MinnesotaCare dysfunction nearly bankrupted me

MinnesotaCare almost bankrupted me

On March 1st of this year, with no notice, MinnesotaCare dropped my health insurance coverage. Despite their usual passion for sending paper mail to its customers for every trifling reason, before, during and after what happened next, MinnesotaCare never sent anything to alert me about this crucial change. I had to discover it myself, the very hard way.

On March 5th, after ignoring an unpleasant stomach ache for 24 hours, a level-11 pain bomb exploded in my abdomen. Bent in half, I staggered to Hennepin County Medical Center’s (HCMC) emergency room under my own power. After several more hours of the worst pain I’ve experienced in my 47 years of pain-experiencing, my ruptured appendix, so gruesome that even my surgeons were impressed, was removed. (Don’t ignore persistent stomach aches, folks!)

While I was checking out of the hospital the next morning, a man with a clipboard appeared to inquire how I would be paying for my hospital stay. I stared at him, my brain swimming in oxycodone, trying to understand the question. “Health insurance?” I offered. It was then I learned that I had no health insurance and I was on the hook for the full sum of my hospital bill.

The reason I suddenly had upwards of $50,000 in debt, was because it had taken MinnesotaCare 10 weeks to process my health coverage renewal for 2018. Not apply for new coverage, mind you, renew existing coverage. How did this happen? While I would love to share the blow-by-blow of MinnesotaCare’s myriad dysfunctions over the previous 10 weeks, in the interest of space I’ll stick to the broad strokes.

Communication with MinnesotaCare, in the technologically magical year of 2018, is limited to two options: snail mail and fax. None of the renewal process is available digitally, namely a website form, relatively straightforward technology most institutions have enjoyed for going on two decades. If you call MinnesotaCare and ask if you can email your paperwork to them, you will be told that they “don’t have email.”

Relying on a 19th-century form of communication—I wasn’t about to humor them by trying to find a fax machine—wasn’t what took up most of the processing time, however. Based on their own date-stamps, forms I mailed to MinnesotaCare would sit for up to eight business days before being attended to. Processing my paperwork would drag on for up to 14 business days in one case. Even more astonishing, I repeatedly received return snail mail date-stamped from five or six business days earlier, meaning after printing out the communication, the letter sat collecting dust for three or four business days before being dropped in the mail.

I promptly attended to and mailed back their requests for information the same day or the following morning in every instance, partly because I’m a good, rules-following Norwegian-Minnesotan, but also by the time the letter made its way to my mailbox, the deadline for returning their paperwork would only be one or two business days away. Postal date stamps confirm that my mailed materials to MinnesotaCare were almost always delivered overnight only to once again sit untouched for several days.

With insta-bankruptcy looming, I filed two appeals with the Minnesota Department of Human Services (DHS) for retroactive coverage. Despite glaring evidence of MinnesotaCare’s dithering, I was denied. In the eyes of the DHS, my dropped coverage wasn’t due to 10 weeks of old-timey paperwork processing. Instead, I was to blame, because my approval and premium payment letters arrived while I was out of town. They were, incidentally, date-stamped from three business days (four mail delivery days) before I’d departed, but once again they apparently took the scenic route to my mailbox.

[EDIT Nov 9, 2019: With the recent news stories about the breathtaking dysfunction going on at DHS, I feel it’s important to add two pieces of detail I hadn’t included previously. 1) The first person I spoke to at DHS, Nicole Kralik, was so shockingly rude to me on our preliminary phone call, including hanging up on me in mid-question, that I called in a complaint about her conduct. You can only imagine my deflated hopes later when I learned she would be the judge for my appeal. Considering the toxic atmosphere at DHS, I have to assume that her denial of my appeal in the face of overwhelming evidence of fault on the part of MinnesotaCare was influenced by my complaint about her behavior. 2) I did a little digging on Nicole Kralik only to discover that she is both an enthusiastic republican and, apparently, not a fan of social services in general, so my chances of winning the appeal were already pretty slim without my complaint. How a deeply biased, petty person like this is allowed to make judgments on people seeking social services assistance or justice for the incompetence of MinnesotaCare is baffling.]

Those precious few days, when I dared continue living my life while MinnesotaCare did god knows what, led to me submitting my premium payment for the month of March one day late. While virtually everything else at MinnesotaCare transpires at a glacial pace, their billing department seemingly never sleeps. They were at the ready at dawn on the morning of March 1 to terminate my coverage for the entire month. Incidentally, if they’d emailed the premium payment notice, apparently the one and only area in MinnesotaCare where deadlines actually matter, I could have handled it in mere minutes from anywhere in the world on my phone.

Despite diligently, even urgently, appeasing MinnesotaCare’s demands and deadlines, their incompetence and alarming antiquation was going to wipe out my meager savings. Only my poor income in 2017 while I started a new business and the generosity of HCMC’s Financial Assistance office saved me.

My terrifying brush with unearned financial ruin, and the months of emotional ruin that accompanied my appeals to fix this life-changing, bureaucratic fuck-up, seems to be only a blip on the radar of MinnesotaCare’s problems, which in just a few years have included mailing out erroneous coverage termination information to thousands of participants and a fraught accounting system that forced them to eat tens of millions of dollars in unpaid premiums.

Months later, I’m still mildly traumatized and armed with many questions.

  • How many other people have had, or nearly had, their lives turned upside-down by MinnesotaCare’s blundering?
  • Why does paperwork in MinnesotaCare offices sit unattended and later un-mailed for so long?
  • In 2018, is it really not possible for MinnesotaCare to start coverage when they receive a payment, rather than delaying coverage until the first day of the following month?
  • How on earth do they not have email (I think what they meant to say was “we don’t have email addresses that we can share with you”) or, for that matter, much in the way of paperwork processing technology from the current century?
  • And why are their customers penalized for these failings?

Finally, can this be fixed or is Minnesota doomed to limp on with a program that, if it were in the private sector, would go out of business in a matter of months?

For the record, I reached out to the Minneapolis Star Tribune, MinnPost and Minnesota Public Radio about my story. After mulling it over, the Strib declined print a shorter version of this blog post as an opinion piece. And there was just silence from MinnPost and MPR. It seems that a critical social resource this damaged would merit more coverage than just on my semi-deceased blog. Or perhaps that’s just the trauma talking.