Health Link customer frustrated over coverage issues


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Health Link customer frustrated over coverage issues

By Michael Lopardi. CREATED Jul 25, 2014

Las Vegas, NV (KTNV) -- Open enrollment is long over but some customers of Nevada Health Link are still running into trouble.

Christine Davidson of Las Vegas is studying to be a nurse but she's learning a tough lesson in health insurance.

"I've been dealing with it for over two months and it just keeps getting worse and worse," said Davidson.

Davidson said she ran into an error message when she tried to enroll through the health link website in April so she signed up with an agent over the phone. Davidson said the deductible and maximum out of pocket prices quoted by the agent were thousands of dollars higher when she received her insurance card in May.

"On the card, it said my deductible was $2,250. It said my max out of pocket was $6,000," Davidson said, noting the agent quoted her $750 for the deductible and $1,500 for max out of pocket costs.

Davidson said she chose the Anthem Blue Cross Blue Shield plan because she thought her doctors accepted the coverage. Turns out, they did not. She was tired of getting nowhere.

"I've spent hours and hours trying to get it resolved and that's when I decided to contact you guys," Davidson said.

We started digging for answers. Health link spokesman CJ Bawden said insurance companies can't change deductibles after a plan has been purchased meaning an exchange discount, like a cost share reduction, may have been calculated wrong and later corrected or someone may have made a mistake. Davidson has requested the Nevada Division of Insurance look into her case.

Action News also reached out to Anthem Blue Cross Blue Shield. Spokeswoman Joyzelle Davis said in an emailed statement, "Not all providers are participating in all of our networks.  We built a new network, called Pathway X, for our Nevada exchange products." There was likely confusion over which network the doctors were participating in.

Davidson cancelled her previous policy to sign up through the health link and needs coverage for her schooling.

"Thankfully I'm healthy but there's a lot of sick people out there that can't deal with this kind of stuff," Davidson said.

The Nevada Division of Insurance recommends customers with insurance problems reach out to their consumer services office. Experts can investigate cases and help come to a resolution. Complaints can be filed online or over the phone at 702-486-4009. Davidson said she already contacted the office.

Anthem said it offers a list of providers through its website and customers can verify providers by calling the number on the back of their insurance card.