Channel 9 investigates gaps in health insurance

CHARLOTTE — Opening medical bills is never fun for anyone but especially for people who owe amounts that sound more like the price of a small home.

In 2010, the Affordable Care Act, also known as Obamacare, forced insurers to cover pre-existing conditions, but when the law took effect, a small number of plans that were active (and have stayed active since) were grandfathered in.

According to the North Carolina Department of Insurance, only about 100 individuals in the state are on plans like that.

Jonathan Floren says he had a heart valve replaced 18 years ago. He was told he’d eventually need to have it done again.

Two years ago, he tried to get coverage through Obamacare, but he couldn’t afford the cost of $1,200 a month, so he got private insurance for $700 a month.

“So I thought it was fine. Well, the day after Christmas 2021, I had to go in for the valve replacement,” Floren said. “Every time they did something, they had me sign something that I would be responsible for if the insurance didn’t cover it.”

Now his bills total more than $178,000.

“They’re very polite, but at the end of the day, I know what’s coming,” Floren said. “They’re going to come for me to take everything that I have.”

If you have private health insurance outside of the Affordable Care Act marketplace or if you work for a small company that’s been around since before 2010, you should check the fine print on your policy to make sure pre-existing conditions are covered.

“It’s your responsibility, I guess, which I didn’t know, to find out if your particular procedure is covered,” Floren said.

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