With the Health Insurance Marketplace starting its second open enrollment period on Saturday, freelance writer Virginia Anderson talks about her recent misadventures with the marketplace. After last year’s disastrous launch, government officials now say upgrades will make HealthCare.gov run more smoothly this time around. Still, insurers, consumers and others are bracing for a bumpy ride.
If I heard the word “glitch” once more, my head would have exploded and I'd have gone to the emergency room.
The problem was, I couldn’t go to the emergency room — if my cranium suddenly detonated, if I had chest pains, if I twisted an ankle — and have the costs paid by the insurer I chose on the federal Health Insurance Marketplace in late August. A “glitch” is blocking me.
You might think that I would have an easier time of enrolling in the marketplace and getting coverage than the average consumer. I have been a medical reporter for more than 10 years. I specialize in consumer health. In addition, I have been a personal finance reporter and columnist, and I have written about medical insurance, benefit selection and flexible spending accounts with a fervor that some people write love poems.
So when my 26-year-old daughter and I needed to buy health insurance when ours ended in August, I was not a bit concerned. We both had graduated in May. Insurance coverage from our respective universities was about to end. She needed coverage for only a month, until she began her full-time job. Her father and I both explained that she needed to sign up through the Obamacare marketplace, even if she only needed coverage short-term until she moved. I was thrilled and grateful we had the opportunity to buy insurance.
As for me, I wanted a bare-bones, catastrophic policy — the one that you don’t pay much for and that has a sky-high deductible.
I was not daunted by the prospect of enrolling through the marketplace, in part because of my background writing about medical insurance. I also had a freshly awarded master’s degree in health journalism, and my daughter had just earned her law degree. Between the two of us, we should be able to select health insurance, right? With her father — who has four degrees — looking over our shoulder, we could figure this out. How hard could it be? Three people with eight degrees should be able to get this right.
It wasn’t hard at all for her. For me, it was and is a major hassle.
My daughter chose a low-deductible plan from Kaiser Permanente. For those three weeks before she started working, she wanted something that would cover everything from a bee sting to a broken wrist.
Kaiser was great. They sent her letter after letter almost immediately. Within a week, she received her insurance card and member brochure.
I was so impressed that I selected a Kaiser plan for myself two weeks later. I chose a high-deductible plan because my needs — and budget — were different.
I didn’t know it, but the “glitch” already was at work behind the scenes.
While Kaiser had started sending my daughter membership cards and other material very quickly, I received only a one-page, “welcome to Kaiser” letter, telling me how much money I owed. I didn’t really owe Kaiser money, though. I already had paid my first month’s premium online. Was I being treated differently because I chose a catastrophic plan?
I called the member services line. No worries, a representative told me. My card was on the way. Just give it time.
I waited another week. No card. I called again.
This rep told me she could see my information in the system, but that member services must just be backlogged. Give it another week.
The same thing happened the next week. Soon, a month had passed, time to pay a new premium. I called again.
“Something must be wrong,” I told the rep. “Too much time has passed.”
“Oh no, I see you in our system; it’s just that the cards aren’t out,” the rep said. “But you can go ahead and pay.”
I was feeling like it might not be in the cards for me to buy insurance in the marketplace.
As the bill for my October coverage was due by Oct. 31 at the latest, I felt anxious as October rolled by. I called for the eighth time.
Again, a rep told me to go ahead and pay, I’d be getting my card soon.
She assured me that I could walk into any Kaiser treatment facility and be treated.
But what if I need to go to an emergency room?
They’d reimburse me eventually, but I’d have to pay the whole bill up front and out of pocket.
Not what I wanted to hear.
I made another call on Oct. 24.
“Can you tell me if your files show that my card has been sent out?”
This rep apologized and said the system was “ridiculous.” I asked to be transferred to member services.
That’s when I learned about the dreaded glitch. As it turns out, this rep said that I am lost in translation. When we enrolled in the marketplace, the rep said, the government’s computer wouldn’t “talk” to Kaiser’s computer, or that of any other insurer. Instead, a third-party vendor took the information from the exchange and parcels out the data to the insurers.
Believe it or not, nearly three months after I signed up, my new card arrived in the afternoon mail on Thursday.
It made my head hurt.
But now I can go to the doctor for that.
Improving access to health care is a priority for Kaiser Permanente, and it is the reason we chose to offer plans through the health insurance marketplace. Although we were able to successfully enroll thousands of Georgians through the marketplace, we put in a new system to do this, and it's clear that we made some mistakes in this case.
First of all, we should have clearly communicated the policy we put in place this year: Any new member who comes to us for care is provided that care regardless of whether they have their card in hand, and are not asked to pay for everything out of pocket and be reimbursed later. We are reinforcing our training for our call center staff.
Second, while we’re still investigating what happened, we’ve learned that the error in your enrollment paperwork was the result of a glitch in our new system. We've only had a small number of these, and in your case, we did not move quickly enough to fix it and issue your enrollment card. We are working to make sure we don’t delay solving these problems in the future. Bottom line, it shouldn’t have happened, and we should’ve fixed it sooner when you let us know there was a problem.
We apologize for the mistake and the inconvenience it caused you.
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This article was done in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.