Blue Cross Blue Shield, Blue in the Face Over Health Insurance

ABC News Fixer sorts out frustrating insurance mix-up.

Feb. 4, 2014 — -- Dear ABC News Fixer: I purchased insurance through my state health insurance marketplace with Blue Cross Blue Shield of Illinois.

At first, I was going to apply $250 of my subsidy credit and have a premium of $345 – but I later called back to change it and use the entire $286 subsidy, making my premium $309.

Everything seemed all right until I received a billing statement saying I owe $345. I called, and the BCBS rep told me to just send a check for $309 and attach a note explaining that I decided to use my whole subsidy. I did that, and BCBS cashed my check.

Meanwhile, I tried to get my medication, and the pharmacy told me I'm not covered. I called BCBS and they were able to get the pharmacy to supply my medication. But one month later, I am back where I started – BCBS says I never paid them the $345 I don't owe, and the pharmacy doesn't think I'm covered.

I have called several times and can't fix this. The buck keeps getting passed around. Help me. I work three part-time jobs and cannot spend hours on the phone every day.

- Renate Galgano, Niles, Ill.

Got a consumer problem? The ABC News Fixer may be able to help. Click here to submit your problem online. Letters are edited for length and clarity.

Dear Renate: Clearly, you needed to put a stop to this, and with the help of a Blue Cross Blue Shield of Illinois spokeswoman, we were able to get you on the right track.

Spokeswoman Mary Ann Schultz was able to first get you reinstated in the Prime Prescription program so you could get your medication. So that's fixed for now.

As for the problem with your premium, BCBS told us it hadn't yet received your updated subsidy amount from the Department of Health and Human Services. The most recent amount they'd received was $250, paid by HHS on Jan. 21, Schultz said. They've put you in touch with a caseworker and expect to have the numbers fixed soon; you were told it would take about 30 days. Let us know if you hit any more snags.

As for other consumers who qualify for health insurance subsidies available to people with incomes at 100 to 400 percent of the federal poverty level (currently $11,490 to $45,960 for an individual), whether you want to use your entire subsidy up front may depend on what you expect your income to be this year. If you earn more money than expected, you may have to repay some of the subsidy at tax time.

The Kaiser Family Foundation has an online subsidy calculator here. For general info, check out

- The ABC News Fixer

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