It’s the law in Massachusetts: You must have health insurance.  But as Hank Philippi Ryan reveals the state’s system set up to help “connect” people with affordable insurance is in critical condition. The result of her investigation: An apology from the state and help for viewers who contacted Hank Investigates begging for help.

The results of her eye exam were terrifying, to save her vision, she needed surgery.

But then this Pembroke resident got more frightening news from her doctor: He said she didn’t have insurance.

Paula: “I was blindsided, literally!”

This Plymouth woman got the same upsetting news after a dentist appointment: No insurance.

Elaine: “I was totally shocked!”

So Elaine couldn’t get dental care. Paula’s surgery was cancelled! But wait, their bank records proved they’d both paid the Massachusetts Health Connector for insurance every month.

You know the Health Connector, the state agency that’s supposed to help get Massachusetts residents their health insurance.

But our investigation found a massive pattern of disconnects at the Health Connector. New Executive Director Louis Gutiherrez admits it.

Hank: “There are some people who think they paid for insurance and don’t have it because your system didn’t work.”
Louis Gutierrez, Executive Director, Massachusetts Health Connector: “Let’s take a for instance…”
Hank: “Yes or no?”
Louis: “That is correct.”

Here’s why. The Health Connector’s website offers online payments.  But we have learned those payments sometimes went into a black hole instead of to the insurance company.

Paula: “That was the most infuriating part, of course, was that I was paying all along.”

Even more infuriating, when Paula and Elaine called customer service in a panic they couldn’t get help!

Elaine: “I have spoken to 24 different people.”

Paula: “I spent, literally, 36 hours on the phone.”

What’s more,  we found thousands of other people couldn’t get help either!  Earlier this year more than 13- thousand customers were stuck in a backlog. They could not get refunds, account changes, or even answers!

Hank: “Did the call center people not know what they were doing? Did the electronic systems not work? Was your database flawed?”
Louis: “Hank, it was everything.”

We got the state to fix Paula’s problem and Elaine’s, too.

And if you’re still waiting for help, the Health Connector’s new boss promises they’ll soon fix your problems too.

Louis: “We owe the public integrity of operations.”
Hank: “Do you owe them an apology?”
Louis: “We owe every single individual who’s experienced extraordinary difficulty this year our regrets for that experience.”

If you’re having difficulties, the Health Connector says they’ve now added a new customer service advocate program.

To contact the Health Connector’s new Ombudsman Office please click here:

https://betterhealthconnector.com/about/contact#contact-ombudsman

 

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