Anthem says: Here's your health insurance; oops, never mind

Anthem calls a woman, saying she and her son are approved for health insurance, on the same day she gets a letter denying coverage.

Jennifer Frankenberg recently learned that she had been approved to receive much-needed health insurance from Anthem Blue Cross.

She also learned that she'd been denied coverage because of preexisting conditions.

All in the same day.

On one level, this is a fairly routine story of corporate incompetence. But it's also a stark illustration of what's currently wrong with our healthcare system and some of the ways that the healthcare reform law, for all its imperfections, addresses these problems.

"I feel duped, angry and generally kicked around," Frankenberg, 43, of Laguna Hills told me after Anthem raised and then crushed her insurance expectations.

She has every right to feel misused. For the last few years, her family has been paying Anthem at least $1,565 a month for insurance under the COBRA program that temporarily extends coverage for people who lose their jobs. That coverage expired at the end of July.

Frankenberg's husband, Rich, recently turned 65, so he was able to seek shelter in the Medicare system. But Frankenberg had to apply to Anthem in mid-July for a new individual insurance policy for herself and her 10-year-old son.

The company got in touch by phone July 26.

"The woman was very bright and cheerful," Frankenberg recalled. "She said, 'Welcome to Anthem! You and your son have been approved!'"

The service rep went on to say that because Frankenberg's son was born with a brain tumor, which has since gone into remission, his monthly premium would be $356, twice as high as expected. Frankenberg was willing to accept that.

"I was just glad we had insurance," she said.

That same day, though, she received a letter from Anthem notifying her that her own application for coverage had been rejected. The reason: Frankenberg was taking antidepressants and had been treated for uterine fibroids — non-cancerous growths in her uterus.

She contacted the Anthem salesman who originally sold her the insurance policy.

"He looked on his computer and said it showed that I had been approved and that I'd been notified of this by phone," Frankenberg told me. "But he said that a letter had been attached saying that I had been denied.

"He said I shouldn't worry about it. He said Anthem would honor the phone call."

That would be the stand-up thing to do in such a situation. But it's not what Anthem did.

The next day, the same service rep who'd called with the good news that Frankenberg had been approved for coverage called back to say that a mistake had been made. Frankenberg's application had been denied, the rep said, and that was Anthem's final word on the matter.

"She wouldn't explain to me what had happened," Frankenberg said, "and she wouldn't let me speak with a supervisor."

Not only is that a shabby way to treat someone who's been paying you more than $1,565 a month for several years, but it shows a breathtaking coldheartedness considering that, just a few months from now, Anthem won't be able to turn down someone in Frankenberg's position even if it wants to.

Thanks to the Affordable Care Act, a.k.a. Obamacare, insurers won't be able to deny coverage to anyone as of Jan. 1.

Featured Stories

CTnow is using Facebook comments on stories. To comment on articles, sign into Facebook and enter your comment in the field below. Comments will appear in your Facebook News Feed unless you choose otherwise. To report spam or abuse, click the X next to the comment. For guidelines on commenting, click here.



Business Midday Get daily business news sent directly to your inbox for free weekdays at 1 p.m.

After signing in, click on your username at the top left of this screen and then on "My Newsletter Subscriptions."