We the Patients

Mrs. Wilson’s $100k Horror

In the summer of 2020, Mrs. Wilson was at her Staten Island home battling an active COVID infection when she heard a knock at the door.

 Northwell Health was suing her for $100,000.

Three years prior, Mrs. Wilson started receiving care she needed to manage her chronic condition. Working in administrative services for the city of New York and living with a disability, she was well-equipped with three forms of insurance – United Healthcare from her husband’s employer, Medicare for her disability and Emblem Health from her retirement plan. In total, Mrs. Wilson and her husband were paying over $400 per pay period for insurance. That’s $800 per month.

Despite what she thought was ample coverage, medical bill after medical bill started arriving in the coming weeks and months of 2018, each in its own thick FedEx envelope. Mrs. Wilson’s three forms of insurance couldn’t coordinate with one another to cover her care, resulting in a mess of errors and unpaid bills. During our Zoom interview, the Wilsons hauled over the cardboard box where they kept the stacks of envelopes – it was overflowing. “Insurance is great,” Mrs. Wilson said. “Until you need it.”

A master of coordinating events for friends and family, Mrs. Wilson tried to tackle the issue by getting the three insurers on the phone. However, this quickly became a frustrating and burdensome process. “You’re sick and trying to get better, and you get these phone calls and letters in the mail. It brings back all the stress and pain that you’re already going through.”

Making matters worse, Mrs. Wilson found herself avoiding getting much-needed care for fear of piling on additional bills. “It’s adding up and adding up, I keep accumulating bills. That’s the primary reason I stopped going to the doctor.” Instead, she turned to home remedies and simply “dealing with the pain.”

After making payment arrangements with her doctors and believing the problem to be resolved, Mrs. Wilson entered a panic when she learned Northwell was suing for $100,000 in unpaid medical bills two years later. At this point, Mrs. Wilson was avoiding the health system altogether while struggling to overcome COVID-19 at home. As she was now retired and on a fixed income of social security disability payments, having to pay Northwell $100,000 would be life-altering. “You think you’re going to lose your home and everything you worked hard for.”

Luckily, Mrs. Wilson  had an expert in these cases on speed dial: her daughter Nakia, a manager at Community Health Advocates. Nakia connected Mrs. Wilson with the guidance she needed to get the lawsuit dropped, which required the extraordinary measure of contacting the Attorney General’s office.

No longer facing the fear of a lawsuit and recovered from COVID-19, Mrs. Wilson has one final battle to fight: repairing her damaged credit score. Even after her three-year ordeal, a few of Mrs. Wilson’s providers still have not received the payments that they should have from insurance. In the meantime, Mrs. Wilson could face higher interest rates and other additional challenges due to poor credit.

“I am an advocate.” Mrs. Wilson said. “I learned to never give up, because things can change.” With the lawsuit behind her, she was looking forward to spending time with family and friends rather than pouring time and energy into wrangling her insurance representatives. As of today, she is still fighting with the insurance to cover the claims but hopes she is closer to having the situation resolved.

To other patients facing a similar horror, she says, “There are advocates out there who can help. Do your research, don’t give up, fight for your rights. Fight through your pain and frustration.”

Have a story to share about your health care experience? Contact us at wethepatients@cssny.org.

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