Is there anything we can do? Debt collector asking for 7k due to Aetna paying before retroactive plan change
tl;dr we got absolutely fucked by switching insurance because an expensive medicine went through the previous insurance–before we had even submitted the paperwork to switch insurance–and retroactively is not covered and they sent it STRAIGHT to a debt collector without contacting us first.
Dec 2022: I get a new job and sign up for Aetna health insurance for me and my spouse My spouse gets prior auth for a very expensive injection medication through Aetna, delivered monthly July 2023: my spouse gets a new job and we compare the BCBS plans to Aetna and decide to switch after I confirm with my HR that this counts as a qualifying life event for me to end our Aetna insurance. However I can't end it without a letter from the new insurance. First week of Aug 2023: Spouse's new job HR doesn't have their stuff together and submits the form with a typo on my name and birthday. I have to wait to get those each fixed before I can get the letter to submit my QLE. Meanwhile their expensive medication gets delivered. I submit the QLE. New insurance starts retroactive to Aug 1. Oct 2023: I get no notice or confirmation from Aetna as to whether or not the QLE went through other than when I log in, it only shows dental now (I kept dental, not medical/pharmacy). Nov 2023: We get a letter from Rawlings Debt Collection that Aetna is collecting 7k from us because they paid for this medicine on Aug 2 and now have discovered that I stopped being covered July 31. We call the specialty pharmacy and ask them to resubmit the claim to the new insurance. They say they'll call us back. Specialty pharmacy calls us back and says it's too long ago to resubmit the claim but they will try something else and call us back. We wait a week+ and call back and again are told they will call us back. No call back. We also have been traveling and very busy with work, thanksgiving so it's very hard to remember and be available during business hours to keep calling. I also did call Aetna and was on the phone with them for ages and they literally couldn't even see this on my account. Today: we get another letter from the debt collector so I am freaking out again
For extra info, BCBS did do the prior auth for the medicine as well and so my spouse is receiving it. But I'm scared that they won't accept this claim because it's dated before the prior auth. I'm also upset because it's mail order so for all we know we ordered it before July 31 but the fill date happened to be Aug 2 and now we're screwed?!
submitted by /u/spherical_cow8
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