Healthcare.gov Customer Service – Think Edge of Tomorrow/Judgement Day

So almost two months ago now, I got a letter from Healthcare.gov advising me that I needed to verify income.  Sad, when one is unemployed, but a hoop one is willing to jump through when suckling off the government milk jug.  Supposedly, said information could be submitted online, but we could never figure out how to do it.  But being compliant citizens in need of insurance, we made a copy of the letter, along with copies of all the related proof of non-income and mailed it into the address provided on their letter.

Case closed right?  Nope. Only just beginning.

Toward the end of September we received a letter the Healthcare.gov advising that they received information from us, but unfortunately “life event changes” may not be made by mail and must be transacted online.  Life Event Change?  Huh? I didn’t make no stinking Life Event Change.  So they got my info…but put it in the wrong place.  No worries, just ignore until further notice; a strategy successful for about a week.

Last Friday night at about 7:00 p.m., in the middle of dinner no less, the phone rings and it’s my friends at Healthcare.gov  advising that they need my income info.  Oh boy, here we go.  We explained that the government clearly received our information based on the letter they sent us and asked the representative if they would track it down.  Nope, the customer service (hah) rep can’t touch that and refers us back to the 1-800 customer service # so we can speak with someone who can help us.

Called that # today and did a repeat of the call last Friday night.  It’s an “amazing” infinite loop.  They want us to send in all the information again because danged if they are going to try to hunt anything down from their end.  They made note in the file that we had called in and supposedly we will not put our insurance at risk.  I think the enrollment period for next year is in about a month, so my strategy now is to roll my eyes a few times, ignore their harassment and absolute incompetency, and hope the problem either goes away.  Or maybe the paper work that I sent in finds its proper home.

Have you been to the netherworld of Healthcare.gov?  It’s starting to make me feel like I am in Tom Cruise’s fantasy world, but without the payout.

CONGRATULATIONS. You qualify for a $3 Obamacare Tax Credit.

 

So this past Monday (that would be April 28, 2014 for future readers), I decided not to put my trust in the supposed case worker assigned to review my Obamacare enrollment application. As of this posting, it has been over a week since I was supposedly assigned to my case worker, but have received no acknowledgement and have no clue if I have a case worker or if Priscilla was blowing smoke.

Anyway, I girded by loins, went back into my application, under the premise of updating my income and re-enrolled. Once again, some of my information was saved and some not. I am guessing the data input took a half an hour or so. Anyway, after putting all the same information back into the system…. again…. for the fourth time…., I nearly fell out of my chair when it actually said I was qualified to enroll. Furthermore, my unemployed family is entitled to a $3 per month subsidy which would lower the monthly premium on the cheapest plan to $738 per month BUT…. it only has a $12,600 deductible/out of pocket max.

So annualized if you add my premiums to my maximum out of pocket, I will have to spend $21,456 before I get real relief. Is this affordable healthcare? In fairness, one does get the benefit of the insurance companies’ negotiated rates with healthcare providers, but one must become very sick and in my case very broke, before getting any relief.

I want to mention once again that at the end of 2012 I was on an individual insurance plan with Humana. The premium for my high deductible health plan was $300 per month and my max out of pocket was $10,400. My total annual exposure was $14,000 (total annual premium plus maximum out of pocket).

So what does all this mean? It means I am going to step back and assess my options off the exchange, take a break from this nonsense and then try again.

Perhaps Obamacare Should Be Called Obamadon’tgivarip?

I find it mildly humorous and mildly disturbing that President Obama is doubling down on his rhetoric regarding the 8 million enrollments into Obamadon’tgivarip, aka Obamacare.  This in light of my personal experience so far with the Affordable Care Act (ACA).

So this morning I began round four with the actually nice, hugely apologetic, and functionally impotent folks at healthcare.gov.  My mission was to speak with a real person and try to understand why, despite the fact that I am recently unemployed, I am not actually eligible to enroll in Obamadon’tgivarip.  I am becoming a bit cynical, but not wholly unobjective.  This on the heels of my failed third attempt to enroll.

I did speak with a live human; two in fact.  First with Robert, who looked at my eligibility letter and confirmed that it said…what it said, and who then transferred me to Priscilla.  Priscilla in turn confirmed that the letter said….what it said and ultimately could not help me.  Turns out neither Robert nor Priscilla could actually look at my application.  There neither could not begin to help me troubleshoot my application, which, as previously noted says I am both eligible and ineligible to purchase through the Marketplace.  After Priscilla asked me a bunch of questions, including whether I was recently unemployed and on what date, she said she would refer me to a case worker who would review my file and would be “in touch.”

She could not tell me when my file would be reviewed (wouldn’t even venture an estimate when asked) or if I would be notified by phone or email.

Here’s the rub, the clock is ticking on my 60 day window  (but it is more like 45 if I don’t want a coverage gap in June) to enroll for healthcare on the marketplace which should be possible from the date I lost my job.  I can COBRA if I have too to the tune of $927 per month, which for a guy with no income at the moment is not a sustainable value proposition.

So, for the moment I look for employment and wait for the next chapter of my healthcare.gov story to unfold.

As an aside, if you look at the bottom right hand corner of healthcare.gov there is a logo depicting The White House and a website called USA.gov with the slogan “Government Made Easy” under it.  I have no clue what USA.gov’s role is in the Marketplace, but if it is to make it “Easy” they are getting an F- in my book.

Obamacare – Welcome To The Land Of The Lost

Apparently I am both eligible to purchase health coverage through the Marketplace and I am also ineligible. At least that is what my eligibility letter says…

So last Friday I went through the online enrollment process…online….again. If you want the history of my first two attempts read my previous post. Friday was attempt #3.

I spent 1.5 hours re-applying/re-enrolling, ultimately to be told on my eligibility letter that (and I am paraphrasing here) while I am eligible to purchase health coverage through the Marketplace, I cannot enroll at this time. So in effect, I am NOT eligible (although I actually am) to get coverage. Can you see why this might be confusing and perhaps frustrating?

During the course of attempting to complete my application, I was booted off the site four separate times. Each time I was kicked off, I had to go back and re-enter various bits of information which were not saved prior to me being disconnected. I should mention, because there are four members in my family, I had to answer most every question 4 times….over….and over…..and over again.

I fought the healthcare.gov website for 1.5 hours and was then dismissed. You can pick your own colorful adjectives for the word “dismissed” and you will probably have a sense of how I felt I was being treated. Rejected if you will.

I should note, that during the process a tree fell on a power line down the street, and I completed the application using my mobile hot spot. I was determined to succeed.

WRONG! I think it was divine intervention that the tree fell on the power lines, because the power was knocked out for 5 hours and by 7:00 Friday night, I knew I had until Monday to cool off from my rejection.

In the meantime I am sitting here wondering if anyone is actually benefitting from Obamacare, if the government is counting all 3 of my applications as enrollments, what the heck I put on my application that caused the rejection, if this will ever be resolved, and why exactly am being forced to waste my time mucking around with this when my time would be better spent trying to gain employment with a friggin’ health plan.

“If This Does Not Work, I Can’t Tell You What To Do”

These are not the words of comfort you want to hear from the enrollment specialist after trying for three hours to enroll in the Federal Health Insurance Marketplace.

After receiving the panic inducing quotes from my insurance broker, she recommended my wife and I come into her office. This way we could go onto the Exchange together, and we could explore our options on the fly. The fact that I had to enlist the expertise of a broker might suggest that attempting to sort out individual insurance in the era of Obamacare/ACA alone, may not be a good idea for the average bear.

Prior to my meeting, I went on the Exchange and created an account. I didn’t want to create an account because all I wanted to do at that moment was research, not enroll. Unfortunately, after the general enrollment deadline on March 31, I could not find the tools I had used prior to the deadline to research plans and estimate costs. If they are still there, I could not find them. Perhaps they figure individuals experiencing death, divorce, or loss of job don’t really need the tools. This smacks of the Nancy Pelosi comment years ago when she basically said we had to pass the ACA and then we would figure out what was actually in it. Enroll first, then we can tell you what you are enrolling in….

Anyway I did not complete my first enrollment because ½ way through the process they asked for my broker’s agent ID number, which, not surprisingly, I did not have at my disposal.

Yesterday, when I tried to log in….over and over and over again unsuccessfully, I finally threw in the towel. I started the entire process from the beginning and amazingly it allowed me to re-use the same user name and password as I had the first time, and then it let me go through the process.

After two hours later, the system was telling me my daughter could be eligible for catastrophic insurance, my wife and I could be eligible for Medicaid, and my son could be dumped onto the state CHIP (Medicaid for kids) plan. Well this recommendation was patently absurd because I had included my income for year to date plus expected unemployment insurance and neither my wife nor I are disabled.

After failing online, my wife, our broker and I called the healthcare.gov customer service number and spoke to a nice man named Nathan. Nathan informed us that he could flush our application from the system and then we could wait 24 hours for it to re-set and try again online, or he could re-enroll us by phone, which he estimated would take another 20 minutes.

At the end of an hour with Nathan, he informed us my daughter could be eligible for catastrophic insurance, my wife and I could be eligible for Medicaid, and my son could be dumped onto the state CHIP (Medicaid for kids) plan. Sound familiar?

Our hypothesis relates to a single question on the enrollment form, which asks if you had any income “this month.” Being unemployed and not yet receiving unemployment, the answer was $0. Apparently, the system is having trouble reconciling the estimated income for the year with a single month of no income. Nathan could change the monthly income figure from zero to one twelfth of the estimated annual income, but the system could not handle it…….neither could Nathan….neither could I….nor my wife…nor our broker.

Because my broker had already wasted 3 hours and I had now spent 3 hours not looking for employment, we all decided to go to neutral corners. And yes, during the course of the conversation Nathan said, “If this doesn’t work, I can’t tell you what to do.”

He offered to trash the second enrollment application and start over, but we really had to get on with our day.

We decided to let healthcare.gov rest for 24 hours before we would try it again.

Stay tuned for more personal adventures of the “Affordable Care Act.”

Shock in my Jock. What Obamacare is Doing to Me. Survey Says…It’s Twisted Sister

This blog is like an old friend, and it’s been a long time since I spent any time with it/him/her. But friends are forgiving, right?

So where have I been and why should you care?? I am about to come off a magical ride back into corporate America after the years I spent as an entrepreneur in the HSA/HDHP space which answers the “Where” question. And if you are still reading at this point, the answer to the more important “Why” question? Well, I am back into the individual health insurance market right after the crunch of the enrollment deadline for the “Affordable Care Act.

As I wade through the morass (I like that word, morass, because I can use the word “ass” with no shame. If I can figure out how to use the word “assassin” in this article I will use it as it is one of my favorites, and I will let you figure out why) a classic line from my favorite Billy Joe Shaver song, “Georgia on a Fast Train” races out at me.

 “I Got a good Christian raisin’ and an eighth grade education, Ain’t no need in y’all a treatin’ me this way”

WARNING: I FEEL A RATHER LONG ARTICLE COMING ON SO HERE COMES THE PUNCHLINE IF YOU WANT TO BAIL.

On one hand our government is treating us like we are absolute idiots and assuming (there’s that word again) they have got it all figured out for us. On the other hand, they can’t figure out how to explain it to us. Who is the idiot here? Here’s a thought for our supreme leader and his party; Please respect our eighth grade educations.

If one has to have a master’s degree in healthcare policy, administration, and insurance to figure this thing out, how’s does one suppose the rest of us are going to do it?

This is quite a pre-ramble to my own personal story, but a bit of ranting and complaining is always good for the creative juices, so thanks for bearing with me. You may find some similarities to your own situation here.

First item, I am learning a lot by being forced into this process. However, unlike the last time I was in the individual insurance market and was able to figure it out myself, this go round, after my initial plunge, I have had to turn it over to an insurance broker.

Until January 2013, I had an HDHP through Humana (Humana One) which was a bare bones policy with a $10,400 deductible for my family and no drug benefits. It did cover physicals for the family. I paid $310 per month for that policy. When I went back into Corporate America I continued with their HDHP/HSA group option.

Today, from a broker, I received quotes both on and off the Federal Exchange. It should be noted that I have been RIF’ed from my job, and that is why I am being forced to sort this out. I have been out of the individual market for exactly one year, and if I purchase the cheapest HSA qualified HDHP the premium will be $778 per month. So, the “Affordable Care Act” for me represents a $151% premium increase and a $1,600 increase in my deductible. I do get “mental health” coverage, which, after writing this blog I might need in order to address with my budding insanity or inevitable substance abuse treatment resulting from my looming poverty.

If I elect to go off the exchange, the broker found me a high deductible health plan similar from Assurant Health with benefits similar to the on exchange plan, but the premium is $946 per month. I can go COBRA which until I started doing my research was going to be my worst option, but it is actually $18 less per month that the Assurant plan and the deductible is 47% less.

So now I am trying to figure out what my subsidy from my fellow tax payers will be if I go on the Exchange. But here are the things that have me scratching my head.   First, the less I work, the more affordable my healthcare becomes. Second, the government is happy to give me subsidies for something I don’t want (their plan) but won’t give me subsidies for something I do want (my former employer’s COBRA plan). Third, why is it that a year ago I could afford to cover 100% of my family’s healthcare insurance needs, but now, based on my expected income, the Government, if I go through the Exchange it is trying to force me to put my child on the state CHIP/Medicaid program? Fourth, why should any person, driven to purchase insurance through the exchange, expect a health care product equal to or better than what our veterans receive? Fifth, how did my 7.1 million fellow Americans who elected to go through a government exchange figure out what insurance made sense for them and for what % of them is their healthcare more affordable?

To be continued, because….after beginning this article 2 weeks ago, the saga goes on…

Two Words…Flu Snot

Seriously,  If I had said Flu “Shot” would you have given it a second look?  The idea of a blog about snot is more intriguing.  My only tip there is, if you have a river of snot running cold, remember to empty your pockets before throwing your pants in the washer or you will have a ticker tape parade of snot free Kleenex crumbs all over your clothes when they come out of the dryer.  But I digress…

 …Last night I rolled into my local CVS pharmacy and got my annual flu shot….for “free”.  And it didn’t even hurt.

Even if you’ve never read this blog, it should be no surprise that I have a high deductible health plan.  I am also one of the thriftiest people I know.  My HDHP provides annual physicals for my family so the bulk of our well care is covered.  Pretty much all our other health expenses, I cover at 100%.  But remember, the 100% I cover is paid at the Humana negotiated rate.

Anyway, about the “free” flu shot, last year, on a whim I asked the pharmacy if my insurance plan would cover my shot.  After what appeared to be a 10 minute love affair with the computer, my pharmacist advised me that it was covered at 100%.  I rolled up my sleeve, then wandered down to the cosmetic aisle, and advised my wife of our good fortune, and she rolled up her sleeve.  We then proceeded to go pick up my son from his job, and shared the good news with him, although he did not see it as good news at all and was pretty much pissed at us for the rest of the day.  We called our daughter and told her about her special plans for the afternoon and to saddle on over to the drug store and share in the fun.  She whined and complained and then complied.

At $25 a shot, we saved $100 and avoided the flu.  I haven’t gotten the rest of the family to get their shots yet, but how can they resist?  It’s a total friggin’ no brainer.

So there are a few points to be made here.  First, if you don’t have health insurance, even a modest plan like my HDHP will enable you to purchase medical services at a discount.  Basically you get the negotiated purchasing power of your insurance company, if you shop right you can, through an HDHP get coverage for your well-care (annual physical), and as an added bonus, you might even get your annual flu shots for free!

Last night I rolled into my local CVS pharmacy and got my annual flu shot….for “free”.  And it didn’t even hurt.

Even if you’ve never read this blog, it should be no surprise that I have a high deductible health plan.  I am also one of the thriftiest people I know.  My HDHP provides annual physicals for my family so the bulk of our well care is covered.  Pretty much all our other health expenses, I cover at 100%.  But remember, the 100% I cover is paid at the Humana negotiated rate.

Anyway, about the “free” flu shot, last year, on a whim I asked the pharmacy if my insurance plan would cover my shot.  After what appeared to be a 10 minute love affair with the computer, my pharmacist advised me that it was covered at 100%.  I rolled up my sleeve, then wandered down to the cosmetic aisle, and advised my wife of our good fortune, and she rolled up her sleeve.  We then proceeded to go pick up my son from his job, and shared the good news with him, although he did not see it as good news at all and was pretty much pissed at us for the rest of the day.  We called our daughter and told her about her special plans for the afternoon and to saddle on over to the drug store and share in the fun.  She whined and complained and then complied.

At $25 a shot, we saved $100 and avoided the flu.  I haven’t gotten the rest of the family to get their shots yet, but how can they resist?  It’s a total friggin’ no brainer.

So there are a few points to be made here.  First, if you don’t have health insurance, even a modest plan like my HDHP will enable you to purchase medical services at a discount.  Basically you get the negotiated purchasing power of your insurance company, if you shop right you can, through an HDHP get coverage for your well-care (annual physical), and as an added bonus, you might even get your annual flu shots for free!

I haven’t had a tetanus shot in about 15 years….wonder if my plan would cover that.  Hmmmmmm.

My HDHP Covers Well Care. What’s That All About?

Last month I had my annual physical.  It is covered under my High Deductible Health Plan with Humana.  Well, most of it is.  They covered the basic office visit, plus because I am of a special age, they covered the… ahem…prostrate exam.   I have to say, that was awwwwwwwkward.

Anyway, if you are just stepping into the world of HDHPs, “let me be perfectly clear” when the plan says it covers “well care” that means it covers your physical.  Now insurance companies are kind of squirrely when it comes to what exactly they cover in the physical, but in my case it was pretty much the visit and the prostate extravaganza.  Extra stuff like lab work and ECGs in my case, were not covered.   But here’s the thing, if you were paying for all that stuff out of your pocket without insurance at all you would probably go into shock if you had to pay the entire nut. 

Even if you have a high deductible health plan, you get the benefit of negotiated rates, which can be pretty significant.  If I had been a contestant on the Price is Right, trying to guess what the cost of the physical was and the cost of the lab work, “the actual retail price” of those babies would have been $1284.90.  But after the insurance discount I paid 104.84 out of my pocket.  For my money, peace of mind and general health, a hundred and some change seems reasonable to me.

So why well care?  Because it’s like basic maintenance on your car, which could prevent serious problems later on.  If you have a High Deductible Health Plan, the insurance discount can make the price of it affordable.  And if you have an HSA you can pay for it from your HSA either now, or let your Health Savings Account grow, and pay yourself back later.

That’s why well care.

What Is Consumer Driven Health Care?

The title of this article makes 99.9% of the citizens of our country’s eyes glaze and move to the back of their heads.  But, if you are reading this, chances are you might have a bit of interest in the topic.  You are also near brilliant.

Last Saturday, a local hospital sponsored a free skin cancer screening.  Three years ago, I would have never known about it, and if for some coincidental reason, I had, I wouldn’t have given a crap.

 But, when you have a high deductible health plan with a health savings account and then hear the words “free” combined with “health” your ears are likely to perk up like Mr. Spock’s.  Vulcan “A” man!  

 That was me last Saturday.  I went down there and just had a Vulcan great time having my moles inspected by the mole inspector general.  Actually, it was a very nice and competent PA from one of the local dermatology offices who somehow got enticed (maybe it was a Vulcan mind meld) along with about a half a dozen other qualified PAs as  to check out the moles and other skin irregularities of hundreds of total strangers. 

Not only did they check everyone out, but they gave away a ton of free sun screen samples; and I’m not talking the no-named stuff you get at the dollar store, this was the good stuff.  They were also giving away Braves baseball caps to help protect all those pretty faces.  Now who gets that kind of treatment at the normal doctor?  The last free thing my Doctor gave me was a stool sample kit.  It kind of stunk if you asked me.  

Because I have a very high deductible, the opportunity to take care of my health for the low low cost of nothing, is very appealing.  And that in short is a little bit about what consumer driven health care is all about.

It’s about becoming a smarter health care shopper.  It’s about tuning into one’s own body.  It’s about taking control of one’s well care and health care.   It’s about saving money smartly.  Consumer driven health, in my book, is a pretty Vulcan good idea.

How HSAs Work at Saving Money – A Real Life Example

My son rolled in from school yesterday afternoon complaining of aches and pains (as he pretty much does everyday) and me, being the presumably typical dad, promptly ignored it. He did manage to muster the energy to bike down the road to the neighborhood pool, so I went back to work and didn’t give it another thought until momma came home from work and advised me that after having been asleep for two hours, he was running a 102 temperature and I needed to take him to the nearest clinic.

So I rolled the by now clearly sick boy into the car and headed for the “Take Care Clinic” about a mile away located in the Walgreens. It is extremely convenient and at 7:00 at night, it was a total no brainer.

Anyway, I checked him in, gave them my Humana insurance card, and in about 45 minutes he’d been diagnosed and the prescription to take care of his strep throat has been electronically sent to the Publix across the street (sorry Walgreens, but Publix filled the prescription for free plus I was able to load up on Gatorade and Popsicles while I was there).

 My only gripe about the process, is that I am not sure exactly what I am going to have to pay for the visit, because, even though I am obligated 100% for the amount, I couldn’t pay it on the spot because Humana can’t, or won’t, tell the clinic what I am supposed to pay. That’s another rant for another day because that little detail adds to the cost of health care and generally chaps my butt. They will send me a bill eventually and I will pay it. In the meantime I will rationalize it as a free loan.

 The above said, the posted price of the visit was $65 plus the cost of the test, so I’m guessing my visit and the strep test is going to run somewhere between $75 and $100 after the insurance discount. As a bonus I can pay for it from my HSA.

 Now if you are one of those folks who has traditional insurance you might be chuckling at your good fortune, because you would have only had to pay the $25 co-pay for the visit. But I am chuckling at you because unless your employer is a saint, you are having some big chunk of $ taken out of your paycheck each pay period to give you the privilege of that $25 co-pay. In all likelihood, your premiums far exceed my $250 monthly premium (which covers my family of 4). So in the end, I most likely paid less.

Now my insurance plan is less than perfect, but I have saved a ton of money over the past 3 years since I moved out from under my former employer’s COBRA plan and into a high deductible health plan with a health savings account. In addition to the premium savings I have received, my HDHP has provided other benefits including the tax advantaged HSA which have made it a good choice for me. In my plan, I pay for what I use, I have coverage in the event someone in my family has a major medical need, and I have a mechanism to save like crazy.