A Broken Broker?
I (33M) got a part time job in August 2023 (after a few months of unemployment) and was on Minnestota’s Medical Assistance. So back in April of 2024 I started another new part time job, and I informed Minnesota’s Department of Employment (I think). They informed me that I would have to find new health insurance on my own, which is totally fair and understandable. However the thought of venturing into insurance-land all by myself had me a little stressed out. Therefore I went to an insurance broker (cause I thought that if anyone knew something about insurance it would be them).
Picked a broker from the MNSure website, called him up, and we looked over plans. He told me I would have to go through a third party for one of my medications and I’d have to get a new primary care doc, but that certain plan would be 60 some a month and my therapy and my meds had a 0 dollar copay. I thought it was a pretty good deal! How naïve I was.
I go to pick up a med and it costs $25 which is a lot more than 0, and I call him later to ask him about it and he says that its a tier 2 med which is why it costs more. This is a little frustrating, but I can handle the payment so I go on with my day. Then my therapist informs me that their insurance person is showing that I still owe close to $300. We email back and forth with my insurance broker who is adamant about it costing $0 (and goes so far as to circle the policy’s mental health statement and scan it to an email).
It turns out that the out-of-pocket amount is around $7,000 and the deductible for the policy is around $3,000. Only after I pay the $7,000, does it cost $0 for those services (I believe). Keep in mind that I work as a PCA and for a mental health non-profit, so my paychecks aren’t super impressive. So I’m stuck paying out the ass for anything health related (I finally set up a visit to a new primary care doc and I was informed that the cost estimation is $500, which spurred me to write this).
I’m a single guy who just wants to get by, trying to save a little so I don’t have to live paycheck to paycheck, and I dont know what to do. Is this cause for an appeal to change health insurance plans? Can I take any action against this broker? It makes me angry that he doesn’t have to face any of the consquences, even though he’s the one who signed me up for it in the first place. Is this just a result of my lack of research into the specific plan? I knew healthcare in America was not great, but dear lord, now I really understand why people dont see a doctor for years. Is there anything I can do or am I just screaming into the void? (in either case, thank you for listening)
TL;DR An insurance broker set me up with a shitty plan. Is there anything I can do to fix it?
