Advertisement

17 Responses

  1. Judi
    Judi April 11, 2012 at 7:29 am | | Reply

    Write a letter to your state attorney general and insurance commissioner. Send Aflec’s COO a copy. Usually gets someone’s attention.

  2. David
    David April 11, 2012 at 8:04 am | | Reply

    You have my heartfelt sympathy. And thank you for publicizing AFLAC’s behavior. This isn’t normal even for profit-grabbing insurance industry norms and no one in their right mind should accept it.

  3. Scott Strange
    Scott Strange April 11, 2012 at 8:17 am | | Reply

    That sucks Mike, at this point I’d involve the State Insurance Commissioner (I think that is who regulates Flex accounts anyway) because I do believe they are at least “distorting” the regulations if not outright ignoring them.

    I had a similar occurrence earlier this year when my Flex folks wanted a letter of medical necessity for dexcom sensors. I told them they were req’d a doctor’s prescription to obtain and to show me the statute that let them require information beyond the detailed invoice I had provided. Turns out, what they already has was sufficient…

  4. jb
    jb April 11, 2012 at 8:20 am | | Reply

    I think you should send this article to the New York Times. You should not have to suffer like this. I tried the flex savings one time but it was absolutely too much paperwork. and I didn’t like the monthly fee they charged. TG I didn’t have AFLAC.

  5. Sarah/@smartDpants
    Sarah/@smartDpants April 11, 2012 at 8:58 am | | Reply

    Oh Mike, I’m so sorry for the crap you’re going through. It feels like there’s an even deeper level of evil and frustration b/c it’s YOUR MONEY, right?!? Even higher pile of doo-doo than the “regular” insurance crap. Urgh. I think Scott has a point about contacting your state insurance commissioner’s office–they are supposed to want to hear from consumers who are having problems with coverage/services/companies, and I think your experiences would be right at the top of that list! Also, is there someone at your wife’s employer who coordinates the benefits, and/or who works with an benefits broker to do so, that she/you could ask for help in communicating with the evil duck? I’ve gone that route a few times for various insurance issues before. Brokers have power we individuals do not, at least a little. GOOD LUCK.

  6. Linda
    Linda April 11, 2012 at 10:35 am | | Reply

    We’ve had the same thing happen with Humana. Make a claim and have it denied, and then the original paperwork is lost, and can you re-send ? Over and over to get our flexible spending account money back. The last time, my husband re-faxed the information, and told them if we didn’t get our money right away, the lawyer would be called. That worked!

  7. Kelly Booth
    Kelly Booth April 11, 2012 at 11:02 am | | Reply

    That is crazy. I agree with Scott, contact the State Insurance Commissioner or whoever handles flex accounts. When I had mine, we were allowed certain OTC items and I can see needing something from the doctor that you needed those vitamins but not prescriptions or doctors receipts. I don’t think that there is anything in the flex laws that say they need to know why you were at the doctor. It saying office visit should be all they need to know.

  8. Bill Woods
    Bill Woods April 11, 2012 at 11:09 am | | Reply

    Michael I feel your pain. I tried to convince my insurance company that an insulin pump was a need and not a want. So sad how you have to beg for coverage.

    So sad

  9. k2
    k2 April 11, 2012 at 11:34 am | | Reply

    Mike –
    THAT SUCKS.
    I agree with Scott, contact the State Insurance Commissioner, Also, I’d send your receipts in via certified mail or Fed – So you can find out when they got it and who actually signed for it. It’s such bullsh*t that you have to go through this. You’re doing everything you’re supposed to on your end, and they are dropping the ball in order not to pay your medical expenses.
    Keep up the good fight my friend!

  10. mcityrk
    mcityrk April 11, 2012 at 11:49 am | | Reply

    I’ve always thought that the concept of FSAs was weak at best. Why not put the same money aside in a personal bank account instead of possibly having to fight with insurance morons trying to confiscate what amounts to a savings account???? If a bank did that to you, you would never let them handle a cent of your money again!!

  11. Mike
    Mike April 11, 2012 at 12:25 pm | | Reply

    What a pain in the pancreas!!

    My current fsa is the first time that I don’t need to submit any receipts unless they ask for them. So my doctor’s visits and pharmacy purchases are routine and I never have to submit anything.

    I did have to submit documentation for my eyeglasses, but that was all done virtually and was a piece of sugar-free cake.

    Get with it AFLAC!

  12. victoria
    victoria April 11, 2012 at 1:06 pm | | Reply

    I agree with Scott. Take this higher. This is absolutely absurd. And HIPAA has to fall in here somewhere. Besides, it is YOUR money. And the biggest advantage is that it’s tax free. So if anyone should be upset, it should be the government, not Aflac. But then again, I imagine at the end of May, they get that money of YOURS that YOU don’t get back.

    Seriously, this is absurd! I am so sorry you are going through this. Today, I posted about the ridiculousness of doctors. Healthcare is wonderful when it works. It’s dreadful and nearly useless when it doesn’t.

  13. Terry
    Terry April 11, 2012 at 1:16 pm | | Reply

    Mike – you have demonstrated an unusual amount of patience with Aflac. The Flexible Spending Account is authorized by federal law. It appears to me that Aflac, the FSA administrator, is deliberately making it very difficult for you to claim *your* money! In fact it make me suspicious that Aflac may receive some kind of compensation based on the amount of unclaimed money.

    In addition to contacting your state insurance commissioner, I would find a federal enforcement agent to help you. I know that there is a new federal consumer agency that helps consumers with all manner of things financial. You may even want to contact the constituent services person at your Congress member’s office. This is an outrage!

    I worked for a large international airline before I retired. Their administration was exceptionally good. When a health insurance claim was finalized, a record of it was electronically submitted to the FSA administrator and the money was automatically deposited into my checking account. There were times when the FSA money was deposited in my account before I received the explanation of benefits form!

    I for one would be interested how this all works out for you. Good luck. You should not have to fight for your money!

  14. Andrew
    Andrew April 11, 2012 at 1:26 pm | | Reply

    I actually work for an FSA administrator so maybe I could shed some light.

    First, freezing the card is a rather standard procedure when an expense requires substantiation and it was not received. The IRS requires substantiation on all expenses, but with the debit cards they can have certain auto-substantiation methods that don’t require the physical receipts. When that doesn’t work they’ll typically ask by email for the actual medical documentation, and if not supplied after a certain time,. or the expense was deemed ineligible, the will freeze the card until it is sorted out.

    As far as documentation, the IRS requires certain items on any documentation for reimbursement:
    -Name and address of the service provider
    – Date service/expense was incurred
    – Name of person for whom service/expense was provided
    – Detailed description of the service/expense provided
    -Amount charged for the service
    They also do not allow credit card receipts as sufficient documentation, and that can be murky sometimes what that actually means, even if all the information is available on it. Sometimes it’s necessary for the Merchant to actually draw up by hand a medical invoice that supplies the information, as sometimes they only offer credit card receipts. When in doubt, an Explanation of Benefits from the insurance carrier, if applicable, is always the best form of documentation.

    Most over-the-counter medications and items do actually require a doctor’s prescription to be eligible. This was part of the health care reform law that was passed. Anything diabetic, however, should be exempt and you should be able to use an FSA card or submit for reimbursement without an RX.

    It sounds like your administrator is being very cautious of what is being reimbursed. Ultimately though it is to serve your company and the employees. The risk of having a non-compliant plan reimbursing ineligible expenses could cause the company and their employees to lose their tax-free eligibility retroactive to the beginning of the plan’s first start date!

    In the end, the administrator serves your employer. If there is a discrepancy in reimbursements you should be able to bring it up with your HR Department, who can advise the administrator how to proceed. If you can show your HR Department that these expenses are eligible, they can let the administrator know to reimburse them.

    Hope that helps.

  15. nick
    nick April 11, 2012 at 6:30 pm | | Reply

    This website is the answer to your problems. http://www.Hope4rx.com It has amazing deals on diabetic supplies. I think every single person on this site can benefit from this website.

    My nephew is 9 years old. He has been type 1 diabetic for 4 years now. My sister in law found this website that took their cost from $348 to $69 a month. http://www.Hope4RX.com there is a great deal for diabetic supplies there and a free prescription discount card that saves up to 85% on prescriptions. I saved $90 on my prescription using this card. now that i learned of this website i want to spread the word to the diabetic community.

    Sincerly,

    Nick

  16. Will Miceli
    Will Miceli April 13, 2012 at 12:11 am | | Reply

    Mike – sorry to hear about your troubles with FSAs. Many folks face the documentation challenge in the name of saving money. If you’re interested in a creative solution, take a look at this video (http://www.flexminder.com/how-it-works/), hopefully it will at least make you smile :-) .
    -Will

  17. dargirl
    dargirl June 9, 2012 at 4:53 pm | | Reply

    Tell them you want to talk to the Duck. AFLAC!

Leave a Reply