ST. LOUIS, MO - Steve Radinsky’s confusion started the moment he read a letter he received from Blue Cross Blue Shield of Kansas City regarding his Medicare Part D insurance.
“We determined that you owe $274.56. We are required to attempt to collect the missing copayment amounts. If you cannot pay this amount, we will not cancel your plan or contact you about it again.” read Radinsky from the letter he received.
“I couldn’t understand why I owed money because I’d paid for my deductible and co-pays and there should not be any other charge. That was very confusing to me. I said, do I really owe this? They said they weren’t going to cancel my plan.” added Radinsky.
His confusion became a curiosity, so he called the number on the letter.
“She said nothing will happen to you if you don’t pay it, but it’d be nice if you did pay it. I said well I’ve never heard anything like this,” said Radinsky.
Radinsky says the representative told him that when some drug companies raised their prices for 2017 Blue Cross Blue Shield of Kansas City failed to enter those changes into its billing system. Simply put, Radinsky wasn’t charged more when the price of his prescriptions went up. His insurance company sent this cryptic letter trying to recoup the money he should’ve been charged.
Fox 2's contacted the company to explain this tactic. A representative explained that when overpayment occurs by a Medicare Part D plan, guidelines from the Centers for Medicare & Medicaid Services require the plan to send a notification to the member in an effort to collect payment. But just like Steve’s letter, it was noted that no action will be taken if the payment is not collected.
“I knew when my father ever got a bill when he was older, he paid it. Whatever he saw he paid. And it doesn’t say right there that you don’t have to pay it. It says we just won’t cancel your policy.” said Radinsky.
Due to the confusing nature of this correspondence, Colombo also reached out to the Centers for Medicare & Medicaid Services. A spokesperson told him in situations like this, the insurance company not only has to contact members like Steve Radinsky but also report the overpayment to CMS so it can recover the money from the insurance company. CMS also made it clear that insurance companies can’t cancel a plan for not paying the amount due in these notices.