I've been trying to navigate the Healthcare Marketplace since October 1. We all know there've been many problems. I got through the process a month or so ago, with the result that I was not eligible for coverage through the Marketplace. No reason given. It was suggested I apply for Medicaid.
So I did, knowing I would be disqualified and thinking all I would need to do is go back to the Marketplace, denial in hand, and get this thing done.
Not exactly.
What I had to do was download, print and complete a multi-page form appealing the decision that I don't qualify to purchase a plan. The basis of my appeal was, simply, that I didn't know why I wasn't eligible.
So I completed the form and decided to give the government one last shot, hopefully to save some time.
I called. And spoke with Karen, who said I could either send in that appeal or she would delete my current application and help me fill out a new one.
I WAS SO FRUSTRATED I NEARLY CRIED. Right there on the phone. This would be my THIRD application process.
She explained it would take only about 20 minutes and she'd be able to tell me instantly, upon completion, if the results were different. And she was pretty confident they would be.
After all, the Affordable Care Act was written expressly for people like me: Not covered under an employer-provided plan, not covered under Medicaid and paying
So she asked and I answered and voila! The new result was, indeed, new. I qualify for a subsidy and all I have to do now is log back into my account, compare plans, pick one and write a check.
I'm one of the few people I know who still trusts the government. I'm not sure why the process didn't work the first time. I'm just grateful it did, and looking forward to shopping for insurance! From an insurance company! That's still going to make a profit!
I could move to Vermont, where legislation was just passed which will create a single-payer system in that state. And having Bernie Sanders for a Senator would be a nice perk, as well.
But for now I'll stay put and get my gratitude on.
Thank you, Karen, wherever you are, for your patience and understanding and confidence that this would all work out.
About that website, though …
2 comments:
I hate to admit it, but I've officially given up on healthcare.gov. Being as how I have virtually no income right now, I'm sure they would direct me to Medicaid as well, and I'm not interested in going that route, so I'm in the process of contacting insurance companies directly - in fact, that was my mission this afternoon.
On the bright side, I did get confirmation that I would get the same prices by buying direct that I would get going through the exchange - and I have more plans to choose from. Since I don't want a subsidy, this seems like the better process at this point.
I do feel bad about circumventing the website though, as I want it to work and want to support the basic concept of affordable health care. The plan I'm currently zeroing in on will save me $150/month in premiums and lowers my deductible by $1300! Plus, the OoP max is lower by half!
But I do hate this whole process of investigating and making the decision. It seems like there are so many questions to ask and get answered, and I fear making a decision based on a lack of understanding. But this is one area where I can't afford to let decision paralysis take hold!
Glad you were able to successfully navigate the process.
I spent the day with Covered California, our state fortunately being Democrat enough to have its own website. It took three phone calls, but at least I got thru each time, albeit with a minimum hold time in excess of 25 minutes. The problems I had were:
1) I had not checkd the box for assistance. Once that is entered it can't be changed, you have to start over again. HUH? All the other info can be changed, but not the (arguably) most important, the main reason the exchanges were created?
2) My application was accepted, pending ONLY verication of CA residency, Trying to upload .jpg, .gif, .bmp, or .png graphic files didn't work, format not acceptable, I was told to try .pdf, which worked. HUH? Many, maybe even most, but certainly not all computers have software with the ability to save files to this proprietory format, yet they want this format, while none of the standard graphic formats are acceptable?
3) After finally being able to submit Proof of Residency, I was then told I needed to verify my income. Which was entered as $0 (living off savings). HUH? How do you prove NO income? The rep had no advice except to wait a few weeks to see what kind of proof is requested. I'm hoping I won't have to provide affidavits from every employerj/agency/lottery in the world that I am not on the payroll/dole/winners list.. I think I can get notarized statements from every person on the planet that they will not be giving me handouts, but that's private citizens. Comanies are harder to work with, you know?
Congrats on your sucess!
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