Well guys, I never wanted to be back in this situation reporting on how terrible the Massachusetts Health Connector can be, but here I am nonetheless! Your response to my ordeal, as well as noise from this post on Universal Hub, has prompted me to write a follow up post detailing how to fight the good fight when your enrollments get screwed up by the Health Connector’s incompetent billing center.

TLDR on the last post: last year, I spent about three months without access to coverage because the Massachusetts Health Connector couldn’t process a simple “retro request” properly. A retro request is when you move your effective date to a date other than when you started the plan, for example, when you leave your job but your enrollment won’t start until the next month, and you need coverage now.

What I learned during this three month battle is quite simple: the Massachusetts Health Connector’s main line (1-877-623-6765) is operationally incapable of helping you, and that only an inaccessible department called “billing” calls the shots when it comes to modifying your enrollments. Not too surprising, right? I mean, most bloated corporate monstrosities have inaccessible billing departments: I spent a good two weeks dealing with some messed up billing with Bright House, a cable company in Florida, and wasn’t allowed to speak to their money people either. But in that dismal situation, at least there was real communication between the CSRs on the front lines and the accountant robots in the back room. In the Health Connector, not so! Neither the main call center nor your insurer (in my case, this was Neighborhood Health Plan) can pick up a phone and talk to the person screwing up your plan. Be prepared for the fate of your health insurance to be handled by carrier pigeons flying over volcanoes!

Anyway, if you get caught in the unfortunate situation where the Massachusetts Health Connector is threatening to terminate your insurance for nonpayment (when you’ve already paid all your premiums on time), and/or they’ve “restricted” your account without telling you (meaning, you have to pay full cost for your prescriptions) this is what you do to get it fixed in days rather than weeks.

Be Meticulous

First of all, in ALL cases, take down the first name and identifying # of anyone you speak with, whether on your insurer’s side or the Massachusetts Health Connector’s side, and note the time and day you called. If you’re unlucky like me, you may have to call the Connector 32 times, so after that many calls things can get confusing. Most insurers have ID numbers attached to their CSRs, and the Connector does too, though their CSRs will sometimes lie to you and claim they do not. I wish I could recommend recording your phone calls, but since we can’t be certain where the Connector’s or your insurer’s call centers are located, you might run up against two-party consent privacy laws with respect to the recordings.

Make an Ally of Your Insurer

Don’t bother calling the Massachusetts Health Connector directly just yet. Call your insurer and gather all the information they’re aware of. Ask for a supervisor immediately, and demand that the supervisor stay on your case specifically. Explain that the Connector is being intransigent and that you need someone on the insurer’s side to help you get on the case. Confirm that your account has been restricted and verify the dates of enrollment they have on file.

100% of the time, I’ve found that the Massachusetts Connector and the insurer will have a different idea of this, because the Connector is always reporting days or weeks old information to your insurer. This will give you the info you need to keep your story straight in the nightmare you’re about to embark on. While the insurer can’t modify your billing and doesn’t have access to any paper trail of payments you’ve made to the Connector, they can communicate with the Connector’s billing department by email.

Ask them to send a request to the Massachusetts Health Connector’s billing department to review your case, and provide the insurer with any relevant data proving that you’ve made your payments on time. One supervisor I spoke with at my insurer kept insisting that I needed to call the Connector and give them the confirmation number and amount of each on-time premium payment I made, but I was persistent enough to get her to do it for me on the insurer’s side. The Connector’s billing department can’t exactly ignore the insurer, so that’s why we go this route first.

Call the Dreaded Massachusetts Health Connector

Now that you have the insurer on the case, call the Massachusetts Health Connector, choose the Billing option on the robo-menu, and immediately ask for a supervisor. They may tell you there are no supervisors available, or that they can have someone get back to you in 3 days, which is ridiculous. They’re lying. The supervisors are just overworked and don’t want to talk to you. Tell the CSR that you’re willing to wait on the phone however long it takes to talk to someone. They’ll probably want you to explain what your problem is, but don’t bother, because they’re just trying to keep you away from a supervisor, and if you explain your convoluted case to them, it’s just going to get mangled in the game of telephone (if they even explain your problem to the supervisor before they transfer you). Put your phone on speaker and do some other work until they get you someone. Don’t relent.

Once you have a supervisor, explain that you’ve received this termination letter and that you’re disputing it. Explain that you’ve made all your premium payments and can prove it. Give them the dates of all your payments, the confirmations numbers from your bank, and the account IDs you billed them to. If you foolishly used their autopay, give them the dates the money was taken out of your bank (and then promptly turn autopay off! ONLY EVER SEND PAYMENTS MANUALLY TO THE HEALTH CONNECTOR. I use my bank’s autopay to schedule checks to be sent to them, so I can control when money comes out of my account). Ask them to explain why their system is telling them you’re past due and make sure that they write down your explanation for why this is wrong. In my case, on the second go-around this year, the problem was that the billing department was taking months to process a canceled application I submitted during a single day of enrollment in January. That is, whatever system is connected from the website to their billing department is so awful that if you jump into a plan and cancel it, then jump into another plan (all during the open enrollment period), the billing people process each of these events individually, increasing astronomically the possibility of screwing up your enrollment. This meant that they were shuffling me between plans from January to March, all the while demanding payment for the difference between these plans, even though I was never supposed to be enrolled in anything but the one I actually signed up for.

Do not let the Massachusetts Connector initiate any “retro requests,” because that will only make matters worse. The supervisor may insist this is the only way to solve the problem, because it’s the only way they know how to solve the problem. Or, they may also ask you to make the difference in payment, so they can reactivate your insurance now. Don’t do either of these things. If Amazon shipped you an empty box instead of whatever you paid for, would you send them more money before they sent you the actual product? I didn’t think so. Instead, ask them to send all of the information you’ve told them to the billing department for review. Ask the supervisor to re-read what they’re about to send back to you, so they don’t misinterpret anything you’re saying.

Call the Governor’s Constituent Services Office

Finally, this is the all-important step in the process. You are a citizen of the Commonwealth who’s forced to pay for coverage. You paid for coverage, and now because of the State’s technical incompetence, you’re being punished. Doubly punished if you ask me: not only are you being denied the coverage you paid for and that you’re required to pay for as a citizen of the Commonwealth, but you risk being penalized for not having full coverage by year’s end. So this is very much so an issue for the State’s constituent services department. Call the Office of the Governor and you’ll get one of their pleasant phone reps. Don’t use their form—call them. I tried using their form and nothing came of it. When you call, explain simply that you are being denied coverage despite that you’ve made all your premium payments on time, and that you need the restrictions lifted on your insurance immediately. Be polite, and don’t over-explain. The governor’s office will take information from you, and then forward your case down the line.

The end result of this—in the two times I tried it (which, admittedly, isn’t a large sample!)—is that you’ll get a phone call the next day from the Massachusetts Health Connector’s secret “Urgent Care Services” line. As far as I can surmise, the people at this number are a layer of the Connector management that can actually communicate with the billing department, as well as issue requests for technical assistance with the enrollments system. They will immediately lift whatever holds you have while they fix their systems. In the case I described above, it actually required them to make changes to the infrastructure of the system to void out the erroneous enrollment they placed me in. They fixed my problem in two days, in both cases. At the moment, the phone number for this line is 844.558.3454. If you try to call this number directly, however, it may backfire on you as they assign you a “case number” to proceed.

Takeaway

Getting out of Massachusetts Health Connector hell is not easy, but it’s not impossible. You have to talk to the right people, in the right order, as if you’re trapped in some kind of State-mandated insurance version of the horror movie The Cube. Be polite, but firm, like you’re talking to a bunch of airplane pilots who are flying on hallucinogenic drugs. And most importantly: try to keep your story straight. For me, that’s always the hardest part when I venture into the Kafkaesque torments of dealing with labyrinthine customer service.

Rhonda Brockman

Starting in November of 2015, the nightmare began. After receiving a notice from the Health Connector that I could call or apply online, I called and then attempted to apply online. My application was frozen, I then called the Connector and proceeded to go back and forth for days, racking up almost 15 hours on the phone, and going through several reps, all with different stories, I got….nowhere. Each rep would start a new application to fix the problem, which only made it worse. I finally had to go to the local office at 7:30 p.m. and get the problem fixed. Their claim, I had to show proof of identification. I spent one hour in this office, starting a brand new application with a new rep.

We finally had health insurance, but now that my 18 year old son started his co-op job at a bank, he had to call and apply for his own health insurance because he was working. He would still be under me, but he had to apply. He was fine for a year, paying his premiums for dental, and health was covered because he was still in high school.

Forward to Feb of 2016 his premium was increased and he was fine until February, 2017 following my nightmare tax return, and, after the advice of a rep, it was decided that he should come out from underneath me, and get his own health insurance. I cancelled his health insurance and they kicked out several notices of the cancellation. They continued to withdraw the premium which prompted him to call the health connector and ask why they were still withdrawing. They refused to talk to him because he was not the head of the household, and refused to allow him to apply for his own because he was still under my plan.

I then called them back to cancel the plan (again). I was told that his premium would increase to an amount he can’t afford. I mean the kid is fresh out of high school by now and going through saving up for college for the Fall of 2017. I was told he was better off being under me, or basically he would be forced into this policy. Mind you he was not at my house for this phone call, and the rep informed me that Josh (my son) would have to be present to be signed up. Josh comes home calls the connector and proceeds to sign up for the plan he had before I cancelled him. He was told he would pay the same premium and that because they already deducted the money he was covered for April.

Wrong. I received two notices from the Connector informing me that my son was not eligible for the high priced plan because he had been removed from the account. A second notice received on the same day stated that a total of two months for this high priced plan would be due by May 9 or he would be cancelled. A plan that he was not eligible for but being billed for on the same day. Right.

I told my son to leave the notice and reassured him that it was a tech glitch and that the female he had spoken to told him that everything was all set.

On April 26, they took the money out of his account, for a plan, he was not eligible for, and a plan that they put him on without his permission. The plan he signed up for was the standard 2 plan, they put him on a silver plan without his permission. He would not have agreed to a premium that high.

I contacted Health Connector, and was basically told tough shit. They had sent me a bill for monthly premium and that I was lying, even with the evidence in front of my face, I was still lying. If anything they claimed, they would only be responsible for one payment, which they would not refund but credit him on his connector account. If he wanted his money he had to fight them for it. I said I wanted a supervisor, they said that one would call me the following day…..nothing. This caused me to research. I found your blog, and guess what? Another run around. I contacted the governor’s office, left a message with their nice rep, and waited. Nothing. I called the Urgent Care services and come to find out, they had received the request from the gov. and proceeded to put me off with a story of hope. Hope, that by two weeks, the problem would be solved, a refund would be received within two weeks and the problem would be solved. Here’s my number, we are an important department, this case will be fixed right, bla bla bla. I was told I was welcome to call and check on the status of the case at any time.

I would have sat on those two weeks had it not been for the ridiculous notice I received today telling me that my son’s health insurance would begin on June 1. I contacted the rep by her phone number and once again the run around starts. They’re not sure how long it will take because the IT department is handling it, and they don’t know what the IT department does, so I can’t have an approximate time frame. I asked them to at least assure me that a refund was being issued….nope, can’t do that because the IT department hasn’t solved the problem through their many steps that it takes. They can’t tell me now if he’ll receive the refund by the two weeks that was first stated.

I called the gov again, spoke to the same nice rep. I explained that my son had no health insurance and that I was being given the lying run around again. He stuck up for them.

I told him, as a tax paying citizen I have the right to know the step by step process being made with the private information of my son and I. I have the right to know. The connector is a government entity. I have the right to know the steps. He wasn’t sure if I did.

Sorry, but eff them all. My 19 year old is out the money he was saving up towards books for college. This huge, reckless, money grabbing department stole money out a 19 year old college bound kid’s checking account. I hope they’re happy with themselves. From the first rep to the last. None of them give a crap. Deflecting is their main purpose.

How can you force a 19 year to pay for something he never uses? How? Take his money, give him the run around? How? What kind of real world lesson is that? My son can’t even be his own man, because what the hell does a 19 year old know about the ways of a huge far reaching government. I’ll tell you what he’s learning now. No matter what, they own us. And you have to be that disconnected to not give a crap. I’m sorry, I’m mad, and this is a rant. I’m crying cause no one cares. At all.

Sorry for my anger.

Comments on Escaping Health Connector Hell: How to Fix Your Broken Enrollments

Raechel

Hi, going through my own hell here. Did you take or do you know of anyone who took any legal action against the Health Connector? What about recouping doctors’ or dentists’ fees that had to be paid out of pocket while the Health Connector still showed no enrollment (despite the fact that enrollment had taken place and all premiums were paid, all checks cancelled, etc.)? Thank you.

Daniel Quinn

Hi Raechel,

I’m unaware of anyone who’s tried to sue the Health Connector directly. In my case, they had tried to withdraw extra payments from me because of their screwed up billing process, and managed to royally botch the whole situation. I got around this by filing a merchant dispute through my bank and ultimately got a refund that way. In your case, you’re stuck in the middle of the insurance company and the Connector: the Connector is incompetent and will always have your billing wrong (and report the wrong status of your account to your insurer) while the insurer will do nothing until the Connector gets its act together. What I recommend you do is make sure that you have proof that you made payments to the Connector for your premium during the time you got care. That is, make sure you can demonstrate that you sent a check to them (and that they cashed it) for each month during the time you paid those out of pocket fees. This will prove later on that you should have had coverage when you paid those out of pocket fees.

Next, don’t bother trying to dispute it directly with the Connector or your insurer. They won’t help you. Instead, contact constituent services at the Governor’s Office: http://www.mass.gov/governor/constituent-services/contact-governor-office/. I called them before and they were helpful. Tell them you have a dispute with the Connector and that they are refusing to insure you despite that you paid your premium on time, and that you’ve been forced to pay out of pocket for care. This will cause the Connector to get contacted by the Governor’s Office, and they’ll elevate your case to the “Urgent Care” hotline, which is hidden to the rest of us. The phone number is 844.558.3454 (unless they changed it again). Don’t call that line directly though: it may backfire on you. Just wait; as soon as you set up a case with the Governor’s Office, Urgent Care will call you.

The Connector is capable of issuing refunds for premiums, but I don’t know about out of pocket $$ you paid because they didn’t activate your coverage when they were supposed to. Most likely, the insurer will need to refund you. Just make sure you’re working with the Urgent Care hotline and not the main callcenter (1-877-623-6765). The main callcenter is run by Dell employees and they are undertrained and misinformed 50% of the time.

K

Call the governors office right away is the most effective route i have found. The connector would not allow me to wait on hold to speak to anyone and calling the urgent number only got me transferred to the connector that does nothing.

THANK YOU!! For blogging and putting this major issue out there and giving us hope that one day this mess will be sorted out.

Hi K, I’m glad this worked for you!

Christina Babin

Hi Daniel,
First of all, thank you for this. I just hung up with the Governor’s Office. They are reaching out to their contact at the Health Connector. Yay, finally feeling some hope.
I have been dealing with the same issues as you for months now. And promised April 1st my healthcare would be active again. Guess what, its not!!!! And hasn’t been since January 31st!! Such. A. Nightmare. Sadly, I’m happy to know I’m not the only one who has gone through this 🙂 but I’m sorry for everyone’s agony at the same time. The HC sucks. In every way. The hold music sucks too. Anyway, before I start a real rant…THANK YOU for the ideas!
Christina B.

Good work! The governor’s office is the first step to forcing the Health Connector to sort out the mess. They have access to people who aren’t part of the general call center.

Christina

For all of you currently going through this pain, I’m happy to report that I finally have health coverage again! Calling the Governor’s office did the trick. They appointed me a secret agent in the upper level/secret office at the Health Connector, and my coverage was renewed in about 2 weeks. So glad I found Daniel’s article that directed us to do so. Thanks again! I went from Jan 31st – 2nd week of April with no coverage, and was paying monthly through it all. Now that my coverage is back, I am gearing up to start dealing with the next issue, which is getting reimbursed for the months I didn’t have coverage, as well as my overpayments (@$3,000) from last year (due to all the random threatening bills I received – each one a different amount). I’m a little nervous to begin this process as I’m afraid they’ll cut me off again! No one can truly understand this HC torture until they live it, but reading Daniel’s blogs about it pretty much summed it up exactly. I wouldn’t have had the energy to write it all down, but glad someone did. Hours on the phone, call after call, promises, lies, frustration, the insanity of it all. The insanity is almost laughable. Shaking my head.
The more people who contact the Governor’s office, the better! Call!!! They can help!! Good Luck!

I am so glad this worked out for you! Now that you have your insurance reactivated, don’t give up on getting refunded for all the time they refused to provide coverage. Continue to negotiate through the Governor’s office if the HC refuses to help you. Open a separate case if necessary. There is no excuse for them charging you premiums for months they refused service.

Joe

I’ve been using the Health Connector off and on for health and/or dental coverage for about 18 months. I have found they usually do the opposite of what I ask. If I ask them to cancel coverage, they do not cancel it and I continue to receive bills. If I tell them not to cancel coverage, they immediately cancel it. Their answer to everything is “it will take 24 to 48 hours for our system to update.” Yet, days or weeks later, there is no update. After about 10 calls with them trying to solve my first (of several) problems, I finally contacted the Ombudsman and the issue was cleared up in about a week. It’s sad that no one else over there can help.

It’s worse than sad – it’s a disgrace. The Health Connector needs to get its act together because it’s doing a disservice to so many Massachusetts insured.

Amy

Hello everyone. I am sad for everyone that is dealing with these issues, however I am so happy to have found you!!! I am going to start off by saying that as sad as this may sound, The Health Connector absolutely ruined my entire summer last year….I am not kidding! I will begin by saying that I stumbled upon this site, while searching for all of the articles that i am sending to Atty Generals Office to yet again explain what has happened to me, and by the looks of it thousands of others. It’s been almost a year now, however the residuals seem to never disappear! That being said I must finish my research to send to them as much evidence of incompetence as possible. I can imagine that it will not be a difficult task, however if anyone has anything that they wouldn’t mind sharing with me, I will send that in with my evidence. I let it go for a while, but I have been stewing about it, the reason I use Health Connector is because it is the law and because of my income. That being said, I don’t have a lot of money, I have just enough and sometimes not even enough for my monthly bills. So when money is taken without my consent….Bad things happen!
Thank you for any links or anything you can send. I will be writing back with thanks and hopefully we can discuss and get all of this taken care of it. I am sick of them!!!!

The Health Connector strikes again! I wish you the best of luck in your battle with The Beast.

Nightmare is only the beginning of what I’ve been going through with the Healthconnector. Everywhere from no insurance for two months, to 12 applications/case tickets taken out, to a whopping double payment out of the blue.

I’d love to hear your experience. Feel free to leave a rant here for all the world to see!

That is quite the nightmare. I know not everyone has the time or wherewithal to keep playing the Connector’s game, but if I were you I would persist in calling the Governor’s office and filing certified letters attesting to your experience in as great detail as you can, until you get the answers and compensation you deserve.

Marianne

Thank you for posting. I had/have been going through Health Connector HELL since my company closed in September and I lost Private insurance. My situation is a little different as I have a child who is medically disabled and has Mass Health as a secondary. Mass Health had told me they were terminating him so I had him enrolled on the HC with the family. MH decided they would cover him and when I tried to un-enroll him from the HC they un-enrolled the entire family. Now mind you, I have another child who has severe Asthma and now no insurance. Oh, and then they sent me another bill. After several phone calls and a call back from a supervisor (who got short with me) they said they would fix it. Oh boy did they fix it. They went back to when my son was on it and re-enrolled the entire family. Now they messed up my sons MH again. Well needless to say my son ended up going through radiation and was in the hospital for Pneumonia. Because MH does not work with the HC we are now on the hook for thousands of dollars and have been told there is nothing that can be done. We have had to suck it up but want people to be aware of the damage the HC can cause mentally because they have no clue and financially because they have no clue.

Marianne, have you called the Governor’s office? If you have not, you should do that immediately and open a case. Many people here, including me, have had positive results speaking to them. There’s still a chance of forcing the Connector to make things right. Explain your case at length to the office, and also send a certified letter describing everything that happened. You may be surprised how fast things turn around.

john

Sometime in April,2017,Health Connector canceled my Ins. with Tufts for non pymt.. but still got my reg. monthly bill from them in May-June(which I paid & they took the money from my bank account)not saying anything about any cancellation . I found out when I went to CVS to get me prescription in early June,went to pay & CVS said $597.00!! I pulled out my Ins. card,they ran it,told me my Ins. was Terminated for non pymt.. Now out raged, went home contacted Health Connector,told me they canceled it for non pymt., told them, I’m looking at all my bank statements for 2017 & it shows every check you cashed this year(Jan to May), told they would look into it,call back tomorrow. June 16th, I sent my June pymt., with a copy of all the checks they cashed this yr.. from june 19 to july 3,called 5 times,was told I was right(SORRY FOR OUR SCREW UP!!)& just waiting for Tuft’s to sent back a form. I only have a few puffs left on my inhaler,so a day before a Holiday & won’t be able to re fill it, I had to go into emergency mode & restrict all my activities(meaning stay on couch-don’t do any thing-don’t leave the house) til 07/05/2017, when i can re fill my inhaler. Noon time,CVS say’s still Terminated,called HC,got same story,waiting for Tufts to sent form,told them I proved all my pymts.,you screwed up,canceled me for no reason other than your Incompetence to run anything & I can DIE tonight because of you. Agent gave me a # to Tufts to call & see what is holding the form up?? I did call Tufts,looked up my account & told me they haven’t received anything from the HC.(This is 4 wks. of there lying,Incompetence,putting my life in danger,taking my money for Nothing,Ect.), Tufts told me to call them back,ask for a Supervisor & ask Super to send a 203 form to Tufts showing I always paid & Tufts will re instate my policy. This was noon time,called back HC.,told them what Tufts said,was told how sorry they are,you were right,we screwed up but I will go to my Supervisor(right now) with all this info.(on hold), came back & said Supervisor will have it taken care of,wants a contact # from you & will call you later today, gave my #. It’s now 4PM,no call, still not re instated, called back,told Super is not at desk but looking for her,call back tomorrow. Next day,07/06,called back HC., Told by HC, even though we screwed up,canceled your Policy for non pymt. & you proved that we took all the pymts from your bank account, my Supervisor says that it’s HC Policy that any Member who is being re instated because of non pymt. must pay 2 months up front before it can be re instated! F–king kidding me. They screwed up,took my money,making me a prisoner in my own home & now tell me that I have to put up 2 months pymts. or nothing they can do!! No choice for know, I paid the 2 months on the 6th,the 7th,HC took the money out of my account,OK,On the 8th,got to CVS as fast as I could to get my inhaler, still Terminated!! Know on my way to Emergency room(no choice,can’t breath) on 07/08 7PM!!! I’m Lawyer ing Monday, HC. put my life in danger for the past 5 wks. while still taking my money & lying to me like a sucker in those weeks!! I don’t care about getting any money, I want this INCOMPETENT AGENCY OVER HAULED & REPLACED WITH COMPETENT WORKERS!! (NOT SOME POLITICIANS FAMILY,DONORS FAMILY ,FRIEND’S HIRED!!!)

Wow John, this is terrible to hear, but the worst part is that your story seems to be one among many that recounts people being screwed over by the HC’s incompetent billing department.

Please please call the Governor’s office on Monday, and speak with Constituent Services. Tell them that the HC is denying your coverage and your insurer is no help, despite that you’ve paid your premium (OVERPAID, in fact). Also let them know that you are in serious physical danger if they don’t activate your plan so you can get medicine.

The number is here: http://www.mass.gov/governor/constituent-services/contact-governor-office/

Phone: 617.725.4005

The Governor’s office will bypass the HC’s incompetent main call center and work with your insurer and the hidden priority line within the HC.

You can still get those payments back. From what you’ve written here, they owe you the premiums you paid during the months they canceled your insurance, or they have to apply those premiums and any overage to future months. The key in the meantime is to use the Governor’s office to get your plan reactivated.

Also, the supervisor who said you have to pay “2 months up front” for a canceled policy is completely lying. I had my plan (which they had canceled several times) reinstated as soon as I called the Governor’s office. You have to put pressure on them from outside, as the main call center is generally useless when it comes to any sort of timely filing.

caroline

My plan has been a disaster for over a year! It was canceled in January for nonpayment – even though I was on autopayment – and my account switched to a non-subsidized plan.
I then had bills for over 1,000 and called the connector almost EVERY DAY for a month until finally someone credited my account and corrected my insurance. Except the credit was $113 short. So I’ve been carrying a disputed amount due of $113 since April, but otherwise paying my monthly bill on time.
Fast forward to October – I learn in November that the connector canceled my insurance as of Oct 31 for NON PAYMENT OF $113! I’ve now called 8 times, and opened up yet another complaint with the OMBUDS office. They told me I had 2 accounts active (how is this possible) and that I had to pay THREE MONTHS plus the $113 – one for Oct, and Nov. and Dec. up front – which i did just to get my insurance reinstated and I figured I would sort out the credit after the fact. The most important thing to me was having coverage because i had two doctors appointments and prescriptions that need renewing. That check cleared my bank on 11/20. Since then I have called FOUR TIMES and my insurance is still NOT REINSTATED. Every time I request a supervisor and no one ever responds. No one calls back. Just now I called and the person who answered had NEVER HEARD OF THE OMBUDS office. She transferred me to the OPTIM staff person. So, I’ve now OVERPAID through the end of the year, I cant get my prescriptions filled, I had to cancel two doctor’s appointments (one of which took me 6 months to get) and I STILL HAVE NO INSURANCE. And I cant speak to anyone at the connector.

Hi Caroline, I’m very sorry to hear about this. The Connnector doesn’t seem to be doing any better than when I had to deal with it years ago.

My advice is twofold: you say you contacted the Ombudsman, did you contact the governor’s constituent services office (mentioned in this post)? Tell them you paid for your insurance but it’s been deactivated, and they’ll get in touch with people who operate above the call center. Also keep a case open with your insurer, and insist a supervisor there sends a message to the Connector that you can prove you paid your policy and that they need to reactivate it. These two things together made them reactivate my coverage.

Wanita

My son applied for and received a letter in November saying he was approved for health insurance, he suffered a collasped lung right after Xmas and was in the hospital for a week, on his final day he was told his insurance had expired how do you get insurance for a month? After many calls they said they put him in to a plan which has monthly premiums and that he’d receive the package soon, been about 10 days nothing yet and can’t get through to anyone… worse system ever….

Hi Wanita, when you said you applied for / was approved for insurance in November, what time period was the coverage for?

Josephine

While searching for a backdoor to the Hell That Is The Massachusetts Connector I came across this post. Thank you for confirming my experiences with the Connector’s useless CS reps and supervisors. The Connector mistakenly billed me for a 2018 plan into which they had auto-enrolled me that I had cancelled before signing up for and paying for a different plan during open enrollment. They then sent me a termination notice based on non-payment for *both* insurance plans combined, which I was told to ignore as my payment hadn’t yet posted and the “old insurance charge” would be dropped. They then sent a retroactive cancellation based on non-payment of the erroneous invoice (that I was also told to disregard). I’ve been trying to correct this with them as have receipts noting that my premiums were all paid in advance (before statements even cut). I was told by a cs “supervisor” that “if you prepaid then you did not pay when you were supposed to so your coverage was cancelled,” and when asked why my invoice reflected the prepayment by showing a zero balance due I was told “oh, well, the invoices aren’t always right, but we know here on our system whether you owe or not.” Finally, she told me “well, since it’s been 45 days since the original notice it can’t be retroactively reinstated.” I’m beginning to think the connector staff practice incompetence to keep themselves employed – I have spent at least 40 hours of phone time with them over the last 2 year trying to fix their various mistakes. It’s infuriating and laughable at the same time. I will be contacting the Governor’s Constituent Services first thing next week.

Ugh Josephine, sorry to hear that the Health Connector is still hell. It’s sobering to see so many comments over time on this post, which I originally wrote out of frustration.

Please keep us updated about your experience with the Governor’s Constituent Services office. You’re welcome to reference this article and the experiences people have reported here as evidence of the Connector’s longstanding (and often willful) incompetence.

Susan Codero

Hi
I am so relieved that I am not the only one going through the most stressful, frustrating nightmare in years! The article you wrote describes exactly what I have dealt with all week. All the customer service reps are trained to do is transfer calls. My daughter met a woman who works for them and verified that yes, they hang up on people constantly, it’s a joke with alot of them. Often an irate person is ranting about the horrible bs Connector/Mass Health has put them through and the rep who has the call puts it on speaker so all the other morons/customer service asswipes can get a good laugh.
I am going to try to make sure someone in their joke of a bureaucracy, gets outed.

Oh man Susan, I’m not surprised by any of this. At the very least I’m happy my posting has provided an outlet for everyone frustrated by the Connector.

However thank you for confirming my suspicions about the CSRs at the Connector being willfully malicious. I’ve personally experienced that behavior from so-called supervisors over there, so I’m not surprised they do this. I once worked for AAA and some of the reps would do the same thing to frustrated customers. Sometimes it was warranted, I grant, but at least we weren’t dealing with life and death situations like the CSRs at the Connector was, and at least we could be held accountable for our behavior, unlike the Connector’s agents.

I wish you luck in your fight against the Connector!

Sheila

The site won’t let me change my address, won’t let me cancel one insurance without canceling it all, the lead-time they expect for changes made on their end is outrageous, while requiring instant compliance from the policyholder. When calling, I’ve been on hold in 2, 5, and 6 hour spans — and then disconnected!!! When I call back it start over. Yes, I GIVE UP and then get punished for it.

I hear you Sheila, the Connector is the worst. Every few weeks I hear more horror stories demonstrating that they haven’t changed in the least. The only advice I can give is to never surrender! Keep calling, keep documenting. It’s the only thing you can do. Also try all the steps I mention in this article: make the insurer accountable on your behalf by working through them, and not the Connector.

Don

I’m just starting to get into it. I retired in March of 018. I took Cobra Health Coverage which was very expensive and decided to go to the Health Connector office in Worcester to see if I could get a more reasonably cost plan. Because I took a buyout from my company I was not eligible for a plan for 2018.

Since my only income for 2019 will be Social Security and Interest on my investments my monthly income will be very low. So I applied again. This time thru the website. After all this I was approved for eligibility and got a decent plan for a decent price. I then got a letter asking to send proof of income and send back to the Taunton office which I did. I then got another letter about a week later from the Boston office asking for the same information on my income and proof of citizenship? I have ID number and password and was able to make online payment for my plan (before the Dec 23 deadline). Now I’m of course worried that I may not have coverage and can be denied again! I’ve been able to log into the account and periodically check my notices but today (nov 25) I cant log on and I keep getting
“You are not able to log onto this application because you have another active application in our system ”

Very frustrating! Of course I’m going to call them on Monday to see if I can straighten this out. I havent cancelled my Cobra Insurance yet and now I’m afraid to as I don’t want to have any coverage at all. Comments?

Oh boy Don, this is of course worrisome. Have you tried calling the insurer to see what they see in their system? From all my experience (and the experience of people commenting here) the Health Connector’s call center doesn’t have a way to know the “true state” of your application. That is, they only can tell you the last thing they know to have occurred to your application, because they’re bubbled off from any real time information. So what the Connector may tell you may be wrong because their information isn’t up to date. It sounds like they are verifying your eligibility. Have you ever logged into the website prior to when you applied for coverage for 2019? Just want to make sure you’re logging into the correct account. I would first call the insurer and see what state they see your insurance as being in, then call the Connector and compare accounts. Keep your Cobra active until the very last possible day to cancel.

Hi Dan,

Thanks for your comments! In the middle of 018 I did apply when I went to the Worcester office (big waste of time). I realized after I did that there may be two active accounts now. As I knew I was not going to be eligible for help for 018 I decided to wait for November as this was the start of the new enrollment period for 019 so I started from scratch on the website and was able to get thru the whole thing (application). Since beginning of November I’ve logged into the account several times to check my notices and make my first payment etc. but today I get the message as I mentioned in my first post. Not sure why, but I’m planning on calling the office at 8:00 am tomorrow and dig into this. I suspect the old application is still in the system as I was getting letters from Health Connector saying I was not eligible for 018 help and the member ID number was different. As far as the proof documents as it is an actual letter you send to them I think the issue is the taunton office and the boston office are out of sync, At any rate I’ll try to document if I can resolve this and post on your blog to let you and your readers know what I did. As I read all the comments on your website I hope I fair better. I’m starting to regret taking my companies early retirement offer. It really is a great benefit when your company offers you a good health care at a real low price. If I can’t get this straight where I can get a reasonable health care plan at a reasonable cost I may have to go back to work. I’m paying $1540 per month for Cobra(I’m in great health and never used it) and the plan I got from health connector was $408 so I’m crossing my fingers and toes that this is real(i’ve already payed for Jan 019). Sorry for the long winded post.

Thanks,

Wow, $1540!? That’s insane!

I think you’re right about them having two applications. This will most definitely muck up the pipes when it comes to them processing your application. Like you said, I bet they’ve tracking the progress of the old account despite having the physical paperwork from the new one.

Definitely try getting the insurer in on this mess: that is, call the insurance company for whatever plan you applied for (not the Health Connector) before talking to the Connector, to see if they at least have you attached to a plan on their end. The insurer might not even have you in the system at all yet, but it’s worth checking in case it’s been processed by them. Try giving them the member number for both applications, though they should be able to look you up with an SSN. If they have you in the system, force the insurer to communicate with the Connector and explain you already sent your verification. They won’t be able to call the Connector, but they CAN send emails back and forth. You’ll probably need to escalate to a supervisor. This will help you bypass the Connector’s incompetent phone reps.

Great advice!

Finally got this whole thing squared away. Most of the issues I had were with the two applications. Which was self inflicted on my part. Every time I called the Health Connector (at least 6 times) I got thru right away.

My advice to everyone reading this is be paranoid,double check everything and don’t assume after you apply that your all set. In my case I made it more difficult than it had to be with the two applications. I also found thru my many calls with Health Connector is that the people I talked to were nice and really tried to help. I think there are more knowledgeable service reps than others so today I was able to talk to someone who knew my issue and was able to help me (it took an hour but I think I’m all set). As you suggested I called the actual insurance provider before I called today and they did not receive anything yet from Health Connector but told me during open enrollment it may take awhile before they see it on their end.

So in summary. Patience is key. Since I’m retired now I had time to call and be on the phone the multiple hours it took. I think the bottom line is their systems are not designed for human error (the two applications) which spawned many confusing letters from them. But I think I’m all set (until the next ??) At any rate I hope your blog gets more popular as it could be very helpful.

So glad to hear you may have this sorted out!

I also think you’re spot on about their systems not being prepared for human error (or really, anything out of the ordinary).

Keep us posted if anything goes awry!

Erin

Thanks for posting this. Currently living a similar health connector hell-story, so I appreciate the advice on next steps!

Glad to know this post is still helping people out there. Let us know how it goes.

In Hell, Brain Injured DV victim who fled SC in Sept

I am in hell. I do not know where to begin. But HOW do you get the page to LOAD?!!? I can’t even begin ….I have no income, do not drive, I have a relentless cyber pursuer and brain injury. This has surpassed the unthinkable. I have urgent medical needs been going without treatment meds and doctors, now risk losing housing bc of the requirements , it’s sick. NOTHING is working and I mean HELLLLLL , no one touches my story here, as mine is not about payment by me, and I’ve no alternative , I’ve got a tooth broken out, and been here since last year, chronic serious conditions, trying to get my supplement paperwork in, bc need SS and MH Standaed, can’t , I am so overwhelmed and overworked , I fled for healthcare and I’m literally in the worst health possible, I risked all, including never seeing my child again to come here for safety….which began with surprise my dv placement falling through upon arrival, not knowing a soul, and in quarantine for $1000 of my family’s last savings back home, after job loss, I was self employed and qualify for nothing bc of an ex back home wrenching that states system, I’ve never needed assistance in my life, it was dire, it’s only gotten more dire, every agent has lied and failed me, it’s shocking , I’m terrified

Hi there, where is “here” that you’ve gone to? What is “DV” placement? What page are you trying to load?

IN HELL AGAIN,

I didn’t know these “terms” either….and that’s how it’s taken me so long. As I said, I never needed help before.

I came here, with an intake process completed , big deal, to be placed in a (D)omestic (V)iolence shelter (women escaping situations….mine was not typical, I fit no template, but I met the criteria , with a doctors note insisting this was my only recourse to healing.) 1 person I knew. They fell thru as a backup plan. I’d be dead if I didn’t leave when I did. And I’ve had cyber stalking to boot, anticipated Rest. order and address protection here, but nope, not representing yourself with brain injury, those forms didn’t work out well, the stress just as high as this, I’d learn later oh there was help for that too, they just watched me suffer …..back to MH :

Had me on a plan in another region so having it did me no good, left tons of specialists and appts and meds and therapies and now I’ve made a situation for disability look 20x worse going without care so long due to ,H incessant f ups and their inability Or willfulness to keep changing my address back to a place I never was. (That of an advocacy group for my safety…ha!)

DV “placement” or shelter I learned was like, a safety plan of escape, to keep from being homeless upon arrival, yet it’s not much a step up, but I happen to have disabling conditions (which have kept me from being able to do these forms and such) and they have “transitional” programs, no I have no substance or alcohol….I do not fit any template , so I even completed an arts residency somehow in my short stay, wtf.

I thought of Charlie’s office , but I’m so weak now from all this, 4 Covid tests In a month, that’s how great I’m feeling …..all negative but still so much else

I landed …..eventually after so much in the cape. And the town I’m in is so whack. Stg
I’m in a building I had to get 2 sponsors for loans ….just to make it and it’s infested with rats and not cheap, all things considered. Again, I am in hell. But I must agree to certain terms to keep my housing to boot , to computer with this congregate arrangement….was the only shelter avail for months, they almost forced me to Connecticut bc of a shortage, which I’d not have survived.

The site? MH CONNECTOR….oddly today I got in after reading reddit but I got the same error message “you can’t log into application bc you have one open” well I need that to upload my documents ready since sept , which are required for me to keep the emergency aid of loans in anticipation that I will be approved for disability and apply as I agreed…..and things like 10-12 address changes (the same one) , and is required for me to potentially get approved for MH standard which was what I told I got already at sign up bc of the direness of the need and circumstances of health and letters to prove it…..well shocks daily monthly along with the life itself , I’m new here….to only find a “case open” today whatever that means, meds I can’t get, doctors who can’t keep prescribing , pcps I can’t get set up so specialists are impossible and I’ve gone without care so long I’m soooo not well and now have horrible chances at disability bc I haven’t been going to a doctor (tho the ER has sucked-can’t help with anything) , and I have serious chronic conditions past what I’ve stated here, MH told me I had a plan , sent me a letter from the commonwealth on the 17th of sept , had a card , the works, easy brain injury friendly plan …..and that was never true, and there’s 8000 stories like that since sept 1 , these are literal tiny glimpses

It doesn’t help that my building is rat infested and has wreaked hell on my health and if I speak up or get sick which yes, both happened, the way it’s set up is that they can say “it’s no longer a fit, I need more care” and in 48 hours I’m to the curb (just completed move of my stuff with all emergency savings to complete an art residency here I surprisingly got for a few months and only way I’m sane -ish) but this town is …….NOT as expected , no one taking new patients and I can’t seem to just have the right address and a number that’s not picked from the sky …..the MH reps hang up on me the plan reps too and I have limits of support and even printing ability. I have been working miracles with injury and an Apple Pencil to no avail , can’t get a human and an acct online …..I should have lost ALL already bc of the delays and that means all emergency aid also, but COVID gave more time ….but still.,

I’ve needed accommodations for essential services bc vision and brain impairment of a human to sit with me , to no avail, a case mgr, etc. I literally came here to begin a nonprofit on brain injury …..one day, the brain injury Mecca, and even my SHIP application (head injury program) can’t get a reply ….Commonwealth is the common denominator….basically I fled from 2 decades of abuses to continue to have breaches here also and MH is so f’d I can’t even ascertain if it’s a potential safety issue…but there’s been hacks to all my accts back home and here as well, can’t get help getting address protection or much else.

HIGH.lights.✋

Bless you for this

Even if you never reply , you asked. It’s something.
For safety I don’t wish to disclose more detail on this , hoping this helps, my brain is trash right now I should even be up, but was sitting here with 100 papers bc another appt this week impossible, and asking myself if I should give up and go back knowing MH made me cut off all appeals in other state so I’d be back to the no coverage Medicaid gap of full cost and debt that landed me here. And the ex exploiting the injuries to financial ruin.

Nah, I’m okay …..????????

Sorry. ????????????????????????

Hi there, so I’m still not quite sure I understand your current situation: it sounds like you were going to be (or are currently) placed in a domestic violence shelter. Is this shelter the rat-infested apartment in the Cape? Or is this an apartment you secured because you completed an art residency application? It sounds like when you try to update your information in the Connector’s application, it’s telling you that you already have an application open, correct? And that you need to provide documentation so you can be approved for disability. You also write that the Connector claims to have issued you a plan on 9/17.

Start with the insurance provider. If the Connector claims to have issued you a plan, call the insurance provider in that letter you received and ask them if that’s the case, and whether your plan is active/valid. The insurance provider will be able to explain why they can’t activate your plan, or whether it exists. The key here is learning what specifically has your plan disabled, and whether it’s paid to date (I assume in your case you do not have a premium?)

If you’re having trouble updating the online application because you already started one with a different account (and you don’t remember the email address you used/can’t gain access to it), then make copies of all your documents and mail them certified to the Health Connector and your insurance provider, including identifying information (like your SSN and any information you have on your current plan). Once the documents arrive, try to get the Connector to confirm receipt of them. Knowing how incompetent they are, they will likely not be able to confirm anything, though the insurer should be able to. That’s OK, because at least you’ve done your part. After that point, call the Constituent Services office per my blog post above and explain that you’ve provided all the information they required by certified mail and the Connector is still not activating your plan. The gov office is good at following up and getting to the bottom of it, but you’ve got to make sure you’ve given the Connector everything they want first.

Alfred DeAngelis

I got kicked out of health connector for no reason I paid every month and on time and now they ow me a refund and I can’t get it why? This is a nightmare where can I turn to help me

Nancy

I’m in MA Health Connector HELL right NOW!!!!!!! I can’t believe this but thanks for the tips!