Sorry To Bother You

Quick Personal Update – Thanks for asking. I’m feeling stronger everyday.  Already spending too much time at the office.

Frank (name changed) knew exactly what he wanted. Frank wanted the kind of policy he used to have twenty years ago when he worked in the family business.  He wanted a small deductible, office copays, and an Rx card.  A throwback.  The policy needed to cover him and his twenty year old son.  He wanted Platinum in a Silver or Bronze environment.  Frank was insistent.

There was a way. I could put Frank and his son into the Government Exchange.  Medical Mutual of Ohio was still offering a Gold Level policy through the Exchange, and even though he didn’t qualify for a tax credit subsidy, we could access this contract for them.  I DIDN’T WANT TO DO IT.   I warned Frank that accessing the Exchange needlessly simply multiplied our chances for failure.  But Frank was insistent.

I can’t tell you how many hours I have invested in this disaster. It is difficult to even explain how healthcare.gov messed this up.  But they did.  The original mistake isn’t the interesting part.  It is all of the subsequent steps that leave us today, May 2, 2016, with Frank and his son uninsured.

Let’s skip ahead to April 9, 2016. Frank sat in my office for almost two hours that day.  We were on hold for over 40 minutes before we got to talk to anyone.  We were lucky.  The woman we worked with seemed both knowledgeable and caring.  Here is what she told us:

• I can see where we corrected the initial problem and got Mr. Frank and his son covered as of March 1, 2016
• I can see where we corrected that mistake and got Mr. Frank and his son correctly covered as of February 1, 2016
• I can see that the policy then automatically cancelled itself out on March 1, 2016 through no fault of the insured
• I can see that this was supposed to be expedited
• I can see that it was never expedited

She promised to get this into the right hands and assured us that there was no reason for this problem to persist. We actually felt pretty good about the process when we finally hung up with her.

Don’t get too comfortable

The rejection letter came three weeks later. The government had decided that he didn’t deserve to have his policy reinstated.  The letter helpfully included the marketplace appeal hotline 855.231.1751.  Frank came in today.

By the way, this isn’t a specific problem of the Patient Protection and Affordable Care Act (Obamacare).  This is a bureaucracy issue.  This is a regulatory issue.  This is a full-fledged screw up.

Frank sat in my office as I called the hotline. Working through the automated system I finally hit the button to file an appeal.  WE WERE IMMEDIATELY DISCONNECTED.

Second call. This time, to the surprise of a Ms. Shannon, I managed to get to a human being.  She had no interest in hearing why we were calling.  The process demanded that we must first go to healthcare.gov, file an appeal, and then, and only then, will anyone talk with us.  Maybe.  I tried.  She wouldn’t budge.

We went to healthcare.gov with her on the line. She made sure to point out the next to the last section, Choose an Authorized Representative.  Frank had the right to name me as his contact, someone who could easily answer their questions and make sense of this.  We got off the phone and completed the appeal form.

And once the appeal form had been completed we hit the link to the special authorization form. The picture at the top is where the link takes you.  We’re so screwed…

DAVE