How Insurance Works

I-Team: Thousands Paid For Health Insurance They Couldn’t Use


NEWS, THE SUN RETURNING AND THE TEMPERATURES WARMING. I LIKE THE SOUND OF THAT. IMAGINE PAYING HUNDREDS OF DOLLARS A MONTH FOR HEALTH INSURANCE THAT YOU CAN’T USE. THE I TEAM HAS LEARNED THIS IS A PAINFUL REALITY FOR THOUSANDS OF PEOPLE IN MASSACHUSETTS AND THIS IS CAUSING MANY TO MAKE DRASTIC DECISIONS ABOUT THEIR HEALTH. SEAN MAYFIELD’S BACKYARD WAS COVERED IN SNOW WHEN SHE FIRST WANTED TO SEE A DOCTOR ABOUT THE PAIN IN HER STOMACH. I NEEDED TO HAVE SAY SCOPE LOOK IN MY STOMACH AND SEE WHAT’S GOING ON AND I COULDN’T HAVE IT DIN. Reporter: PATRICK WENT MONTHS WITHOUT HIGH BLOOD PRESSURE AND ADHD MEDICATION. I HAD TO DROP OUT OF SOME OF MY CLASSES LAST SEMESTER BECAUSE I COULDN’T GET THROUGH THEM WITHOUT MY MEDICATION. Reporter: BOTH WERE INSURED THROUGH THE MASSACHUSETTS HEALTH CONNECTOR,. HOW LONG DID YOU GO WITHOUT INSURANCE WHILE YOU WERE PAYING FOR INSURANCE? EFFECTIVELY THREE MONTHS. I’M PAYING $331 A MONTH. Reporter: YOU HAVE NOT BEEN ABLE TO USE IT AT ALL. I CAN’T USE IT. Reporter: SHAWN BEGAN MAKING CALLS TO THE STATE BACK IN FEBRUARY . SHE TRIED THE HEALTH CONNECTOR, THE ATTORNEY GENERAL AND EVERYONE THE GOVERNOR’S OFFICE — EVEN THE GOVERNOR’S OFFICE. IF THE GOVERNOR’S OFFICE CAN’T GET SOMETHING DONE, WHERE DO I GO? I CALLED CHANNEL 4. Reporter: THE EYE TEAM REACHED OUT AND A FEW WEEKS LATER ACTION SHAWN WAS OFFERED A PARTIAL REFUND OF HER PREMIUMS. WE ALSO LEARNED THE HEALTH CONNECTOR IS DEALING WITH SOME 3,000 SIMILAR CASES. Reporter: LUIS TOOK OVER THE AGENCY THIS YEAR. THE HEALTH CONNECTOR IS JUST, IT’S GOD AWFUL. Reporter: MORE CUSTOMER SERVICE AGENTS ARE BEING ADDED TO HELP SOLVE PROBLEMS. FOR THOSE WHO PAID PREMIUMS FOR INSURANCE THEY COULDN’T USE. WEIER COMMITTED TO A FAIR AND EQUITABLE SETTLEMENT. Reporter: SHAWN WILL NOW FOCUS ON GETTING AN ON PAINTMENT WITH A — APPOINTMENT WITH THE DOCTOR. THIS HAS BEEN VERY STRESSFUL FOR ME. Reporter: THE STATE HAS RESOLVED MOST OF THOSE 3,000 CASES BUT GUTIERREZ SAYS THE AGENCY HAS A LONG WAY TO GO BEFORE


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