After husband dies, Shawnee woman forced to pay hundreds due to health insurance mix-up

Problem Solvers

SHAWNEE, Kan. — Denise Sax has a drawer full of receipts for bills that she knows she should have never had to pay.

“This one is for $126,” Sax said before pointing to another one for $223.

Altogether Sax estimated that she had been overcharged more than $900 since late August. The problem started just days after the worst day in her life: the death of her husband Duane.

“He woke up one Sunday morning and his sugar was so high, we couldn’t get it to go down,” Sax said.

She drove him to the hospital, but minutes after arriving his heart gave out and couldn’t be restarted.

“It just stopped,” Sax said. “He was 58.”

It was two weeks later, while she was still reeling from her husband’s death and trying to figure out how to survive on one income, that she got a new shock.

It happened when she picked up her monthly prescriptions at the drugstore.

“Why are you charging me?” Sax remembered asking after she was told she needed to pay $226. It was for a drug she had stopped paying for months earlier because both she and her husband had met their $7,600 out-of-pocket limit on their family plan.

The pharmacist told her he had to charge her by order of Express Scripts, the company that handles her prescription billing for her health insurance company Cigna.

So she called Express Scripts to find out why. But Express Scripts told her to call Cigna. At Cigna, a customer service agent told her: “I don’t understand either. It says here you’ve met all your deductibles and your out-of-pocket expenses. You should’t have to pay anything.”

Cigna said it would contact Express Scripts (a company Cigna owns) and get the problem resolved. But it never was.

When she finally received an explanation, it wasn’t one that made sense.

She said a customer service agent at Cigna told her that because her husband had died, the portion of money he had paid no longer counted toward her out-of-pocket maximum.

“How can you do that? How can you take away our money, keep the premium I’ve been paying you and make me pay again?”

Sax called the Kansas Department of Insurance for help, but when that didn’t work, she called FOX4 Problem Solvers.

“If they are doing this to me, who else are they doing it to?” Sax asked.

John Carney, with the Center for Practical Bioethics, said health insurance billing problems are not all that unusual after a loved one’s death.

He said a health insurance company will almost always immediately put a freeze on a deceased person’s account. That freeze can, at times, cause problems for anyone else on the same policy. To solve the problem, ask for a supervisor. Don’t deal solely with the customer service agent.

FOX4 Problem Solvers contacted Cigna on Sax’s behalf. Two hours later, Cigna contacted Sax, acknowledging she had been erroneously billed by Express Scripts. It’s sending her a check for more than $900.

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