Friday, January 17, 2014

I just wanted good health insurance for my children….

When I decided to stay home with my children and only work part-time jobs, it wasn’t for lack of work offers or desire to follow my dreams. I wanted to stay home as my mother and grandmother had done before me, intimately knowing my children and taking care of our little home. And besides, what was the point in paying someone else to raise our children for us? At the end of the day working for a parochial school, I wouldn’t be making that much money after paying day care. My husband’s jobs always include good benefits for him, but the small engineering firms would charge almost half of what he makes in a month for us all to join his insurance. It was cheaper to go it alone on our own individual plan. What I did not foresee is that having a $10,000 deductible and paying $440 a month for health insurance for the three of us would continue to financially devastate us. Perhaps I should have kept working, for at least the healthcare bills would have been manageable.

Unlike my Libertarian father and Republican brother, I was excited that the Affordable Care Act passed because I felt that finally, we the "working class", might catch a break. $1,500 deductibles for what I was already paying? Sign me up! Sadly, though, you often hear that some things are “too good to be true”, and this is one of those stories…

November 2013-

I receive a letter from our current health insurance company that says my plan is no longer legal according to the ACA. They give me an option to be grandfathered in with this same plan, leave, or accept a modified plan at a discount. As mentioned earlier, the $10,000 deductible was reason enough to leave, but I also had a hard time bearing (pun intended) the fact that I do not have Maternity/Labor insurance. As a baby and husband loving woman of child-bearing years, I find it despicable that my taxpayer dollars fund abortion, yet I cannot have a baby on my own insurance plan. We decide that the children and I should leave our insurance company and look for something on the Marketplace, despite the numerous complaints about the website in the media.

I begin applying at for myself and my two children.  First time through, website crashes. Second time through, I get all of the way to the end of the application and it says the “eligibility results are not ready at this time” or something to that effect.

December 2013- I get an email from the Marketplace, so I log back in; all of my information is gone. I start back over. It continues to say that my son is my husband and will not let me change it. I delete this application and start again.

Up until this point, I was willing to offer up these minor inconveniences for the sake of the Affordable Care Act being something new. New things do not always work perfectly the first time through. As someone who often tries to create new programs in the schools, I wanted to give everyone the benefit of the doubt. Even our Federal Government. This might be my first mistake.

December 15, 2013-

My husband and I restart my approximate 4th application after I leave Urgent care for a disgusting sinus infection. We knew we are running out of time to get covered by the New Year. After we complete the application, I am deemed eligible. My 2 year old daughter is deemed eligible through a state run agency (more on this later), but my 4 year old son is deemed ineligible for any insurance in the Marketplace. He has no income or any difference on the application than his sister.

At this point, the numerous Marketplace agents I spoke to should have told me to delete my application and start again. They should have assured me that this was one of the "glitches in the system". Instead, I pick a plan for myself, hoping that the appeals and State agencies would get back to me so that we could all start the New Year with quality health insurance.

December 23, 2013

I file an appeal, (because it must be done within 10 days) and even to date I still have not received ANY response. I continue hoping that perhaps they might get back to me within the week, and I realize now my naïveté.  I pay my new health insurance plan premium online, because New Plan called on 12/22/13 and said I must do this ASAP to be covered.

December 27, 2013

After a lovely Christmas spent with family, I am in a car accident with my son. We are fine, but both cars involved are not. As Dave Ramsey says, “Murphy’s Law will happen” or something to that effect. Things are not looking up on the health insurance front.

December 30, 2013

Now I am starting to panic. I have heard nothing on the insurance front for my children, but I am enrolled in an excellent plan with New Company and selfishly feel relieved. The relief is short-lived, as I continue to call the Marketplace, who state that they have no record of my appeal, and who all remark that it’s “so weird” that my son was rejected, etc. etc.  I call Old Company and try to explain the situation, asking if it is possible that the children can stay on our crappy plan for January or at least until I can figure this out. Old Company says that our State law requires an adult to be on the plan with children. If I leave that plan, Old Company will drop the children and they will have no insurance.  If I STAY on the plan but also get insurance the New Plan (can’t I double up?) the OId Company says they will drop me nonetheless.

In between trying to get the car sorted out with insurance and police reports, etc. I call New Plan and ask if I can just forward the $250 premium I put down into February. They say this is impossible, that I must cancel my health insurance enrollment with the Marketplace.

I call the Marketplace. They say that since I already paid my premium, this is especially tricky. They tell me not to delete my application though, since I have an appeal pending for my son. They assure me they have cancelled my enrollment with New Plan. I call New Plan. New Plan assures me my money will be refunded when the business department gets wind of everything.

I pay Old Plan so that we go into the New Year insured. I plan on restarting the calling and hunting process into January, but at least we have something.

Or so I thought…

January 13, 2014

I get a letter from New Plan stating a doctor they picked for me, an insurance card, etc. I am confused.  I call their hotline and leave a message. No return calls.

I call Marketplace and re-explain situation. I wonder now why I never got the names of the numerous, yet friendly people who have assisted me. At least I’d have some sort of trail to follow. Very fun lady is blown away by my situation, advises me to delete my application and start again. When we hang up, she even adds, “I’ll holla at you later girl”, and then corrects herself. We were on the phone so long, she said, that she forgot I “wasn’t one of her friends”.

I reapply online this night, only this time, they ask for wages before taxes and I’m no longer eligible for the Tax Credit of $55 a month. Fine. Get through entire application…and we’re all approved! Son & daughter are eligible through State Medicaid office. Now, as a former Social Worker and Master’s Degree holder, I have to swallow my pride reading this. Upon further investigation, I learn I still will pay a premium, but this program is under the umbrella of Medicaid. Perfect. Fine. We can do this.

I do not pick a plan for myself or pay because I cannot bring myself to take care of myself (again) until I do so for my children. Lesson learned.

January 17, 2014

I am a hard- working woman trying to finish my Administrative license, an academic portfolio, and raise (poorly, I suppose) two loving children that I want the best for. I should have called sooner, but now, a few days later, I finally call back New Plan (after never hearing back) and speak with Jamal, the first name I actually have ever remembered to write down. Jamal tells me my New Plan account is still active, and that I won’t be getting the premium refunded because I have been insured since the first of the month. I go through it all again…Poor Jamal got his supervisor, who was unavailable to speak with me, promised he marked me Urgent, and assured me that someone would call back…

Maybe it’s just $250. Maybe I chalk it up as a loss. I tried something new that was supposed to help the Working Class and maybe it’s just not my turn. I have a great and loving extended family to turn to in times of trial. However, I can’t help thinking that if I am DOUBLY insured now because of the faults of New Plan, myself, and/or the Marketplace, my two children will lose their coverage if Old Plan finds out. 

If that happens, that is the biggest travesty of them all. They are just kids, and I only wanted the best for them.

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