Thursday, November 12, 2015
5pm call back that hasn't come
It's currently 5:10 and I haven't heard a thing. I'll update if I hear back before the end of the day. Otherwise, this lucky mom (with a daughter who has hand, foot and mouth disease we're trying to contain to her and not her little brother, so is running around spraying lysol like I've got a stockpile of it) will get to call back tomorrow.
Wednesday, November 11, 2015
Busy Day!
What an eventful day.
Call #1 reference number 151110001871 Called at 2:54pm
I spoke to a gentleman named Floyd. Upon him asking for my phone number, still irritated about not receiving a call back I said I don't see the point, I gave it yesterday and never received a call back so what exactly is my number for? His response, "Ma'am if you could please act professionally, did you request a call back?" Seriously??? I said, "well like you JUST said, can I have your number in case we get disconnected, doesn't that imply that in the event we get disconnected, I'll get a call back?" His response, "I'm sorry for that implication." What the what?? I pressed and he said let me look into why you didn't get a call back, and he put me on hold. He came back and stated after speaking to a supervisor that they were "having server issues at the time and they show the call was dropped but they were unable to access my contact information". I said "ok, well are the servers up and running now?" to which he replied, "yes" and I said "ok, so seeing as it's now the afternoon the following day, couldn't someone have called me back today?" He didn't have an answer for that. I asked for a supervisor, was put on hold and was told there is no supervisor available even though 2 minutes before he'd gotten an answer from a "supervisor".
Moving on, he assured me he could help me and that we would definitely qualify for assistance. When I stated why does everyone seem so confident when the last person was always unable to find assistance for us he stated "well we all have different skills and some may not have paid attention during training classes". Wow. These are government employees!
While we was inputting the information, I questioned him about appeals and asked if we qualify this year, then we should have last year and if I could appeal what I've been paying this whole year and he said "That's all in the past, lets worry about now." Easy for him to say, he's not the one who has been paying over $500 month for an insurance plan with a $3500 deductible we are no where close to meeting even after a cancer scare resulting in 2 mris, a bone scan and plenty of doctors appointments.
Our call disconnected/dropped at 3:55
I took 5 minutes to get the kids up from naps and I called back at 4pm
Call #2 reference number 151111-003955
I spoke to a woman named Katina who was very friendly and helpful. She understood my frustration and looked over my application. She also informed me that the way the system works is they og if a call is dropped and then it goes into the system to generate a call back. The person with whom you're speaking never actually calls back. Obviously this system is flawed because they "system" hasn't returned any dropped calls.
She stated that it's possible we weren't eligible because we only put annual income and not monthly and assistance goes of monthly. That's the first I'd heard that. She also asked if we own our home, to which I responded yes. She said we could deduct the amount of interest and taxes we pay annually from the gross income reported to also help with assistance. Why is this the first I'm hearing about this? Why did no one mention this last year. This could've made a difference last year and this entire year we've been paying! Again, according to the table (See below) we should be eligible without having to do that and no one can tell me why we're not, BUT if it could help why not. We did this and as we were getting all the numbers in,surprise surprise! We were disconnected at 5:03pm.
Call #3 reference #151111-004176 5:05pm
Spoke with a woman named Deasha.
At this point I was incredibly frustrated. Did I mention my daughter has a 102.7 fever upon waking from nap? I've been at this 2 days in a row now so Deasha got an earful. She made the mistake of asking for my phone number for a call back. I lost it.
She kept asking for my information to get started and I said why!! we're just going to get disconnected again! Who can I call if we get disconnected again? Because with 2 little kids I cannot keep calling back after being disconnected and sit on hold for a minimum of a half hour before speaking to a person. She said you can go online and do the application yourself. I said I understand that but you guys keep telling me there's some error making us not eligible so I should do it over the phone. I said what department runs the health exchange, I need to know how I can go higher because this is ridiculous. She said "you can contact the state of Maryland." Ugh. I give up. So I swallowed my pride and let her start the process for the 4th time in 24 hours.
She again, assured me that based on income we should qualify, yada yada yada. We got through the app and much to my surprise (total sarcasm) we qualified for a grand total of $0 in monthly subsidies. I discussed appeals with her and she said an appeal was something she had to complete. I said ok and if we get disconnected can I assume the appeal has been filed? She said yes. She said the appeal instructed her to first try getting a price from the anonymous browser. I asked what that meant and it's essentially getting an estimate of what you qualify for without entering all your socials, etc. It asks for your ages, income, and county you reside in. I gave her all this and we entered the income minus the mortgage tax amount which falls much less than what the table describes as eligible.
Here's what we get based on that info:
So, the appeals instructions basically say that if this shows we're not eligible to try to defer us from appealing. But according to the table on their website we should be eligible. I asked if maybe it had to do with the county and she said she wondered that too. So she entered all the information again but instead put Harford County -$0. She then tried Baltimore City and Anne Arundel County and both resulted in $0. She decided to try Montgomery County and we were eligible for $1.64/month in subsidies. Well lets just pick up and move so we can get $19.68/year in assistance!
So I pressed on. I still want to appeal. I was transferred to a supervisor at 6pm.
Supervisor's name: Kito
I spoke to Kito until about 6:40 and most of the time was spent with him trying to convince me I shouldn't appeal. His reasoning was that there was additional criteria that could be reason for denial. The reason for the denial he said was most likely our ages and county. If we entered 50 as age we'd be eligible. So that whole doing away with discrimination thing that ObamaCare promised? Instead of discriminating against elderly, now it's the young. And I questioned what in the world does the county I live in have to do with a darn thing? He had no answers for my questions.
I'm hopeful that an appeal will provide me with an answer as to exactly WHY we're not eligible. He instructed me on how to file the appeal myself. (If you remember, the previous staff member told me it's something they handle)
He also suggested in the mean time I contact a broker to try to find a plan more affordable for us because there's no answer as to how long the appeal process could take. Days, weeks, months, no idea. So while on the phone with him, he advised me to finalize the application and then I could contact a broker.
I logged in and followed his instructions and it kept taking me to the beginning of the application as if nothing had been completed. When I tried to start over, I kept getting a server error. Apparently, he'd been logged in to my account at the same time as me so there might be an issue. He said to see if it resvoles over night and he'd call me the following day (11/12) around 5pm to see if it worked and I was able to contact a broker (application must be finalized before contacting a broker). We ended the call around 6:40pm with the understanding he'd be following up the next evening.
Call #1 reference number 151110001871 Called at 2:54pm
I spoke to a gentleman named Floyd. Upon him asking for my phone number, still irritated about not receiving a call back I said I don't see the point, I gave it yesterday and never received a call back so what exactly is my number for? His response, "Ma'am if you could please act professionally, did you request a call back?" Seriously??? I said, "well like you JUST said, can I have your number in case we get disconnected, doesn't that imply that in the event we get disconnected, I'll get a call back?" His response, "I'm sorry for that implication." What the what?? I pressed and he said let me look into why you didn't get a call back, and he put me on hold. He came back and stated after speaking to a supervisor that they were "having server issues at the time and they show the call was dropped but they were unable to access my contact information". I said "ok, well are the servers up and running now?" to which he replied, "yes" and I said "ok, so seeing as it's now the afternoon the following day, couldn't someone have called me back today?" He didn't have an answer for that. I asked for a supervisor, was put on hold and was told there is no supervisor available even though 2 minutes before he'd gotten an answer from a "supervisor".
Moving on, he assured me he could help me and that we would definitely qualify for assistance. When I stated why does everyone seem so confident when the last person was always unable to find assistance for us he stated "well we all have different skills and some may not have paid attention during training classes". Wow. These are government employees!
While we was inputting the information, I questioned him about appeals and asked if we qualify this year, then we should have last year and if I could appeal what I've been paying this whole year and he said "That's all in the past, lets worry about now." Easy for him to say, he's not the one who has been paying over $500 month for an insurance plan with a $3500 deductible we are no where close to meeting even after a cancer scare resulting in 2 mris, a bone scan and plenty of doctors appointments.
Our call disconnected/dropped at 3:55
I took 5 minutes to get the kids up from naps and I called back at 4pm
Call #2 reference number 151111-003955
I spoke to a woman named Katina who was very friendly and helpful. She understood my frustration and looked over my application. She also informed me that the way the system works is they og if a call is dropped and then it goes into the system to generate a call back. The person with whom you're speaking never actually calls back. Obviously this system is flawed because they "system" hasn't returned any dropped calls.
She stated that it's possible we weren't eligible because we only put annual income and not monthly and assistance goes of monthly. That's the first I'd heard that. She also asked if we own our home, to which I responded yes. She said we could deduct the amount of interest and taxes we pay annually from the gross income reported to also help with assistance. Why is this the first I'm hearing about this? Why did no one mention this last year. This could've made a difference last year and this entire year we've been paying! Again, according to the table (See below) we should be eligible without having to do that and no one can tell me why we're not, BUT if it could help why not. We did this and as we were getting all the numbers in,surprise surprise! We were disconnected at 5:03pm.
Call #3 reference #151111-004176 5:05pm
Spoke with a woman named Deasha.
At this point I was incredibly frustrated. Did I mention my daughter has a 102.7 fever upon waking from nap? I've been at this 2 days in a row now so Deasha got an earful. She made the mistake of asking for my phone number for a call back. I lost it.
She kept asking for my information to get started and I said why!! we're just going to get disconnected again! Who can I call if we get disconnected again? Because with 2 little kids I cannot keep calling back after being disconnected and sit on hold for a minimum of a half hour before speaking to a person. She said you can go online and do the application yourself. I said I understand that but you guys keep telling me there's some error making us not eligible so I should do it over the phone. I said what department runs the health exchange, I need to know how I can go higher because this is ridiculous. She said "you can contact the state of Maryland." Ugh. I give up. So I swallowed my pride and let her start the process for the 4th time in 24 hours.
She again, assured me that based on income we should qualify, yada yada yada. We got through the app and much to my surprise (total sarcasm) we qualified for a grand total of $0 in monthly subsidies. I discussed appeals with her and she said an appeal was something she had to complete. I said ok and if we get disconnected can I assume the appeal has been filed? She said yes. She said the appeal instructed her to first try getting a price from the anonymous browser. I asked what that meant and it's essentially getting an estimate of what you qualify for without entering all your socials, etc. It asks for your ages, income, and county you reside in. I gave her all this and we entered the income minus the mortgage tax amount which falls much less than what the table describes as eligible.
Here's what we get based on that info:
So I pressed on. I still want to appeal. I was transferred to a supervisor at 6pm.
Supervisor's name: Kito
I spoke to Kito until about 6:40 and most of the time was spent with him trying to convince me I shouldn't appeal. His reasoning was that there was additional criteria that could be reason for denial. The reason for the denial he said was most likely our ages and county. If we entered 50 as age we'd be eligible. So that whole doing away with discrimination thing that ObamaCare promised? Instead of discriminating against elderly, now it's the young. And I questioned what in the world does the county I live in have to do with a darn thing? He had no answers for my questions.
I'm hopeful that an appeal will provide me with an answer as to exactly WHY we're not eligible. He instructed me on how to file the appeal myself. (If you remember, the previous staff member told me it's something they handle)
He also suggested in the mean time I contact a broker to try to find a plan more affordable for us because there's no answer as to how long the appeal process could take. Days, weeks, months, no idea. So while on the phone with him, he advised me to finalize the application and then I could contact a broker.
I logged in and followed his instructions and it kept taking me to the beginning of the application as if nothing had been completed. When I tried to start over, I kept getting a server error. Apparently, he'd been logged in to my account at the same time as me so there might be an issue. He said to see if it resvoles over night and he'd call me the following day (11/12) around 5pm to see if it worked and I was able to contact a broker (application must be finalized before contacting a broker). We ended the call around 6:40pm with the understanding he'd be following up the next evening.
Tuesday, November 10, 2015
1st call
Today I contacted the Maryland Health Connection Consumer Helpdesk around lunch time. I was on hold waiting to speak to a live person long enough to make my kids lunch, for them to eat, eat lunch myself, change a diaper, put them down for naps,and do some cleaning. After about an hour wait, I finally got through. The woman was very helpful and assured me that based on our income, we would most certainly be eligible for assistance. At this point I did not catch her name nor did I take down the reference number. I didn't realize this would be the first of many calls, rookie mistake. At the beginning of the call they verify your information, ask you for your name and your phone number in case you're disconnected. Every time you call you're immediately given a reference number. They never ask if you've called before or if you have a previous reference number so I'm not really sure what these are for.
She walked me through the application over the phone, and advised that we alter my husband's pay because it was coming up that we weren't eligible. I said that I have 2 concerns with that; 1. This seems like a technical issue, instead of lying, why don't we figure out WHY we're not eligible for ANY assistance when the table (see below) advertised says we most certainly should be and 2. What happens come tax filing time when the numbers reported don't match? I'm not interested in being penalized because a help desk worker advised me to report lower numbers. She insisted it would all work out and a few minutes later we were disconnected. We were disconnected around 3pm and my phone shows I made the call at 11:58am.
Since at the beginning of the call, they asked for my number for a call back, I waited patiently for a call back (silly me). The afternoon went on and since my kids were now awake I decided I'd try again tomorrow.
She walked me through the application over the phone, and advised that we alter my husband's pay because it was coming up that we weren't eligible. I said that I have 2 concerns with that; 1. This seems like a technical issue, instead of lying, why don't we figure out WHY we're not eligible for ANY assistance when the table (see below) advertised says we most certainly should be and 2. What happens come tax filing time when the numbers reported don't match? I'm not interested in being penalized because a help desk worker advised me to report lower numbers. She insisted it would all work out and a few minutes later we were disconnected. We were disconnected around 3pm and my phone shows I made the call at 11:58am.
Since at the beginning of the call, they asked for my number for a call back, I waited patiently for a call back (silly me). The afternoon went on and since my kids were now awake I decided I'd try again tomorrow.
Monday, November 9, 2015
Introduction
I live in Baltimore County, MD with my husband and 2 little ones. I have a 2 year old and a 1 year old. Both my husband I were working up until delivery of my son when we agreed that I'd only be working to pay for day care and not much else, so it'd be best if I stayed home. We're now on 1 income and seem to be about as average middle class as you can get.
As someone who has a history with pre-existing conditions, finding health care coverage has not always been easy. I've been denied and unsure of the next steps. When I heard about Obamacare doing away with denial for pre-existing conditions, I thought, well at least one good thing will come of it.
When I was working, I was working in HR and sat through meeting after meeting, webinar after webinar while Obamacare was being implemented and saw first hand the struggles that employers had to go through to be considered "compliant". In many cases it seemed Obamacare was making it easier for the employer to just pay the fine instead of offering affordable coverage. As someone who has seen the "loop holes" and lack of actual answers and facts, I knew from the beginning this was going to be a nightmare if/when implemented.
When I stopped working my insurance only went until the end of that month, September 30th. I tried to purchase coverage through the exchange so that I would not be uninsured for the delivery of my son. I was told that because I was pregnant, I could not purchase coverage (so much for no pre-existing conditions) and that my husband and daughter could go on their own plan purchased through the exchange but my son and myself would have medical assistance for the delivery and 3 months after. I would THEN be eligible to join my husband and daughter on a plan through the exchange but the price would go up accordingly and they had no way of telling me how much,
This caused a huge problem days before delivery because when discussing this with my OB, she informed me she does not accept medical assistance and I would have to pay out of pocket if I wanted her to deliver my son. Can you imagine the stress at 39 weeks pregnant?
I was incredibly fortunate that when I contacted the company I'd just left, they agreed I could stay on the insurance another month. I delivered my son the next day. HOWEVER, I still was not eligible after that month to purchase a plan and was forced to take medical assistance for myself and newborn for the following 3 months. This caused so much confusion with billing and I am STILL getting bills and calls related to delivery and my son is now 13 months.
Once that period was over, in January 2015 I applied through the healthcare exchange after looking at the table of household size, income and whether you'd be eligible for subsidies based on that. The table showed we would be. I applied and it showed we were eligible for $0 in monthly subsidies. I contact the help desk, and after waiting literally hours, was told we definitely should be eligible and they'd enter the application for me and see if I missed something. They got the same answer. They transferred me around and all anyone could tell me was "you should be eligible but you're not and we don't know why". Not satisfied with this answer I kept asking well who knows why and what can I do? I can't afford this premium and deductible. They said I could file an appeal but seeing as how they're having so many technical issues (back in 2014 and 15 and still now), my appeal "could take over a year if it even got to the right person". These are answers I'm getting by a government agency!
So, I decided not to file and to suck it up and hope for better the following year.
As of last week I began making calls and I want to document my experiences, reference numbers and names. I want to document all the differing answers I'm getting. This blog will follow my journey of trying to attain "affordable" coverage as a middle class working family.
As someone who has a history with pre-existing conditions, finding health care coverage has not always been easy. I've been denied and unsure of the next steps. When I heard about Obamacare doing away with denial for pre-existing conditions, I thought, well at least one good thing will come of it.
When I was working, I was working in HR and sat through meeting after meeting, webinar after webinar while Obamacare was being implemented and saw first hand the struggles that employers had to go through to be considered "compliant". In many cases it seemed Obamacare was making it easier for the employer to just pay the fine instead of offering affordable coverage. As someone who has seen the "loop holes" and lack of actual answers and facts, I knew from the beginning this was going to be a nightmare if/when implemented.
When I stopped working my insurance only went until the end of that month, September 30th. I tried to purchase coverage through the exchange so that I would not be uninsured for the delivery of my son. I was told that because I was pregnant, I could not purchase coverage (so much for no pre-existing conditions) and that my husband and daughter could go on their own plan purchased through the exchange but my son and myself would have medical assistance for the delivery and 3 months after. I would THEN be eligible to join my husband and daughter on a plan through the exchange but the price would go up accordingly and they had no way of telling me how much,
This caused a huge problem days before delivery because when discussing this with my OB, she informed me she does not accept medical assistance and I would have to pay out of pocket if I wanted her to deliver my son. Can you imagine the stress at 39 weeks pregnant?
I was incredibly fortunate that when I contacted the company I'd just left, they agreed I could stay on the insurance another month. I delivered my son the next day. HOWEVER, I still was not eligible after that month to purchase a plan and was forced to take medical assistance for myself and newborn for the following 3 months. This caused so much confusion with billing and I am STILL getting bills and calls related to delivery and my son is now 13 months.
Once that period was over, in January 2015 I applied through the healthcare exchange after looking at the table of household size, income and whether you'd be eligible for subsidies based on that. The table showed we would be. I applied and it showed we were eligible for $0 in monthly subsidies. I contact the help desk, and after waiting literally hours, was told we definitely should be eligible and they'd enter the application for me and see if I missed something. They got the same answer. They transferred me around and all anyone could tell me was "you should be eligible but you're not and we don't know why". Not satisfied with this answer I kept asking well who knows why and what can I do? I can't afford this premium and deductible. They said I could file an appeal but seeing as how they're having so many technical issues (back in 2014 and 15 and still now), my appeal "could take over a year if it even got to the right person". These are answers I'm getting by a government agency!
So, I decided not to file and to suck it up and hope for better the following year.
As of last week I began making calls and I want to document my experiences, reference numbers and names. I want to document all the differing answers I'm getting. This blog will follow my journey of trying to attain "affordable" coverage as a middle class working family.
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