Hi, this is a somewhat complicated situation, so I will attempt to bullet point it. This is in Maryland, and I work for a Maryland State organization.
Son born Sept 12, 2021. We sent in the crib card to the SPS Dept of Budget and Finance system and added him to our BCBS health insurance via my Maryland job. This may not be relevant, but we discovered that the hospital typoed on the birth certificate, and spelled our last name (mother, father, kid have same last name) wrong on 1 of 3 instances on the certificate. We have to fill a form for change request and get it notarized and sent in. We do that ASAP and are still waiting for the new certificate in the mail. We have to send in his birth certificate to the SPS system within 2 months of birth. Here’s where something probably went wrong. They claim I did not send it in and it is not in the SPS system. I have pretty clear memories of sending it in, but it is possible I did not, or there was a technical issue. Point seems to be moot – they don’t have it. Due date for this would have been Nov 12th. We get no notice or reminders they did not get this. Open enrollment comes around with due date Nov 12th. We fill everything out and elect to keep kid enrolled as usual. No ask for birth certificate. We get new BCBS health insurance cards for my whole family, including infant saying effective Jan 1, 2022. This Wednesday, we go to the pediatrician for scheduled checkup and they say he is not covered. I call BCBS they say he was removed Dec 31st via MD dept budget and finance’s request and to call them I call dept budget and finance, and they say they did not get the birth certificate within two months and there is no recourse. They say that my work HR should be able to tell me when an email warning was sent and if it was opened and to call them. I call HR and after being jerked around a bit, they say the SPS system says I did not upload the birth certificate (no surprise) and they can’t help. After pushing for more info, they send an appeal request into SPS which comes back denied again. HR says they don’t have any access to see when any warning was sent. The system only has info that goes in one direction: HR > SPS > Insurance company.
Currently, we are looking on the market for insurance for our son so we can get him covered, but we are wondering if we have any recourse? It seems like a long shot at this point, but could use any advice.
It seems like we are going to have to pay out of pocket for the pediatrician visit this week since he was uninsured?
Something that really gets me is that we had NO NOTICE that he was removed from any of the three organizations in question. No mail, no email, no call. We had to find out from the doctor. And the fact that we had no notice meant we were not able to correctly use open enrollment to re-add my kid and send in the birth certificate. Now our kid has been uninsured for a month and we are scrambling to get him insured starting Feb 1 with much worse and expensive options.
Thank you for any insight regarding recourse or suggestions.
submitted by /u/healthqman
[link] [comments]Hi, this is a somewhat complicated situation, so I will attempt to bullet point it. This is in Maryland, and I work for a Maryland State organization. Son born Sept 12, 2021. We sent in the crib card to the SPS Dept of Budget and Finance system and added him to our BCBS health insurance via my Maryland job. This may not be relevant, but we discovered that the hospital typoed on the birth certificate, and spelled our last name (mother, father, kid have same last name) wrong on 1 of 3 instances on the certificate. We have to fill a form for change request and get it notarized and sent in. We do that ASAP and are still waiting for the new certificate in the mail. We have to send in his birth certificate to the SPS system within 2 months of birth. Here’s where something probably went wrong. They claim I did not send it in and it is not in the SPS system. I have pretty clear memories of sending it in, but it is possible I did not, or there was a technical issue. Point seems to be moot – they don’t have it. Due date for this would have been Nov 12th. We get no notice or reminders they did not get this. Open enrollment comes around with due date Nov 12th. We fill everything out and elect to keep kid enrolled as usual. No ask for birth certificate. We get new BCBS health insurance cards for my whole family, including infant saying effective Jan 1, 2022. This Wednesday, we go to the pediatrician for scheduled checkup and they say he is not covered. I call BCBS they say he was removed Dec 31st via MD dept budget and finance’s request and to call them I call dept budget and finance, and they say they did not get the birth certificate within two months and there is no recourse. They say that my work HR should be able to tell me when an email warning was sent and if it was opened and to call them. I call HR and after being jerked around a bit, they say the SPS system says I did not upload the birth certificate (no surprise) and they can’t help. After pushing for more info, they send an appeal request into SPS which comes back denied again. HR says they don’t have any access to see when any warning was sent. The system only has info that goes in one direction: HR > SPS > Insurance company. Currently, we are looking on the market for insurance for our son so we can get him covered, but we are wondering if we have any recourse? It seems like a long shot at this point, but could use any advice. It seems like we are going to have to pay out of pocket for the pediatrician visit this week since he was uninsured? Something that really gets me is that we had NO NOTICE that he was removed from any of the three organizations in question. No mail, no email, no call. We had to find out from the doctor. And the fact that we had no notice meant we were not able to correctly use open enrollment to re-add my kid and send in the birth certificate. Now our kid has been uninsured for a month and we are scrambling to get him insured starting Feb 1 with much worse and expensive options. Thank you for any insight regarding recourse or suggestions. submitted by /u/healthqman [link] [comments]Read Morer/HealthInsurance