Day 70 In Pursuit of ACA Health Care
My spouse started her attempt to replace a sub-standard health insurance policy 70 days ago. She is and was a huge supporter of the ACA compromise legislation as also am/was I. We were both big supporters of single payer, still are, but understand political compromise.
The attempt continues, one week short of the original deadline faced back on October 1, without success. Now, with the extended individual deadline, she’s two weeks away from the last chance for the Holy Grail by Oct. 23 to be insured starting in 2014.The quest has been amazing.
Here are the basic steps taken by my very tech competent spouse. Many, many attempts in the first month to get on the ACA site only to be blockaded by error messages and appeals to try again later.
In November, in addition to trying to get on the site, she added calls to the #800 to her arsenal. Initial round resulted in neither useful nor correct information. I guess she was dealing with newly trained call center people. Example: conflicting info on what exact criterion for income…hers, ours, gross, adjusted, etc. to know qualifications for a subsidy.
Then I resorted to calling/emailing the Delaware Insurance Commission for help. The only help I got in her behalf was a call back from an Insurance Company guy. Hmmm? When the question at that point came to subsidies, he apparently lost interest and didn’t return calls. So, more web site attempts and more #800 calls.
She was elated then by mid-month or so be actually be able to print out an application and snail mail it to the prescribed address. Still no response back. So, finally, close to mid November she got walked through the #800 process, got a rough idea of subsidy, cost and was able to zero in on preferred plan options (only two company choices here in Delaware), which is OK, one non-profit and one profit. Anyway, more calls and more updates by phone that her phone application was not yet approved. The paperwork apparently wound up in some dead letter file.
Eureka, last week, on December 3 she was finally told by the #800 call center that the process was complete and while on the line several attempts were made to forward her paperwork to the selected insurance company. After a long hold on the phone, she was told they thought it “went through” and to give the process three our four days and if she didn’t get a call from the insurance company, call the call center back.
So, here we are on December 9, no call from the insurance company so, she’s going back with the call center today. Wish us luck !
The good news is, if she actually gets the chosen policy by the deadline, her premium will be half what she is paying for the substandard policy. For that we are both very grateful. For the frustration and hassle to get to this point, not so much.
Tags: Featured
If these were the steps through which your “very tech competent” wife had to go, even if it does yield a good result for her, what, I have to wonder, happens to less tech competent — or patient — applicants?
I wonder why you haven’t called a Navigator. I helped my pal in Arizona (and I’m not a Navigator) with a call a couple of weeks back and she got word today that she’s good to go. In Arizona.
Omitted reporting on that step; I called the Christiana Care Navigators after the first week’s attempt to get on online, locally, having read about them in the NJ. Left message for call back. Got none, ever so, moved onto Insurance Commission whom I thought might assist with the Navigator connection. To no avail. Spouse actually got an appt. for a check up with a Christiana Care Clinic, using existing insurance, such as it is. I had read that Navigators were as stymied as consumers because they too were dependent on ACA web site, which was inaccessible.
Good experience with check up for her but no mention by the provider of Navigator assistance available, which we were already in process trying to contact. Notable to me as a healthcare marketing guy that there was not point of purchase materials in their nice waiting room: ie: brochures, posters about ACA. Just the usual outdated magazines.
The good news in all of this seems to be that people that people who really want or really need insurance will get it.
Not to forget the good news for those that have and can afford insurance but still can be driven into bankruptcy, the pre-existing condition issues and lifetime caps go away and their older kids can be covered too. This alone is IMO monumental improvement for the nation.
Happy to report that after calling ACA #800, my spouse learned she was approved; but, their system was down so she was asked to call the Delaware insurance provider she chose to make final arrangements, payment, et al. Sadly, system still glitchy for the ACA employees. So, she called the carrier contact who had ignored her earlier and voila, they will send a bill for the first payment. Good news for us and quite a relief for her to finally have really superior coverage for half the price she had been paying; why a substandard policy before? A pre-existing condition which has now been eliminated thanks to a President and Congress willing to finally step up the game for the people they serve. Proud to be Democrats, but Sebelius? Really? She failed all of us in execution.
Bingo. Can now close out this saga. On the 77th day a snail mail invoice appeared from the Delaware health insurance company my spouse chose ! And it was in the amount expected, about half her previous premium for a substandard policy she bought about 6 years ago after being cut loose by Aetna for a pre-existing condition.
So a happy ending to this story. Thank you President Obama and Nancy Pelosi.
Phew. Merry Christmas and God bless us, every one!
Stan – It would also be polite to thank your fellow tax-payers for helping to subsidize your health care costs. You’re welcome.
If you’re going to complain about subsidizing healthcare for others then there are a load of fat republicans frying oreos down in Sussex who don’t even want to go down the road of taking personal responsibility for their actual health and well-being. They just want to complain about their premiums going up because people with pre-existing diseases/conditions(many of which are no fault of the person) are now eligible to receive healthcare.
Is it really that hard for people to comprehend that no matter what their life circumstances at some point in their life(be it aging, or freak illness) they will be the person “leaching” off of the system while a healthy person shoulders some of their burden?
I started my application October 20th and actually made it through E-sign but there was a system error and I was told “it was impossible for me to get that far” which gave me a rejection for Obamacare . I made the calls to Dover and much if not all my activities are well documented. On December 1 my application was unlocked and I was able to delete and start fresh! I made it all why through and pick a plan, the Bronze Plan with one choice with Coventry Healthcare of Delaware . $548.98 a month with $300.00 healthcare credit to me! so $248.98 monthly payments getting 60% coverage with a $5600.00 yearly cap out of pocket! So no I honestly question how much routine healthcare I can afford but my family is protected from a catastrophic event. Sucks ! The money I sparing used to pay as I go and urgent care with making sure I get generic meds is pretty much gone. Call it 100.00 a month budgeted allowance. On December 1st after success signing up the online message indicated 7-10 for packet in the mail! Well on December 11th none! I was concerned about that first required payment before the end of the month. I called Dover who called Coventry who said it was in the mail and mailed the 3rd of December! Saif I call make a payment over the phone! BS to that! So I called Coventry and was able to make online payment and print a receipt! It did clear the bank! That packet I was to get in 7-10 came on the 16th of December with no bill just a website to go to to review my benefits!. Though may grammar sucks no thanks to cataracts but I am a master at documentation and creating paper trails with others in it! I did ask for all this and prefer to have my career back with was consumed by the recession but at 59 it’s honestly over! Once I start collecting on my small 401K plan the monthly healthcare credit will most-likely end! So my Obamacare will cost me $548.98 a month and for-sure go up each year. Not the American dream I worked for! And there is a chance I might walk away from a marriage of 33 years as not to be a further burden! But I’ll tighten the belt more and more and more! I ‘ll start social security at 62 which was not part of the plan! I am doing everything I can as not to charge an online fee for those who enjoy Kilroy’s Delaware LOL 🙂 not. I’ve been holding off for the eye surgery that was to cost $5000.00 but I am going blind and must get it done with or without Obamacare! If it comes out of pocket , a loan then I can’t make the monthly Obamacare payments! It honestly sucks! I did mu job as an American and worked all my life from the age of 16. Sucks!