Senator Jeff Klein recently helped Jessica Rivera, a Lurting Avenue resident, regain her healthcare coverage through Affinity Health Plan.
Rivera, an Affinity client for two years without any complications, attempted to call this past October to recertify through the marketplace to get the same level of coverage for January 2017.
On that call, she claimed that the NYS marketplace technician entered her income information incorrectly stating she only made $42,000 a year instead of the $52,000 a year she reported to him.
The mistake lowered her family’s annual earnings and made Rivera conditionally eligible for Medicaid because she had not verified her income change.
Once she realized the error, Rivera sent in her correct income information and Medicaid dropped her conditional coverage on November 30.
Rivera is slated to be covered through Affinity starting January 1 and received a $540 credit on her account because she paid her premium despite not being covered in November which can be applied to her first month’s premium in the new year.
What complicated this matter was that Rivera was scheduled for a C-section on December 12 at Einstein Hospital.
She successfully delivered her newborn daughter, Emily Jule Carrero on December 8.
Klein contacted the NYS Department of Health and verified Rivera’s claim.
The senator contacted Affinity’s member services again and spoke to a supervisor who assured him they would work with the state to facilitate this change as soon as possible.
Klein’s office also contacted Einstein to explain Rivera’s situation to which the hospital’s Medicaid representative discussed coverage options with Rivera.
Her insurance is supposed to be re-instated and Rivera will contact Affinity to add her baby to the plan.