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Insurance drops woman over false incarceration

Posted at 10:30 PM, Nov 09, 2015
and last updated 2015-11-09 22:30:50-05

SPRING LAKE, Mich.— A woman from Spring Lake got dropped from her health insurance, and she says the reason is not her fault.

“I am a little worried,” said Nancy Hoffius, 53. "If anything happens to me, I am worried that could be a real problem, so I am just crossing my fingers."

Hoffius said she’s been getting the run around from her insurance company and the Marketplace, with no concrete answers. Hoffius said the Affordable Care Act is supposed to provide accessibility, but she Is seeing anything but that in her current situation. She said the turn of events before she got dropped make for a sketchy situation.

According to her insurance company, Hoffius served hard time in jail for a crime she says she never committed because it never happened.

“They told me I was incarcerated and that I have insurance while I’m in jail, so they took my insurance away from me.”

Hoffius said she told the insurance company she’s never had a run in with the law, but that didn’t seem to matter.

“We just argued on the phone for a while, and finally I was given an address to send proof, like current utility bills, to prove that I was not incarcerated.”

This wasn’t the first time they accused Hoffius of being a jail bird, it’s the second.

“Now I want to know how they got the information or how they got any information on how I was incarcerated, so I could get to the bottom of it.”

The Marketplace and the insurance company would not disclose how and where they got information that she was incarcerated. She found out the insurance companies thought she was incarcerated when picking up her prescriptions in March and then again in July. The pharmacies turned her away for having no coverage, so she called her insurance company, only to find out they thought she was in jail.

“I have laughed about it, although it has been somewhat embarrassing, too, to go to the store, and you are constantly being turned down.”

After Hoffius sent in proof she was not behind bars, she received a letter  from the insurance company that said they realized she was not behind bars and they were reinstating her insurance. The letter also indicated no further action was required.

“Then I went to use it again a month or two later, and again I was denied.”

Hoffius said the Marketplace refused to give a reason she was dropped. FOX 17 News asked them for comment, but they declined.

“Well, they said I hadn’t paid in a few months, but the fact is I never received a bill, because my account was frozen because I didn’t have insurance at the time. I received no bills, so I made no payments, until I cleared up the incarceration issue.”

Since 2014, Congressman Bill Huizenga’s office has received about 50 complaints from people who were dropped from their insurance. Most people hit red tape if they were enrolled incorrectly, rates change without notification, or other circumstances. The problem is once a person is dropped by an insurance company, as happened to Hoffius, in some circumstances you pay the price, even if it's not your fault.

Hoffius asked the insurance representative if she will be penalized for not having insurance. The representative told her she was sorry but Hoffius will be penalized, Hoffius said.

Hoffius is trying to get help from the Huizenga's office, but she knows that’s a steep hill to climb. The congressman’s office has reached out to Hoffius, but is in their vetting process to see whether they can help.