The complaint has been investigated and
resolved to the customer's satisfactionResolved Wage Works/ Cobra Coverage — Reimbursement for services not rendered
resolved to the customer's satisfaction
I unfortunately lost my job in September of 2008. I am regularly being treated for a previous job related back injury and high blood pressure. Therefore, the very minute I realized I would not be covered for health insurance; I elect Cobra coverage through Wageworks to cover me for a month while I sought out sources for more affordable coverage. Being a single female, and not having the amount of cash available to pay for my first month's premium, I took the money out of savings and elected coverage the first week of December which amounted to $603.04 (I was covered by my previous employee until November 27th, 2008), Wageworks received my check and election on December 15th. Their policy is that once payment is received and processed, your carrier (Empire Blue Cross) is notified. However, during the following weeks, I would go to doctor's appointments and pick up prescriptions to discover that I was not covered at all. Since services were already rendered, I paid out of pocket. This was very taxing on me as my check ups cost me $150 per visit (2) and prescriptions ran me over $100.00. Mind you, I am paying out of pocket from funds I received from an unemployment check! Finally, I called Wageworks after the New Year holiday and demanded to know what was going on. I was informed by the representative that they were behind in notifying my carrier due to the holiday and the amount of layoffs that were occurring. Therefore, I should call my carrier to verify that Wageworks had notified them and that perhaps it was an oversight on the part of my carrier. I couldn’t figure out why it was necessary for me to do the legwork, but I did so in earnest to make sure that I was being covered. When my carrier informed me that they had not been notified, I called Wageworks and cancelled my coverage with them. Additionally, I demanded a full refund for services that were "not" rendered. After an apology from the Customer Services Representative, I was handed over to another representative to file a complaint.
After two weeks of waiting to hear back from them, I called again. I was told that the complaint was listed, but I would not be able to receive a refund as it was not COBRA's policy to provide them. I was outdone! The representative allowed me to file another complaint, and after waiting for another four weeks, I received a check from them for the amount of $36.00. I immediately called them and implied about the check. They informed me that this was what was left me from the time I was not covered until the day I elected to cancel my coverage. This mere check was not going to appease me. I requested to speak to a supervisor. Once again, I was told that it was not the policy of COBRA to return a full refund. And, if I wanted to submit the bills for the "out of pocket" services that were rendered to me, I should notify my previous carrier, (mind you, not them). Needless to say, I was furious!!! I proceeded to ask the supervisor what does this "so - called" COBRA policy state regarding non - reimbursement. She just reiterated by saying, "It's their policy". I then asked for written documentation detailing this, but of course, she would not provide any.
My only recourse is to file a complaint with the board. I also intend to go to the media with this. I'm quite sure that I am not the only recently unemployed individual that is being duped by the scams and schemes of COBRA. It’s sad that you have of come out of pocket to pay for the excessive fees they charge. But, it’s a travesty that many of us do not have a choice, and that America is not doing something about the deviousness of the healthcare monopoly.