I stayed or left I have to deal with the consequences of 2 selfish people's actions.

But TRUST me I wish my DH had his old insurance (which was as good as mine before his company switched to high deductible) because the kid would've just been put on his insurance and this would be a wrap. And I did make sure she doesn't have access to my SSN.

CaveCanem's picture

Thank you, and I can understand her concern for privacy. However, I am also concerned about access, my family's privacy, and the fact that since I'm the policy holder, I cannot tell if fraud or bogus claims are going on my insurance. TRUST me I would've rather had my DH cover this kid, or leave him on the state insurance--I was quite hesitant to have him on my insurance. This was not just for my DH's financial responsibility, but something that protects all of us financially and is best for our entire household. Bad enough I'm watching thousands of dollars leave my home due to no fault of my own (and even if I got divorced, I would've still seen thousands of dollars leave our home), I'm trying to hold onto what we can, so I bit the bullet and covered this kid.

My DH did talk to the insurance company legal dept and yes she was able to do that because she wanted me blocked from knowing everything and she was the CP. She must have put on 1 heck of a show to get this done according to both the insurance company and my HR. However they didn't realize that my entire account was then blocked, and are working on doing something to fix that. HOWEVER, since there's nothing in the court order that says that my husband CANNOT access, he will and can be granted access to the child's info. My HR can discuss things with him as he is the father, according to the law (I don't have it saved right now, but it does allow him to have access as long as there's nothing court ordered barring him). The court order was incredibly vague in only stating that he was to provide for the health insurance and that's it. My HR is looking into the papertrail as to what happened, to make sure no fraud was committed, my information is safe, etc. This BM is highly manipulative and is a master con-artist, so we are being highly vigiliant in making sure we are safe. He picked a winner let me tell ya :sick:

So thank you everyone, I appreciate the input. Back to living my nightmare...

CaveCanem's picture

Thanks, trying to breathe! I did tell my HR if it appears that there was anything remotely fradulent then I want all new cards etc. They are totally on our side and were quite shocked to find out what happened (as the lady who was helping me was a CP herself and didn't have access to the insurance of the NCP)--plus BM apparently contacted them and (of course) wasn't classy at all.

Not to mention I feel it was in bad taste for the insurance company to withhold telling us this information, basically waiting for us to find out on our own. I am actually quite disappointed in the sequence of events and may consider a new policy with a different carrier this summer when I have open enrollment.

Thanks again. I'm really learning that my DH is truly nothing more but a walking checkbook/sperm donor/cashcow/paycheck for the BM.

Rags's picture

If the person who put the PW protection on YOUR insurance account now has access to confidential medical information for YOUR family I would eat that idiot’s ass up with every HIPPA related consequence I could identify.

Since it is of little mystery who did it I would eat BM alive over this one. You have already engaged HR on this which is the right way to go IMHO.

I think the recommendations to file Identity Theft Charges are very interesting and that you should absolutely file complaints with the insurance company including their fraud department, the State Department of Insurance, your companies Benefits Department.

BM thinks her little PW stunt on your account was cleaver and a PITA? :? Show her what a pain in the ass really is. Let her deal with the Feds (Hippa), the State (Insurance Fraud), the Local Police (Identity Theft), hang her manipulative ass out to dry. }:)

IMHO since it is YOUR policy/benefit that YOU carry on YOUR Skid that it is BM who should have no access to the information. There is personal information that is required when an employee accesses insurance benefits provided by an employer that is none of BMs business.

She gets an insurance card for the kid, access to the Doc records, and THAT IS IT. She should have ZERO access to the insurance company records or any other information on YOUR Policy. If she wants any other insurance related information she should call YOU for it. You provide it at your will and convenience.

We nailed SpermGrandMa on some similar stuff. They took our son (my SS-18) to the ER to get a rusty fish hook removed from his leg. SpermGrandMa signed my wife's name as the responsible party on the bill.... and the hospital actually billed us for the visit. We were 1500 miles away. No call from the hospital, no call from the SpermGrandHag, nothing. NO F-IN WAY did we let that shit slide. We had our lawyer bombard her with letters, threatened the Hospital with a law suit, had the insurance company stop payment on all services for that ER visit and had the hospital bill SpermGrandMa. We did allow the insurance to pay the covered part of the ER visit but forced SpermGrandHag to pay everything else. She called and whined and bitched and moaned about how broke she was and could not afford it. We told her to get the money from her worthless POS son (the SpermIdiot) and that when he sent us the bills (we were obligated to pay half of uncovered med expenses per the CO) we would deduct it from the $6K he owed us that he has never paid for his half of my SS's uncovered medical expenses.

I wish we had thought of identity theft. If we had I would have had the toothless SpermGrandHag rotting in jail.

I would own BMs ass if I was you. Give her the very clear message that you will not be trifled with and that what you provide for YOUR family, including YOUR Skid, is none of her concern, business and that her only options are to thank you profusly and regularly for covering her spawn on your police or to STFU and stay under her rock.

Grrrr!!!!!

I am turning purple just writing this.

These people have no redeeming value or qualities. Too bad we can't just turn them in to fertilizer. At least that way they are doing something useful.

When these idiots cause this kind of PITA to the people who are providing for their children what they are too inept and worthless to provide it just pisses me off to no end when they do this kind of crap.

Grrrr!!!!

CaveCanem's picture

Just wanted to update. So according to how our insurance interprets HIPAA, everything she did was legal and right. My DH doesn't even have access to his info! They won't remove the password, my family still doesn't have access to our online info, and apparently she was able to change the address of the claims, etc. I pay for the skid to use our insurance, yet my husband doesn't even get to see the claims so we can check for fraud, bogus claims, etc.?

So he has to contact and send a copy of the court order (plus he's including a copy of the law from our state that allows NCP's access regardless of custody status, as long as there is nothing barring him) to their legal office, plus he's going to talk to a lawyer next week. I decided I am going to look into other plans at my next open enrollment that are cheaper; I can't be with this insurance carrier anymore as I now have a foul taste in my mouth. As a working, paying consumer, the way they treated myself and my husband I feel like they gave me the big F-you. Even my HR couldn't believe this was possible!

Thank you everyone for your insight and responses.

12yrstepmonster's picture

But your HR didn't do anything? They didn't have a personal rep that they deal with that could help in this matter?

CaveCanem's picture

This was the info the HR person got from the insurance rep!!! That's why they were equally puzzled and shocked!