Family With Disabilities Claims They Were Denied Obamacare Coverage

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A woman looks at the HealthCare.gov insurance exchange internet site. (credit: KAREN BLEIER/AFP/Getty Images)

(credit: KAREN BLEIER/AFP/Getty Images)

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For more information about the Affordable Care Act, visit CBSDC.com/ACA.

BANGOR TOWNSHIP, MI (CBS DC) – A family of four, whom all have disabilities, claims they were denied insurance with the Affordable Care Act and will will have to shell out thousands of dollars for medial care.

Ken and Melissa Davert along with their 15-year-old twins Austin and Michaela all suffer from disabilities.  The twins and their mother have a disease which makes their bones extremely fragile called osteogensis imperfecta while Ken has cerebral palsy.

The family says that they’ll be paying nearly $8,000 more per year for medical care after being denied coverage through Obamcare, The Bay City Times reported.  The parents receive their income from Social Security disability payments and also have health insurance through Medicare.

However, the Medicare plan does not cover their children who were covered by a private Blue Cross plan until recently being canceled.  The Michigan Department of Community Health’s Children’s Special Health Care Services covers them through a supplemental plan that only assists in matters concerning their bone disease.

“We received a letter from Blue Cross maybe four months ago stating that their plan was going to be canceled due to new requirements of Obamacare,” Missy Davert told The Bay City Times, adding that the letter did not state what about the Affordable Care Act requirements necessitated her children be dropped from their plan. “I can imagine they didn’t fit criteria of the new plan. There were some particular benefits the new act didn’t cover.”

The Daverts applied to the federal government’s healthcare plan but claim their first application was lost and their second application was denied.  They are waiting for a response to a written appeal they filed in mid January.  The response could take up to 90 days.

“What we did in the meantime, because their insurance was ending Dec. 31, we had to go out and buy a separate plan directly through Blue Cross/Blue Shield,” Melissa Davert explained. “The president had come on TV and said, ‘If you like your plan, you can keep your plan, we won’t require you to get marketplace insurance for another year.’ But Blue Cross/Blue Shield would not continue their plan, despite what the president said.”

In the meantime the family has purchased a Blue Cross Gold Plan for their children.  The out-of-pocket expenses with the new plan are a huge concern for the Daverts.

“The premiums aren’t an issue for us,” Melissa Davert said. “The premiums under both plans are essentially the same. What could be costly for us are the out-of-pocket expenses. In our old plan, the most we would pay was $2,500 combined out-of-pocket per year. With the very best plan we could get them under Blue Cross, we have a $5,100 out-of-pocket maximum for each child for a total of $10,200.”

“That’s the big issue,” Ken Davert added.

“That’s an incredible amount to absorb,” Melissa Davert continued. “The only other plan that had a lower out of pocket maximum was a plan that’s not accepted by their doctors. We would have ended up paying tens of thousands of dollars out of pocket if we would have got that.”

The family has contacted the offices of U.S. Sens. Debbie Stabenow and Carl Levin along with U.S. Rep. Dan Kildee in hopes to receive some assistance from their elected officials.  Mitch Rivard, a spokesman for Kildee, explained that his office is working with the family.

“She’s been working directly with one of our case workers in our Flint office regarding her health insurance being canceled by Blue Cross/Blue Shield,” Rivard said, adding that staff members have been working to help her enroll her children in a new plan.

Rivard said the congressman will meet directly with Melissa Davert sometime next week in a private meeting.

The mother of two said that her family is not eligible for Medicaid due to them coming from a working background, but she tried to re-apply for Obamacare Jan. 15.  She received an “error” message and no coverage.  She just wants to share her story with other Americans about the high costs of insurance coverage.

“We’re coming forward to educate the community, that if these kinds of costs can be imposed on our family, it can be imposed on any family,” Melissa Davert said. “A word of caution is to take notice and if they do think the system is unfair, to speak out.

“It’s frustrating to me. It seems more and more our government has become a controlling power when the power is supposed to be with the people. I’m not saying this law isn’t good for some people. I’m really happy for those people (being helped), and I’m not trying to take away what they’ve gained, but it’s also hurting many people.”

Her husband, who is equally as frustrated, noted that they first trusted the president when he first presented Obamacare to the country.

“We knew this was coming, but we trusted the president when he said, ‘If you like it, you can keep it,’” he said. “That wasn’t the case. We liked our plan, we weren’t planning on changing it, but we were forced to.”

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