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.
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