My Healthcare Journey Part Three, Or, Soothe Me With Smalltalk

In part two of my fanciful adventure through the A-for-caring-F-for execution Healthcare Marketplace website, I had appealed the silicon-based quality-of-life-determiner’s decision to deny my 7 year old daughter health insurance.  I did this through the certified mail.  Because of this, I knew that my appeal had been received on December 18th.  So I waited.  I waited until after Christmas in fact.  On December 26th I called the Health Insurance Marketplace one more time to see about checking in on this appeal process.  I spoke with a lovely lady who wanted to rehash my entire history with the ACA so that she could better solve my problem.  She put me on hold for awhile and came back with the news that there was no way to check on my appeal and it might take up to 90 days.  This was concerning because my daughter’s healthcare is due to end in 5 days.  When I asked her what I should do, she told me that she would like to help me reapply for coverage over the phone.  She was hopeful that the electronic guardians of affordable healthcare would rule in my favor this time.  The process took an hour.  During that time I learned that she was married with children, had friends in the town that I live in, and had a son who always wants to travel to Athol and go to Silverwood.  I also learned that she is unable to put her husband on her work insurance policy because it is too expensive.  There is nothing wrong with that exactly, I just find it ironic.

After my hour of pleasant conversation interspersed with social security numbers, birthdates and annual salaries,  the HTML lords of health handed down a new PDF ruling.  My wife is eligible for healthcare on the marketplace, my 1 year old is eligible for CHIP again, and my 7 year old is eligible for nothing.  The process has failed me once again.  My friendly marketplace representative quipped, “Well at least we tried, right?!” Indeed.

So, what’s next? A letter to my congressman, Raul Labrador, and my senator, Mike Crapo.  Let’s see if this representative democracy thing works.

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My Healthcare Journey Part Three, Or, Soothe Me With Smalltalk

My Healthcare Journey Part Two, or, You're Right, That Doesn't Seem Fair!

Last time we got together, I had just been told for the second time by our automated health-conscious overlords that my 7 year old is not eligible for health insurance.  I was slightly disturbed by this, as was my 7 year old.  (I really need to stop talking about these things with my wife when she is within earshot.)

So, it’s December 6th at this point, and I gave the Health Insurance Marketplace a call.  Before I relaunch into my tirade of continual disappointment with this system, I have to say, every single person I talked to at the Health Insurance Marketplace has been lovely.  I have also been in contact with representatives of The Internal Revenue Service this fall (that’s a different blog post) and they could definitely take a few pointers from the Health Insurance Marketplace call center staff.  Everyone I have talked to there has been kind, empathetic and engaging.  In fact, only occasionally did I get a hint of the fact that they all get yelled at constantly and hate their jobs.

At first I spoke with a young man (I assume) with a nice thick southern accent.  I told him my problem and read him the Eligibility letter that I had received informing me that my 7 year old daughter was not eligible for health insurance while the rest of my small family was.  He asked if he could put me on hold while he looked into that.  I said yes.  He came back on the line a few minutes later having pulled up my file.  He then read me the Eligibility letter that I had already read to him.  I have to admit I enjoyed it more with the accent.  He then exclaimed, “That doesn’t seem fair at all!”  It was at this point that he ran out of helpful ideas.  I asked him why the robo-insurance system might have made that determination.  He did not know.  I asked to talk to his supervisor.  He assured me that his supervisor would not know either.  I insisted.  He obliged me with a slight downturn in his mood.  I can only assume that a customer asking to be transferred to a supervisor reflects poorly on his performance record.  If you’re reading this Health Insurance Marketplace Call Center frontline southern kid, I’m sorry.

I was transferred to his supervisor.  If I had to guess, I would say mid-twenties, young father, maybe a California vibe. (Actually, he told me the young father part)  He was very nice.  He too reread my Eligibility notice back to me.  I reminded him that I was actually the first person to read that notice, hence my call.  He also remarked that this set of circumstances was “unfair” and “weird.”  He had a solution though!  He was going to reapply for me over the phone.  I thought, hey, maybe that’s a great idea. Maybe.

We were about 15% of the way through the application when I realized that he was just filling in the fields on the website that I had already filled in.  At this point my hopes fell slightly, but I thought “at least we can rule out operator error on my part.”  So we did it.

“Is your wife a woman?”

“Yes”

“Does your 7 year old have a job?”

“No.”

I almost threw him when he asked the question about anyone in the household needing assistance dressing themselves, going to the bathroom or eating.  I told him that my 1 year old was still working through some of those things, but he decided that my situation probably didn’t apply to the question the way our cybernetic medical benefactors intended.

We finally finished the application and he remarked “40 minutes for a family of four is a really good time!”  I sincerely hope he will get recognized for that achievement.  And then….drum roll please

I’m eligible for insurance on the marketplace, my wife is eligible for insurance on the marketplace, my 1 year old is still eligible for medicaid and my 7 year old is NOT ELIGIBLE FOR ANYTHING!

My friendly application record breaking Health Insurance Marketplace supervisor said, “huh.”  Then he said, “I’m really sorry man.  I’ve never seen anything like that.”

I asked him what I should do now.  He said I should appeal the decision.  He said there was a form and I could download it and mail it in to the Department of Health and Human Services (what exactly does “Human Services” encompass anyway?)  So I did that.  I mailed it certified mail.

Tune in to part 3 of my tale to hear what happened next…

My Healthcare Journey Part Two, or, You're Right, That Doesn't Seem Fair!

My Healthcare Journey Part One, or, Our System Is Down Right Now

In this series of posts it’s my intention to detail my journey through the Affordable Care Act. While I am fairly Libertarian in my political views I’m not in principle against the idea of the ACA, however my experience with the healthcare.gov website has been incredibly frustrating.

My tale begins back in October when the website first came online.  I enrolled in order to look into insurance options for my family.  I am covered very well by my employer but to add the family to my plan would be unaffordable.  They currently have an individual plan.  It took several attempts to create a login at healthcare.gov, but I finally succeeded.  After creating my login however, it was 2 weeks before the system would let me create an application for health insurance.  At first I just got blank pages.  These were followed by error messages with the “error id” listed as “unknown error.”   Finally though, I got an application submitted for my family.

Good news, my wife and both my kids are eligible to purchase insurance on the marketplace!  Great! Where do we sign up?

This question was answered by over a month straight of “Select a health plan for: null” messages.  I chatted and called the Marketplace call center several times and was always told that there are bugs in the system and to try back at a time that was less busy.  Finally I spoke to a call center employee who thought I might just want to delete my application and try again.  So I did that.

I then proceeded to reapply for coverage for my family.  I told the system all the important things it needed to know for the second time.  I told it that my wife was a woman. I told it that my 7 year old hasn’t been employed in the past six months. I told it that my 1 year old doesn’t have any alimony to report on her taxes.  All the important stuff.  My application went through, but this time, something was different.  While my wife was still eligible for insurance through the marketplace, my 1 year old was eligible for Idaho CHIP (Children Health Insurance Plan) and my 7 year old was not eligible for any coverage whatsoever.  The friendly government-issued pdf document said, and I quote:

Based on your application, you don’t qualify to purchase health coverage through the Marketplace. In addition, you don’t qualify for a tax credit, cost-sharing reductions, Medicaid, or Idaho CHIP.You still might be able to get health care at a lower cost. The health care law has expanded funding to community health centers, which provide primary care for millions of Americans. These centers provide services on a sliding scale based on your income. Learn more about getting care at a community health center on HealthCare.gov.

Sorry small child, you don’t qualify for mandatory insurance that we will fine you for not having.  Good news though, if you can find a “community health center” they might cut you a deal, as long as your income is low enough.

At this point, I knew something must be wrong. So, I deleted that application and started over.  I had the same family for this application, same wife (still a woman), same children, but the soothing blue and green prompts asked me slightly different questions this time. (Does my 1 year old need help paying off the last six  Huh.  That application was successfully submitted and my wife is still eligible for health care.  My 1 year old is now eligible for Medicaid, not CHIP and my 7 year old is still ineligible for anything.

Stay tuned for the next installment in this series where I call the Health Insurance Marketplace and hilarity ensues…

My Healthcare Journey Part One, or, Our System Is Down Right Now