The Quest for Affordable Healthcare - Part 7

Yesterday I was so happy! I was braced for being uninsured as of tomorrow, February 1. But there in the mail was a notice from PCIP offering two more months of coverage for people who have not been able to buy new coverage through the marketplace. Hallelujah! My prayers were answered. I would be able to keep my existing plan until we could iron out the problems with the new application. But that was yesterday.

This is today. It is very clear on the letter I got from PCIP that I cannot buy their extended coverage if I have other coverage. Since the most recent application start date was supposed to be February 1, I needed to make sure that they hadn't sorted it out while I wasn't looking.  I checked with Gene, my agent, to see if anyone had been in contact with him. They had not. I decided to call the folks in Seattle to see how it was going. Once again, I spoke with Nora. I told her that I was trying to determine the status of things because I had a bit of a reprieve in that I could buy another month of PCIP coverage. She asked me what PCIP was.

"It's the Pre-existing Conditions Insurance Plan. They're extending it through the end of March." (She works for the Department of Health and Human Services. Why doesn't she know this?)

"Under the new law, all pre-existing conditions have to be covered. That is the new law."

"Yes, I know. Pre-existing Conditions Insurance Plan is the name of the policy. It is a part of the ACA but it rolled out ahead of the marketplace. I've had this coverage for over a year. It was supposed to end in December, but apparently I'm not the only one with problems, so they're extending it through the end of March." (Again, she works for the Department of Health and Human Services. I shouldn't have to tell her this.)

"You have to apply for coverage in the Marketplace before the end of March."

"Yes, I know. But I can't have coverage through PCIP and the Marketplace at the same time. They are very specific that I should only buy the coverage if I don't have other coverage."

By this time, I was ready to start pulling hair. Since I couldn't reach through the phone to grab hers, my own was at risk.

"I'm trying to see how we're progressing on solving the problem to determine whether I should send in the money for the PCIP extension."

She recapped her case notes for me. Once again getting most of the details wrong. I thought that by the time we hung up on Monday that she had corrected most of the errors. Wrong. She still had the original errors in her notes and she even added one. She had my agent's name down as James instead of Gene.

It's really difficult to get these federal employees to get to the bottom line. But we finally got to Nora's. Her bottom line is that she has transferred this out of her database. Someone in Dallas, Texas will handle it now. She couldn't or wouldn't say who. She said if I needed to follow-up on it that I should call Cigna customer service. She had instructed Cigna to research it, but that I should give it a couple of weeks.

Oh, are we back there? I've already spent hours on the phone with Cigna and they have no record of the silver application. And this woman thinks that because a "federal employee" has asked them to "research it" that it will suddenly appear. You know, I just don't believe in magic.

But for fun, I decided to call Cigna. Wait, that wasn't for fun. Some other word maybe, but certainly not fun. And just as I expected, no silver application has appeared. They've still got that bronze one, though. Although they assure me that as of tomorrow that will disappear. I'm not sure whether to believe them or not. They originally told me it would disappear on January 10th and it didn't.

All I know is that I've got until March 15th to get an application through that wretched Marketplace. And based on past experience, I'm not sure that a month and a half is enough time.
 


I swear this is starting to consume my life. I have cried more about this than two divorces. I'm even considering contacting my congressional representatives. They're supposed to help their constituents cut through the bureaucracy of the federal government. Which one should I call first? Ted Cruz or John Cornyn?

The Quest for Affordable Healthcare - Part 6

I was hoping there wouldn't actually be a Part 6. I was hoping that someone would call, I'd tell them what the problem was and they'd click "Delete" and "Enter" and we'd be good to go. But that's not what happened.

I got a call last Friday evening around 7:30. Of course, we were out for dinner so I didn't hear the phone ring. But she left a message asking that I phone back on Monday. I just got off the phone with her. I am now convinced that I will never have healthcare again until I can get on Medicare.

For starters, she is in the government "complaint" department. I tried to make it clear that I don't have a "complaint".  I have a problem. (Complaints need to be heard. Problems need to be solved.) In turn, she made it clear to me that she works for the Federal Government. (Imagine my relief!)

She said the information she received from the Marketplace was only a sentence or two. She was somewhat interested in how the problem came about. I gave her the quick and dirty version of what happened. But I don't think she got it. When she recapped it for me, she thought that I had the same agent for both policies. No. She did not understand that I applied on one day and paid on another. Hopefully, in the end she got those details right, although I'm not sure they are details that really matter.

She wanted numbers. Application numbers. (I don't have any.) Policy numbers. (I don't have any.) Receipt numbers. (I don't have any of those, either.) She plans to call my agent to get the policy names and numbers. At least this seems like useful information to have.

She told me she needed to do some "research". In my experience, "research" takes a long time. On February 1st, I will once again join the ranks of the uninsured. I have no idea how long she intends to research this.

Her plan is to call Cigna and tell them to drop the bronze application and process the silver one. I tried to tell her that Cigna has no record of the silver application. And once again, she reminded me that she works for the Federal Government.

I can't wait to see what happens next.
 

The Quest for Affordable Healthcare - Part 5

When we left off in Part 4. Barbara had made an online payment and obtained a receipt. She planned to wait a week before attempting to contact Cigna again. Part 5 picks up in the middle of January.

It was January 15th and I still didn't have a welcome email or anything else from Cigna. I did get a paper invoice for the bronze policy that I no longer wanted. I also got a few phone calls letting me know that I should pay for the bronze policy that I had cancelled. But no one seemed to know anything about the silver policy for which I had a paid receipt. It was time to call Gene.

I just left him a message that evening saying that the receipt didn't have any reference numbers on it, and that I would need one if I intended to call Cigna. The next day, Gene called. He had Cigna on the phone. I don't know how long he waited on hold before he conferenced me in, but we were on the phone with them for over an hour. We learned that they had a record of the bronze policy. In fact they showed that it was cancelled twice but still active. (Really? Cancelled twice? Zedrick was even dumber than I originally thought.) They had no record of the silver policy at all. The bottom line was that the information to process the silver policy and cancel the bronze policy had to come from the "marketplace", aka Healthcare.gov.

The Cigna representative was able to transfer us to someone at the marketplace. This is where I really wanted to start ripping out hair - and not my own. We established that I was the consumer and that my agent was on the phone with us and that I granted permission for them to speak with my agent. (By the way, this "permission" is only good for 14 days. What is the likelihood that this can be resolved within 14 days?)

She listened to what had happened. How I had an application for a bronze policy that I had not been able to pay for and how I decided to go with a silver policy, which I had a receipt for, but that to the best of my knowledge, no money had been charged to my credit card or been debited to my bank account.

Then she started blaming Cigna for everything that had gone wrong. She did not care about fixing the problem, she only wanted to deflect blame away from Healthcare.gov! Gene informed her certainly, but gently, that our goal was NOT to assign blame, but to fix the problem. Really hard to keep her on track with that one. She could see that there was a bronze policy. She seemed to think it had been paid. She could also see that there was a silver policy. She didn't know why the silver policy wasn't going through to Cigna. Her bottom line was that she couldn't fix anything. "We don't do that here." It was incredibly hard for me to keep my mouth shut. We were put on hold numerous times throughout the hour long phone call and I remarked to Gene (more than once) that it would be best if I remained quiet and let him do the majority of the talking. Sooo hard. She said that someone would have to call me back. I was thinking, "Noooooooo." But Gene was calmly saying that he would prefer to get it settled today and asked to speak with a supervisor.

The supervisor was polite and not quite as committed to affixing blame as the customer service rep. Gene explained that we were just trying to resolve the issue, as smoothly and efficiently as possible. When she said, "We don't do that" I couldn't help myself. "So smooth and efficient is not something you do?" Fortunately she was still talking and I don't think she heard me. And Gene took over very quickly. Damage control, I think. But it didn't matter how nice and patient we were. The bottom line was "We don't do that". "We can't fix it". What happened to "Yes, we can!"?? This would have to be escalated to someone outside the call center.

It should not be that difficult. Cancel the one I don't want and feed the one I do want through to Cigna. Why should this require escalation? When you have difficulty with a government office, you can contact your Senator or Congressional Representative for help. You think I'll get any help from Ted Cruz? Maybe John Cornyn's office could help out? I can't actually see either of them doing anything other than saying "I told you so".

The entire afternoon was wasted on the phone with these people. I hadn't had that much fun since the hogs ate my little brother.

Gene explained to her that I would not be covered as of February 1st unless they resolved the issue. He said he didn't think it was fair that their inability to resolve the issue might expose me to a fine - particularly when I'd been trying to obtain coverage since October. Like all well-trained customer service reps, she said she "understood". I don't think she did. But she did say that someone "usually" calls back within 30 days. (Seriously, it's not her department. She doesn't know that much about what goes on in her own department. I doubt she has any idea at all what goes on in other departments. She doesn't even know where they are or how to contact them outside of a government form.)

I got a call from Cigna yesterday. I was hoping it was about the silver policy, but it wasn't. They still want me to pay for the bronze. If Cigna could just sell me a policy without going through that wretched marketplace the problem would be solved. But they can't, or they won't. It doesn't matter. I'll just have to wait. 
 
So if they can't sort it out, I will once again be uninsured on February 1st. So envious of Mark going on Medicare and not having to go through this mess. The good news is that I have American Express health insurance for when I travel. I just may have to go on the road this year.

The Quest for Affordable Healthcare - Part 4

In Part 3 Barbara learned that GoHealth.com had bungled the application and sent it through as canceled. She was waiting for Cigna and Healthcare.gov to fix it. Let's see what happens in Part 4.

It was nearing the end of the month - the end of the year. I received a letter from PCIP, the plan that I had in place that was going to terminate at the end of December. Since this was a government plan, and the government was aware that the ACA roll-out had been badly managed, they were offering to extend the coverage through January. But by sending in a payment you were swearing by penalty of all kinds of things that you had been unable to obtain other coverage. I figured I'd better hold on to that letter because there was still time to send in the money if I couldn't actually pay Cigna. We were now into that time period between Christmas and New Year and I still hadn't been able to secure coverage.

Mark and I went off to San Antonio for the New Year Celebration but I made sure to take the Cigna phone number and case number with me. I still needed to pay for the policy. I knew that I had until January 10th, but if I had to pay for the additional month of PCIP, I only had until January 5th, and that required sending the payment by overnight delivery to ensure they had it by the 6th.

On December 31st, I called Cigna back. They STILL showed the policy as cancelled. This was disappointing, frustrating, and annoying.  I decided to call Gene, an insurance agent extraordinaire who had actually told us about the PCIP insurance and helped us obtain coverage in the past. Luckily, he answered the phone. I told him what had happened (well, not as much detail as I've shared in Parts 1 through 3) but the summary of it.

He thought the best plan was to remove the application that was in Healthcare.gov and start a new one. He advised me to set the start date on this one as February 1 and pay the additional month for PCIP. We went through the application. This time I selected a Silver Plan that would give me similar coverage to what I had with PCIP and at a similar price. By this time, Healthcare.gov had been linked up with the IRS and could base your eligibility for a subsidy on net taxable income rather than gross income. (I know that in theory this isn't a particularly good thing - but it does make the whole thing go a bit smoother.) I don't mind paying a couple hundred more if I'm going to have better coverage. This is what the ACA was supposed to do - make good coverage affordable. We successfully submitted a new application. Unfortunately, once again it was with Cigna. Gene told me to go ahead and pay it online right then and there.

I entered my credit card details for the first month's premium. Well and good. But subsequent months must be paid from a bank account. I didn't have my bank details with me. Nobody takes out of town checks, what's the point of traveling with a checkbook? There is no way I could make the payment that day. But I was going to be back home the next day and could easily do it then. Gene said that would be fine.

So we celebrated the New Year and the next day we drove back home. The first thing I did when I got in the house was login to pay for the healthcare. It hadn't saved any of the information, so I re-entered the credit card details and then entered my checking account details. I was hoping for something with bells and whistles to signal my success. But all I saw was that if I logged out and logged back in, it said "Complete". I wrote out the checks for the PCIP and took them (one for me and one for Mark) to the post office the next day. I had to pay to ship them both overnight in separate envelopes to the tune of about $20 each. (I know from prior experience with these folks they only take notice of whatever is on top. When we first applied for these policies, we sent both applications in the same envelope. Mine was the only one that got processed. We're not going through that again.)

Now, I knew from all my previous calls to Cigna that it should only take about 3 days to process the application and that I should get an email from them. I didn't anything. So on January 8th, I got back in touch with Gene. He checked into it, and it seems that my payment hadn't been processed. So on the 9th we went online and did it again. This time, I got a receipt. Now all I needed to do was wait a few days for the email from Cigna.

Will Barbara get an email from Cigna? Will she have coverage on February 1? All will be revealed tomorrow.

The Quest for Affordable Healthcare - Part 3

When we left off in Part 2, it was late November. The system was not performing as expected, the costs were too high and the coverages were unclear. Barbara had decided to phone Blue Cross Blue Shield.

Let's see what happened. Here's Part 3.

Early December: With the deadline for enrollment looming, I decided to call Blue Cross Blue Shield directly to see if I could determine what the plans actually covered. I googled Blue Cross Blue Shield Texas. There it was! "Compare Blue Cross Blue Shield Plans! Call Now..." I called. I noticed that it wasn't BCBS that answered the phone. It was a place called GoHealth.com. Who knows if the information they provided was correct or not? It sounded good to me, and they offered to transfer me to an agent who could get me signed up. His name was Zedrick something or another. I believe he went through the healthcare.gov site and created a new application for me. He certainly asked all the questions that I was familiar with from doing it myself - except for the job questions. I selected a Cigna policy, which represented the lowest-priced option, and which fortunately was now only about $100 more than I'd been paying even though it had higher deductibles and copays. It was my belief that I did not qualify for a subsidy. But Zedrick asked if I wanted to see if I qualified. "Sure, why not?" He asked me questions about my spouse and whether we filed a joint return. He told me that my application would be processed and that I would be hearing from Cigna about payment. Okay! Success!

But then, two days later, Zedrick called me again. Apparently something on the application wasn't quite right. We went over the whole thing again. Zedrick didn't impress me as being the sharpest pencil in the box. But he said that I was getting a subsidy and that my premium would be nearly $300 less than I bargained for. He assured me that it was all okay now and that I should hear from Cigna within a week. Then, the next day I got a call from GoHealth.com indicating that there were a few more details that needed to be handled on my application. Okay, we're coming up on the December 13th enrollment deadline. Let's get it sorted. When I was transferred to the people who supposedly had the questions, they couldn't see that anything was missing and asked me to excuse the call. The next day I got another call from them, again saying that there were items missing from my application. Again I was told that I'd received that call in error. When they called again the next day, I came to the conclusion that they had no clue what they were doing. I told them so and they assured me that it was all fine and that I should get a call from Cigna within the week.

Mid December: I finally got a call from Cigna! It was one of those automated calls - Press 1 to make a payment, Press 2 to inquire about your application, Press 3 for something else.  I pressed 1 to make a payment. Good! A payment seals the deal. "Please say or enter your case number."  What??? I don't have a case number. Where do I get a case number? I returned to the main menu and pressed the number to speak to a representative. After a 40 minute wait, I got through and was given a case number. I was also told that the payment system was down and that I wouldn't be able to pay that day. They did not expect their system to be fixed until the following day. They must have outsourced their system to the same folks who worked on healthcare.gov.

I called back the next day. The automated telephone system did not "recognize" my case number. It expressed this by informing me that it didn't understand what I said. Some systems will ask you three times and then automatically transfer you to an agent. This one insists that you repeat it for all time and eternity. Now I'm upset. My speech is not difficult to understand. I am forced to hang up and try to call back for customer service. To make a long story even longer, after being on hold for over 40 minutes, I gave up. I hung up. My attention span just isn't long enough to listen to that annoying music for that long. This happened at least twice a day for the next three days. When I did get through (and by the way, the human agent did not seem to have a problem understanding anything I said) I was told that I couldn't pay it because their system had accidentally cancelled the policy and they were in the process of re-instating it. I was told that this process could take up to three days, but not to worry because I had until the 10th of January to lock in coverage that started January 1st.

After the three days, I tried to pay again. This time the phone system eventually understood my case number. (We did have some issues with 8s and Hs.)  But it STILL couldn't accept my payment. Once again, I had to call customer service. (Just assume that there's a minimum of a 30 minute hold time any time you call Cigna.) I was a bit concerned. If they couldn't process my payment, God forbid I should have a claim. This time I got a different story. Now it seems that the agent who processed the application  (that would be Zedrick) had sent it through as canceled. (I knew he wasn't the sharpest pencil in the box!) They were waiting for GoHealth.com and Healthcare.gov to fix it. She thought it shouldn't take very long but assured me that I need not worry because I had until the 10th of January to get it in the system and paid for.

I was waiting, but I was nervous. Nobody seemed to know what they were doing and January 1st was just around the corner.

Tune in tomorrow for Part 4 - Will the situation spoil the New Year's celebration? Can Gene Genie save the day?

The Quest for Affordable Healthcare - Part 2

In yesterday's episode, which ended in late October, we left Barbara assuming (assuming - we all know what that means, don't we?) that she had plenty of time to arrange for healthcare.

Let's resume with Part 2 of the story in November...

Mid November: I decided to get back online to select a plan. They were all ridiculously expensive. Premiums three times higher than what I had been paying. Higher deductibles and copays - whose idea of "affordable" was this? I was very disappointed because the policy I had was a provision of the ACA, so I didn't think it would be that much of a stretch for the new plans offered in the marketplace to offer similar coverage at similar prices. Wrong again. I read the information on subsidies, hoping for a price reduction.

Based on the published information, I thought I might qualify, but it would be borderline. I decided to give it a try. All I had to lose was a little of my time. I had to enter information my husband and on places where we both work. In addition to the standard "How much do you make?", they wanted to know things like the employer tax identification number and telephone number for each employer. You would think this wouldn't be a problem. On the company that my husband and I own, it was easy.  But I do some freelance quality assurance and editorial work. It's typically all for the same company but it certainly can't be considered steady work. I do one or two projects a year and typically make between $1200 and $2000 per year. I can pull the tax id number off my W-2, but what to do about the phone number? My contact there has absolutely nothing to do with HR and I did not wish to give out her phone number. A web search for a phone number was fruitless. Who knows how people call them?

Again, I contacted the online chat folks. And again, they advised me to call the customer service number. Unfortunately, the folks there were not able to advise me what to do. Apparently you must enter a phone number. I decided that since I'd not had any work from that company since spring it would just be easier for me to delete that job and not accept any more work from them. I tried deleting the job. But the system still wanted the details on the tax id and the phone number. I logged out and logged back in - more than once. Still, the system continued to insist that I enter the details on the tax id and the phone number for the job I'd deleted. This time I decided to skip the chat people - all they do is advise you to call customer service. I went straight to customer service. The young lady told me that my "delete" hadn't worked. But she assured me that it would work for her. She deleted that job and advised me to log out and log back in, which I did. But there it was - still insisting that I enter information for an employer that "no longer existed".  So the young lady did what any good help desk employee does - she advised me to try again in a day or two. Fine, I wasn't going to finish it that night.

Late November: With Thanksgiving out of the way, I decided to try again. Surely the system had been refreshed or purged or whatever it is they do to remove erroneous data. But NO! The system STILL wanted to know the tax id and phone number for the job I'd deleted. So I entered it. As much as I didn't want to put Lisa's phone number in, I had to. I was up against a government system. What choice did I have? Then the system informed me that I did not qualify for any subsidies and proceeded to the options that were available to me. Unfortunately, they were unchanged. Even the bronze plans were going to triple my premiums and deliver higher deductibles and copays. I clicked the compare button. But I couldn't for the life of me figure out what any of the plans actually covered. The costs were pretty clear - the coverages were not. I logged out without making a selection.

I just felt a bit overwhelmed by the lack of information and angry about the prices. Nothing I could do about the prices, but I was certain that I could find out what each of those policies covered. That information was out there on the web somewhere - just waiting for me to find it. After all, I still had a couple of weeks before the deadline...

Stay tuned for Part 3. Will Barbara find out what the policies cover? Will she get her coverage in place by the December 13th deadline?

The Quest for Affordable Healthcare - Part 1

I wanted to share my experience of getting healthcare. Sharing the experience might help me laugh about it. I started writing it all down and realized that one post is just not going to do it any justice. So without further ado, I give you Part 1.

I was really optimistic about the Affordable Care Act (ACA). Having a pre-existing condition, the ACA roll-out meant that I would be able to buy coverage without being told that they wouldn't cover a heart attack, or a back problem. You don't need me to tell you that the roll-out of the Affordable Care Act was a monumental fiasco. That news was all over every media outlet. In spite of the rocky start, they jumped on it to try to fix it. Lots of systems have issues when they're new. And even though this system had issues unmatched in private industry, I thought they had it "mostly" fixed by mid-December. Perhaps I was overly optimistic.

Let's start with October...

Early October: Roll-out day is October 1. I had one friend claim that she successfully enrolled. Encouraging, even though I couldn't get logged in. By this time the news is out that this is going to be a monumental train wreck - and it wasn't just Ted Cruz talking anymore.

Mid October: I tried again. I was able to log in and create an account. It took me hours, but I was able to complete the application. By this time it was late and I was too tired to look at plans. I was certain that I would be able to resume at a later time. In the meantime, I received an email that said I had a message waiting in my marketplace account. I logged back in but wasn't able to find the message anywhere. I decided to try the online chat feature. The person I was chatting with had no idea how to access my message and suggested I call the customer service number. That person also had no idea how to access the message, but between us, we made the assumption based on the "Eligibility Notice" heading that it was probably just an email letting me know that I was indeed eligible to purchase a plan through the marketplace. I asked if I needed to change my notifications from email to snail mail, figuring that if they mailed it to me, at least I'd know for sure what it was. I was assured that this wouldn't be necessary.

Again it was late and I had until December 13th to complete it. I made the erroneous assumption that it would not be a problem.

Will it be a problem? Will Barbara get coverage? Stay tuned for tomorrow's installment...

Getting it Wrong

I'm a fairly traditional person. I believe in honoring traditions. This post was going to be about the tradition of leaving the Christmas decorations up until after the Twelfth Night. While I'm somewhat familiar with the play by Shakespeare, and the traditions of the Tudor Court, I thought I would do a bit of research before I wrote anything, just to make sure I had it right.

Seems I had it ALL wrong. I thought it was bad luck to take the decorations down before the Twelfth Night. Turns out it's bad luck to leave them up past the Twelfth Night. I also thought that the Twelfth Night was January 6th. Turns out it's January 5th. Since I didn't put the decorations away until January 7th, I may be in for a bit of bad luck.

Not that I'm superstitious. After all, I didn't eat any black-eyed peas on New Year's Day, either.

In 2014

In 2014 I will:

• Read 24 books. (An attainable goal, although I sometimes miss it by half a book.)
• See 12 films. (Easily attainable. Last year we saw 18. It's just that I sometimes get behind during the time in between the Oscars and school starting up. There's very little to see during this time frame because summer releases are often geared toward kids.)
• Use a different cookbook every 7 to 10 days. (Last year I tried recipes from 19 different cookbooks. We just find that eating foods prepared in different ways keeps routine days from being dull.)
• Read the CEB translation of the Bible. (I've never done this before, but I have successfully read other translations, so I'm not expecting a problem. And since I've loaded it onto my Nook, I won't get behind when I'm away.)
• Be attentive to the person in the room with me. (This means that I will NOT be fiddling with my phone. I will answer it if it rings. I might check the weather. I will NOT check Facebook. I will NOT catch up on Words with Friends - so don't bother nudging me. I will give the person in the room with me my undivided attention.)

The first four are basically a "to do" list. That last one is a behavior change. It will be harder. But I think I'll be rewarded for it. When you're attentive to others, they are attentive to you. It will be worth it.