Insurer Stonewalls Federal Employee/Former Marine
I've worked for the federal government in various ways for the past decade. In 2004, I had just finished a 5-year tour in the United States Marine Corps and was working as a defense contractor for Macaulay-Brown, Inc., when I was offered a federal position with the Department of Navy (DON). When I considered the position, one of the "musts" was health care. I have a history of severe pulmonary problems (several cases of recurring pneumonia, chronic bronchitis, asthma, etc.), so the health care offered by the DON would have to be universal, and enrollment would have to be unobstructed by pre-existing conditions.
I was assured that no provider electing to be a part of the federal program could reject an employee for any pre-existing condition, which sealed the deal for me. I was shortly thereafter a DON federal employee. I began the application process, which was provided online at the insurer's website "for our convenience." After being rejected inexplicably via generic "we're sorry, but we can't insure you at this time" letter, I returned to my HR department to ask "what gives?" They advised me to appeal the rejection, which I did. I was denied in my appeal, again, generically.
I scrambled to find the information I was clearly missing, but neither the insurer nor my two-person HR department could help me (despite HR's correspondence with the insurer, our headquarters' staff, etc.). Finally, after I was past the deadline for application, the insurer sent me a detailed letter explaining exactly what went wrong: I had applied under the wrong website. That was it. I needed to use a mirror site with a ".gov" address. There was no difference in application process beyond that point.
So instead of immediately informing me that I had used the wrong web site (upon which I clearly and repeatedly identified myself as a federal employee in the application and appeal that I had filed), the insurer opted to wait until I was past the window of enrollment to save themselves the cost of covering a sick federal employee for 1 year. Reprehensible! During that year I developed pneumonia once. My mother had to plead with a local doctor in her area (Sierra Vista, AZ) to give her medicine, which she sent to me. I also tore my right ACL and crushed my right meniscus, both of which went unchecked for several months and are still damaged.
That being said, THANK YOU for what you're doing! Every person deserves free, universal health care; it's just common sense! Best of luck... Aloha, Dan Holley Hawaii

