Eagle Mountain, Utah (CBS DC) — A family covered under insurance through the Affordable Care Act received a surprise bill for their kindergartner son’s immunizations, with the company responding that her health insurance had been changed back to her old plan that does not cover the shots.
Rachel Miller says that her insurance company, Humana, refused to pay for her son Chase’s immunization shots despite the guaranteed coverage her family has received from the company since her 2010 switch to the Affordable Care Act plan, KUTV reports. However, the company says that the plan was switched last September, and they no longer are required to pay for the $200 bill.
“I was quite surprised when I got the notice from the insurance company saying they’re not going to cover it,” Miller tells KUTV. “[The insurance company] has paid them in the past. My plan was supposed to be under the [Affordable Care Act] where they’re required to pay those.”
And according to the federal Health and Human Services Department, she is correct.
“[C]hildren…that are enrolled in new group or individual private health plans will be eligible to receive vaccines without any cost-sharing requirements,” reads the website.
Under the Affordable Care Act, also called Obamacare, insurance companies are required to “provide notice” of any changes within 60 days – failure on the insurance provider’s part is against the law.
But after spending hours on the phone with Humana, she found out that her insurance had been unknowingly switched from the protections guaranteed under the ACA laws.
“They changed my plan without telling me,” says Miller. “I want them to pay the doctor bill. I think they should have to because I was never notified that my plan had changed.”
Humana’s media relations department, West Region, was contacted by KUTV, who deflected questions due to “federal privacy laws.” Next, armed with Miller’s personal signature of consent, the company then refused to comment on the matter.
However, Miller did hear back from Humana shortly after the inquiry, and they agreed to make a “one-time exception” to cover her son Chase’s 2014 immunizations – but nothing more in the future.
Miller says that this is not good enough, and her family has decided to take their health insurance plan to another company.