Once upon a time, in a galaxy far,
far away, I had a health plan. I liked
it. I wanted to keep it. I had a great doctor, whom I liked, and I
wanted to keep him, too. I was told I
could.
I was hosed.
My dripping-wet hosedhood did not
put my name on a particularly exclusive list.
The same thing happened to millions of other Americans. We all heard the president and other leaders
make the same promise. But they were politicians, and their lips were
moving. That should have told us
something.
The story of what happened to me and
how I coped with it is an interesting, if not tortured, tale. And, although I think I may have turned the
corner, it’s not over yet. What follows
is Episode One. There will be other
installments. (And until my paperwork is
finally finalized and securely secure, I’m not revealing the name of my new
insurance provider).
Until the end of 2013, my wife and I enjoyed our health insurance through an employer-based plan. But in early November, we received notice that the employer would not be offering insurance going forward. Part of the problem was that the insurer the employer used was getting out of the business. The insurance company was a state-sponsored agency, but lawmakers had decided to repeal the authorizing legislation on the grounds that the outfit “would not be able to compete with other health coverage options that will be available in 2014 under health care reform.” The insurer’s cancellation advisory and the employer letter both referred soon-to-be-former customers to the federal insurance exchange at Healthcare.gov.
When we received the employee
notification, the government site had just gone live, if you can use that word
to describe the condition in which it found itself right after the launch. Rather than try to fight my way through all
that, I decided to wait a month for the problems to clear up. On Thursday, December 12, I got on the site without
difficulty, and began to compare plans.
My list of finalists included only those health insurance companies that
named my primary care physician as an authorized provider. On Monday, December 16, I created my account,
filed my eligibility application, and received approval to apply through the
Exchange (and I also learned that we would not be eligible for a subsidy). The next day, I selected my health and
dental providers, and then filed my applications. A screen on Healthnet.gov reported that my enrollment
process had been successful and advised me that the companies I’d selected would
contact me for payment of my first premium.
The process had been quick and easy.
I felt good about it. The same
way Captain Ed Smith felt good about his first night at sea aboard Titanic.
Like his, my mood also changed
dramatically with the dinging of a bell.
The next morning, my phone rang with one of those calls other schlubs
get, but you’re not supposed to. The
previous week, I’d undergone a CT scan to try to track down what had seemed
like a minor issue. But now my doctor was
informing me, somewhat apologetically, that the scan had revealed a mass on my
left kidney. A really big one. Not to put too fine a point on it: Ding, ding.
Iceberg right ahead.
Quite obviously, the kidney would
have to come out. And God knew what
other complications might lie in wait, if it were to turn out that cancer was
involved, which it almost certainly had to be.
And my existing health insurance
would end in just 13 days. You gotta
love that number, 13. As I said: ding, ding.
Right away, I hit the phone to
schedule the next medical steps. In
doing so, I asked my doctor to find me a urologist who was authorized both under
my old plan and my new one. Shortly, I had the name of a qualified internationally
renowned urologist in hand and had made an appointment for Christmas Eve.
Well, here we go with bells again,
as in, Jingle Effing Bells. And slay bells. And hell’s—well, you get the idea. I was in a mood.
In fact, during the process of
working the phone to secure treatment, I began to feel a bit paranoid. I really
was covered for whatever I needed, right?
Despite the cancer? I logged onto
Healthcare.gov to double check my enrollment status. It still read “complete.” But it also warned that my coverage would not
start until after I’d paid my first
premium, which I had not done.
Remember, I’d been told to wait.
Now, I began to fidget. Was this
a done deal, or not? They can’t turn you down by trying to claim your
kidney issue is a pre-existing condition, I told myself. After
all, that’s one of the joys of the Affordable Care Act: walking revenue-depleting profit-sucking insurance
stockholder nightmares like me get to sign up with impunity. Damn the company’s bottom line, and full
speed ahead! I then double checked
to make sure my primary care physician was an authorized provider. His name popped up again. I was good.
Cancer would not eat me without a fight. Nor would any cancelled insurance policy
defeat me. Praise the Lord, and pass the
Obamacare.
But as the saying goes, just because
you’re paranoid, it doesn’t mean they’re not out to get you. Imagine my reaction when, at mid-afternoon, I
open an email from Healthcare.gov and beheld the following: "You’ve taken the first steps toward
getting health coverage at HealthCare.gov, but you still need to complete your
enrollment."
I was speechless. I was horrified. My heart stopped. Beads of sweat popped out on my brow. My hands shook. My bad kidney hurt. I may have spotted. My imagination ran wild. Visions of untreated, pulsating, cancerous
tumors and ugly, slowly creeping lesions began dancing in my head. I was starting to feel like a character in
the zombie novel I’d just published, wandering around a barren, desolate
landscape looking for a place to collapse and dissolve into a green, bubbling puddle
of goo.
Making a mighty effort to control my
rising panic, I examined the unnerving, contradictory email more
carefully. There was no explanation of
what steps I had missed in failing to complete the enrollment, but the email
did contain a link to a web page where the advisory said I could finish up. Guiding the computer mouse across the pad with
both hands, I clicked on the link. It
led back to the same page I'd just checked, the one that had listed my enrollment
status as "complete.” The screen was
still listing my enrollment status as
"complete." There was no
reference on any of my account pages to the alarming email I'd just received,
no information suggesting that I needed to take any additional steps, and no
buttons offering me the opportunity to do so had I wanted. And I really, really wanted.
Atop the page, in huge black
letters, was a question reading, "Forrest, what would you like to
do?"
“Not
die” would do nicely for starters, I thought.
At the bottom right hand corner of
the page was a button reading "live chat." I clicked it. What followed next was—well, the metaphor of a
plague-ridden survivor of the apocalypse stumbling around a bleak, blasted,
barren landscape still works pretty well here.
In chat session #1, I patiently
typed out my problem. The agent assured
me that the scary email was probably a glitch, to ignore it, and that I needed
to “wait for the insurance company to
call you and set up the payment.” This
sounded about right to me, since it’s the same info I’d seen upon
enrolling. But I remained concerned that
there might be some hidden glitch lurking in the shadows, just waiting for the
opportunity to jump out at the last possible moment and bite me on the
you-know-what. Would it confuse things further
if I were to take the proactive step of initiating contact with the insurance
company myself? If I were to call, would
they have my file on hand and know who I was and what I was calling about? Or would the call simply create even more
confusion, possibly even leading to the establishment of a duplicate account
that would ultimately require even more delay to sort out? I typed the questions. At which point the agent simply disconnected
me.
Fine. This led to session #2, with a different
agent. Thinking the length of time it was
taking to type out my tale of woe might be an issue, I cut and pasted the
explanation I’d previously written out. At
which point the agent simply disconnected me.
Session #3, with a third agent. I went through the entire process of
explaining my situation yet again. This
agent waited patiently to hear it all, and then gave me completely different
advice. She assured me that since I’d already
chosen a plan, I now needed to “contact
that plan and set up how, and when to pay your premium.” Now really confused, I pointed out that the
previous agent had told me just the opposite.
Agent #3 was polite and apologetic, but insistent. She repeated numerous times her advice to
contact the company, but finally added that I could probably take either course of action—initiate contact
or don’t—and it would work out okay. Given
the timetable, the stakes, and the dramatically different potential outcome
scenarios (croak, don’t croak) I was not inclined to wait to see what would
happen. I noted that if there were any kind of link on
Healthcare.gov leading to payment or contact information for my new provider, I
had hadn’t seen it. She provided me one,
and then we ended the session.
First thing the next morning, with
credit card in hand and my heart beating with eager anticipation, I followed
the payment link she’d given me. It led
to a company 1-sheet that stated the following: "The Health Insurance Marketplace
will let [us] know that you have enrolled. This may take up to a few weeks.
Then, we will send you a 'Notice of Acceptance' in the mail.... Please wait for the Notice of Acceptance to
come in the mail before you make your payment [bolding is in the original.]”
What?!?!?!
Oh, my God. My stomach flipped, my
ears roared, and the blood drained from my face. A weeks-long delay was so not going to do. With me needing immediate surgery, any lapse in
coverage would leave me in a world of hurt, as I had patiently explained to three agents. Time, tide, and spreading cancer wait for no
one.
Trying not to panic, and ignoring
the 1-sheet’s firmly stated instruction to wait, I called the phone number listed
on it, and reached an insurance company rep. I gave him a summary of the odyssey listed
above. He told me that I had not called
the correct number (which, let me say again, I had gotten from his company’s 1-sheet), and then added,
somewhat phlegmatically, “You’ve gotten a lot of bad information.” No kidding! But his words were reassuring just the same,
because his was the first demonstrably true statement I’d heard yet. He then gave me the correct company number to
call. And within an hour I had made
arrangements to pay my first premium by credit card. (The plan, plus dental, cost us about $35
more than the coverage we had before, and provided slightly better benefits.)
The process of getting there would
have left me with a few more gray hairs if it weren't for the fact that I'm
bald, but when all was said and done, I had received coverage, and the surgery
could now proceed (or so I thought, and please consider that a teaser for our
next installment). No harm, no foul,
right? I was sure that Obamacare
defenders would be quick to say that the inconvenience, the minor panic I’d
experienced, and the episode of the Walking Dead that had played out in my mind
as a result were a small personal sacrifice to make, given that millions of
Americans who didn't have health insurance would now be able to get it. Indeed, when I posted a version of this story
on my Facebook page, that is exactly the response I got. Fine. I
agree that we should have found a good way to take care of uninsured Americans
long ago. But the confused, conflicting,
maddeningly glitchy mess I encountered in my dealings with HealthCare.gov does not
inspire a great deal of confidence that the government knows what it's doing
with our health care—control of which it has largely wrested from us. Based on what I've seen in the media, I knew
my experience was not unique, or even the worst. My thoughts as the week closed were that if
the government is going to compel our participation in ACA under the authority
of law and threat of penalty—which it has certainly done—then it damned well ought
to get it right. And it seemed to me
that telling us the stone cold truth, giving us accurate instructions, and
showing a little customer service would be a really good place to start. Strike that: it would have been a welcome change. The option of starting with those things had passed.
But as I was about to see, confusion
and conflicting advice at the hands of Healthcare.gov would turn out to be only
the beginning of my problems.
###
© 2014 by Forrest Carr. All rights reserved.
You can find the entire series of blog posts on my medical journey on this page: My Medical Travails: Adventures in the Toilet Zone.
And of course, I invite you to check out my author's page, where you
can learn about my novels, see critic and reader reviews, download
sample chapters, and find purchase links: www.forrestcarr.com.
© 2014 by Forrest Carr. All rights reserved.
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