|
Home | Blog Index | Blog Archives | Christianity & Faith Essays | Storm Chasing Essays
How I lost my Affordable Care Act health insurance
I lost my government-mandated (ACA or "Obamacare") health insurance policy on September 30 of this year, directly as a result of the actions of both the US government and Blue Cross-Blue Shield of Illinois. In 2011, I developed a chronic medical condition that requires expensive medication, and as a result of losing my coverage, I've spent approximately $1,200 out of pocket so far for my prescriptions. I am now currently using a less-expensive, more risky alternate medication not approved by my doctor because I cannot afford to keep paying out of pocket. This is a 'public service' blog post meant to get some information out there for others that may be going through a similar issue.
While I was open to seeing how the ACA would change things for me, it turns out this new health care system in the US is not where it needs to be. You can still lose your coverage and be shafted by the system. If this can happen to me, it can happen to you!
A longtime policyholder
As a freelancer, I have paid for my own Blue Cross Blue Shield individual health insurance since at least 1999 (I don't have the records of exactly when I joined). After the Affordable Care Act went into effect in 2013, I was informed by Blue Cross that my individual plan would no longer be available as of the end of the year. I would have to go onto the healthcare.gov web site and choose a new plan for 2014.
ACA web site woes
Like most people in the US, I had considerable issues with the government web site when I tried to enroll after it went online in October of 2013. I could not get past the identity verification step. This step consists of several multiple-choice questions that you must answer correctly. For example, one of them was "You bought a car in year X, what is the make and model?" and another was "What was your address during the year X?", followed by four or five choices, one of which was supposed to be the correct one. In my case, none of the multiple-choice items matched my information, and so simply had to abandon the application process entirely.
In December of 2013, I went back to the healthcare.gov site to re-attempt enrollment. This time, I was able to get through, and was directed to Blue Cross to sign up for a plan similar to the one I had previously. The premium would be $267 a month compared to the $189/month I had been paying on my old plan (the old plan's premium went up incrementally over the years). At this point, I received information from Blue Cross and went onto the Blue Cross Blue Shield of Illinois site to set up my online account access. I honestly do not remember exactly how the Blue Cross site factored into my enrollment, but I do know I had to use it for part of the process. This is an important detail, as it would factor into confusion later.
"The Letter"
Everything was fine until the end of June, when I received a letter from the government stating that they needed more information to verify my eligibility. The letter stated that if I didn't provide this information, I would lose my coverage. So, on July 3, I called the healthcare.gov support line to find out exactly what I needed to do. The healthcare.gov representative pulled up my account, and said that the only item showing under my name was the incomplete application I had attempted to fill out in October 2013. She said there was no record of anything else. When I told her about the Blue Cross policy, she said "since your policy is with Blue Cross, it is not through the government. You do not need to send in any information. The reason you got the letter was because of the incomplete application (from October 2013). Your active policy is with Blue Cross. Don't worry, you will not lose your coverage." She assured me at least twice that I did not need to worry about losing my coverage.
Convinced "from the source" that I was OK, I did not pursue the matter any further.
Guess what? You don't have insurance!
On October 18 of this year, I went to have two of my prescriptions filled at my pharmacy, and was told "your coverage expired on September 30". They checked and checked again, and sure enough, it was not an active policy. I immediately called the Blue Cross Blue Shield of Illinois customer service line and informed them of the issue. Their response was a very apologetic "we are very sorry, this was a mistake. We will reinstate your policy immediately, which could take 7 to 10 days. But for now, you will need to pay out-of-pocket for your prescriptions, and you will be reimbursed after the policy is re-instated." So, I went ahead and paid $700 to fill my prescriptions, and got the necessary documentation from my pharmacy to get reimbursed.
Over a week later, I had not heard anything back from Blue Cross, so on October 26, I called to follow up on the status of my reinstatement. The representative said "we are sorry, we are unable to reinstate your policy. We received a letter from the government that you did not send in the required information to verify your eligibility. We show your policy as an Exchange policy, not a Blue Cross one". It would have been nice for you all to tell me that earlier, instead of leaving me in the dark thinking I was OK! After I gave the full story, the representative initiated a three-way conference call with a healthcare.gov representative. The government then agreed to initiate a review of the policy cancellation, which could take up to 30 days.
The solution no one told me about: go direct
After doing more research on my own, I realized I could simply re-instate my plan with Blue Cross directly, since I do not qualify for subsidies. The premiums and benefits are exactly the same. On October 30, I called Blue Cross Blue Shield of Illinois to ask the question if this would indeed work. "Certainly", said the agent. "We can get an application in today and get your coverage back on November 1". So, after another hour on the phone, I had completed the application process, paid my first month's premium, and would have coverage back on the 1st of November.
Or so I thought.
Guess what? You still don't have coverage!
When I looked more closely at the confirmation email I received, the effective date of the policy was marked DECEMBER 1. So, it was back on the phone with Blue Cross, telling the entire story from start to finish another two times to two different representatives. After reviewing the situation, they acknowledged the error and agreed to make the policy effectine November 1. "This may take a day or two", the representative said. "We'll call you when it is done".
You guessed it, 3 days (plus the weekend) and I've heard nothing back. In the meantime, my prescription refills have run out yet again, and since I cannot afford to keep paying out-of-pocket, I've started using an alternative medication that I was advised NOT to use. However, I have no choice in the matter.
I've paid for my own health insurance for 15 years, only needing to begin actually using it in 2011. Despite doing everything I was supposed to do, paying every premium, following the instructions of government representatives and believing the word of Blue Cross Blue Shield of Illinois, now I'm simply out of luck. Health care is a top-priority item for me, everything else in my life revolves around it. I've taken a significant financial hit in the past 30 days through no fault of my own. This isn't just a minor inconvenience, the government and BCBS are playing games with my life. No one in either entity cares, and I've been simply put off multiple times and left to fend for myself.
I am hoping this blog post will get the attention of some higher-ups and even lawmakers and media, and through search engines, allow others who have faced the same issues to find that they are not alone.
UPDATE 11/14: My effective date of coverage was successfully moved to November 1, and I was finally able to fill my usual prescriptions on November 14 (after going without them for nearly a month).
Unbelievable
- Posted by mom | | |
This all sounds SOOO familar to what happened to me between Nov 2013 and Feb 2014. Healthcare.gov CS was awful, but Blue Cross was even worse. And it just went on and on, with contradictory information, repeatedly unfulfilled promises, stonewalling, refusal to escalate, 1.5 hour phone holds...the whole works. As for the identity quiz, I didn't have a problem with that in THIS case, but I've had huge problems with it elsewhere. To select questions for these quizzes, companies use what they call "publicly available information," which basically means shady scavenger websites. And they can be full of misinformation. In my case, I found one big reason I was failing identity quizzes when I got my annual free credit reports from the three credit bureaus. One of them had personal data for "me" that was actually from a deceased individual with the same name, from a different state. That happened because one bank we both used at one point had mistakenly submitted the bureau his history under my name. They fixed the credit report after I pointed out the error, but that made little difference, because all the incorrect personal info (e.g., street addresses, employer) for this person still resides on the shady "publicly available" databases that companies use for "i.d. verification." In fact, I now purposely answer these questions incorrectly to pass (i.e, I say I have lived on Smith Street when I never really have, because I know the person who my personal data was conflated with did live there). Even without that kind of conflated info there are questions which I would not know the answer to, e.g., questions about the the woman my father married after my mother died.
- Posted by Rick from Chicago | | |
|
