Tuesday, December 31, 2013

ONE LAST PERSONAL BATTLE OF 2013 -- THIS HEALTH INSURANCE DEBACLE!

It began innocently enough several months ago, when I began asking around about what insurance plan I should consider. As a baby boomer, I have a set of circumstances that are not, after all, atypical. In the past three years, I have opted to work as a self-employed (1099) professional, largely due to the flexibility it has afforded my schedule in overseeing my elderly mother's care. Also, my 59 years have exacted a toll on my body, including osteoporosis, rheumatoid arthritis, and the need for arthroscopic surgery following a sudden knee injury in March of this year. I'm a single (widowed) woman, with a post-doctoral level of education, and like many in my demographic, I'm probably going to be quite advanced in years before I can mark my student loan account "paid in full." It's certainly fortunate that I've gone on record as saying I actually want to work for the rest of my life, and to not retire. I don't want an opulent lifestyle; I just want to be okay.

I've been paying for private insurance since 2006, have enjoyed a trusting relationship with both my physicians, and have been able to budget for my soon-to-be-former health insurance plan. In short, the whole arrangement was working well for me -- until this current mess dreamed up by the Obama administration. But, now the government has chosen to interfere in my life in some profound ways. And I'm taking this whole situation very personally.

Early in November, I contacted an insurance agency recommended by someone whose opinion I highly regard. The cheery representative promised me she would get back to me in early December, and would meet me "anywhere that's convenient to you." Actually, as it turned out, when I called her back (she didn't initiate the follow-up as promised), she rather curtly referred me to a colleague. Once I was in the hands of this individual, I was passed along yet again to someone else for follow-up.

I was compliant with their instructions -- downloading the application from the link they emailed me, filling it out to the best of my ability, and after some back-and-forth faxing and calls, got my finalized information to the agency by the end of the business day on December 20, to assure that they would be able to submit it prior to the December 23rd deadline. The insurance agent said I was all set, and all I needed to do was watch the mail for the first premium bill from my new carrier. I sighed in relief...mission accomplished before the Christmas holiday, right?

Wrong, as it turned out! So very wrong.

In addition to the expected holiday distractions, I had the unforeseen issue with my mother's sudden serious illness, rush to the hospital, and then transfer to a rehab center on Christmas Eve. With ordinary work and household duties, I was now even less cognizant of a insurance snafu that was awaiting me. Then on about December 28, I got a form letter (dated December 20th)from Covered California, telling me that I needed to call to clarify an alleged "lump sum payment" that was supposedly affecting the income numbers on my application. On the next business day, December 30, I called the several toll-free numbers provided, and spent no less than one hour before I got a nice-sounding "live person" who assured me that this letter "had been poorly written," and I should probably disregard it...but, in pulling up my application in the computer system, I was told that it had been filed, but that the insurance agency had neglected to complete it with the most important part -- the plan that I had selected! With no selection, I wouldn't have gotten a premium bill, and with no premium payment, I wouldn't have had any insurance coverage.

This Covered California rep offered to finalize the process with me, which, in hindsight, I should have done. But, I was so angry and blindsided in that moment, I opted to defer this and try to call the insurance agency to find out just how they dropped the ball on this. Two calls from me...no answer.

Today, what should have been a laid-back, rare day off for me, has seen me frantically making two calls (consuming almost 2.5 hours of my time)to finally secure my new insurance (which, if I'd had my druthers, I wouldn't have wanted. My old coverage was just fine, thank you very ****ing much!) before midnight. In the first call, I found out from the Covered California rep that the insurance agency had submitted income and personal data that was "totally wrong," and that I would have to settle for a totally different policy from what I was sold -- at a price tag of about $100/month more than what the agency quoted me. As an independently contracted professional with a variable income, that bill is not always going to be very "affordable." Furthermore, I was told that I needed to call my doctors' offices to ascertain their participation on the plan I figured I could afford.

My rheumatologist's office was closed. I left a message that conveyed my concern. In a call to my primary physician, I was told that he was not on the network for which I was opting.

I was up against the clock, and my head was spinning with the absurdity of the situation. I permitted myself a brief cathartic crying spell before picking up the phone again, hopefully for the last time. This time, I got a very sweet young woman who walked me through the long-awaited final steps, and assured me that, indeed, I would be covered at the stroke of midnight tonight. I thanked her profusely, and wished her a heartfelt "Happy New Year."

I then sat back on the sofa, now totally wasted from this ordeal.

There you have it. As we enter 2014, I have insurance coverage, purchased out of desperation and haste, that I really hadn't bargained for. It's for sure I'll have to start over with a new primary doctor, after many years with one I've come to trust, and I don't know what's going to happen with my rheumatologist and the treatment I need for my R.A. And who knows what this means for the medications crucial for my health and well-being.

Thanks a lot, Washington! And to that incompetent insurance agency, damn you!





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