Health insurance (or lack thereof)

Be warned: this story, although full of twists and turns, does not have a nice resolution at the end. It has no resolution (yet).

In early February, Jarom’s work had someone come in to help employees through the process of buying health insurance through the Healthcare Marketplace. Jarom selected a plan that is actually much better than what we had through his company. Yay! Better insurance starting March 1!

Except wait. There was an error in Jarom’s application, so he called the Marketplace folks immediately after finishing the application and asked what to do. He was told that they would delete the application, and he should start a new one online, which he did that same day (February 7).

Hey guess what? Instead of deleting the first, incorrect application, they sent it on to Arches, our selected insurance network. But they didn’t send the second application. The folks at Arches told Jarom it would probably just be a few days until the got the correct information. Unfortunately, they still hadn’t gotten it by March 1, which meant we didn’t have health insurance for the month.

Jarom called the Marketplace again on March 5 and was told that they would escalate our file to a caseworker, and it would take 30 days to complete an investigation into what went wrong and why. (At this point I had already stopped caring why things had been messed up – I just wanted coverage!)

Over the next month and a half Jarom checked in every week with our newly-assigned caseworker at Arches to see if she’d gotten the second application yet. Still no, still no. Whenever he called the Marketplace, he was told that it would be “2-3 days” until a caseworker could review our file and get back to us. Eventually I took pity on Jarom, who was having to use his breaks at work to make these frustrating calls, and I said I would take care of it. And I would get us insurance. I would do it!

Yeah . . . that didn’t work out. I called on April 21 when the kids were playing a neighbor’s house. After an hour on hold, I finally got a real person to whom I had to explain the drama we’d encountered. She tsked and agreed it was so frustrating, she’d get it taken care of right away. By the end of a half-hour conversation with her, she read me what was on her screen: “Congratulations. Your application has been completed. Your insurance is effective today, April 21, 2014.” I felt triumphant! I sure showed Jarom. It just took patience, right?

Of course, Jarom was right, I didn’t actually solve anything. I kept calling our caseworker at Arches, but she never received our information. I desperately needed a refill on my Zoloft; she told me to go ahead and see my doctor, and we could fill out paperwork later to reimburse what I paid out-of-pocket. By May 5, still nothing useful had been accomplished.

So I called the Marketplace yet again. This time I was transferred 3 times, having to explain my situation each time, until I wound up in the “fix it” department. The woman I spoke with freaked out about the April 21 effective date. She couldn’t get over it – “The start date should always, always, always be on the first of the month!” she kept saying. It turned out that the lady who had, I thought, fixed our application so that it would be effective had actually cancelled application #2 and started #3, which was the April 21 one. Freaking-out lady swore that this was the problem: whether a glitch in the system or an error by the previous employee, this mid-month start date was preventing things from working smoothly.

Her first suggestion was to escalate our file. Yeah, been there, done that. And despite the “30 day” timeline Jarom had been given, it had been 60 days since the original escalation, with no communication whatsoever from any caseworker. So instead freaking-out lady cancelled that and started application #4, which would be effective June 1. I expressed quite strongly that I did not want yet another application, there was obviously some other problem preventing our information from ever being sent over to Arches, and I didn’t want to spend another month without insurance. Solution: petition a caseworker to alter the June 1 start date to May 1, but that would take a few weeks . . . and by that point May would be over . . . and I wouldn’t have actually had any insurance during May. I told her again that I had no interest in dealing with petitions and escalations, I just wanted insurance. Soon.

“Our system is all automated, so there shouldn’t be any errors,” she told me. “I know it’s hard to believe something good could happen after what you’ve been through, but there’s no reason this application won’t work.” Ha! Your automated system has failed me, lady. But she was adamant. Come June 1, I’d have insurance.

Aaaaaand Arches still hasn’t gotten our information. Although the last time I spoke with our caseworker there, she said she saw 3 applications for us, but not the most recent one. WHAT? Suddenly applications 2 and 3 have made their way over – and unfortunately, they’ve both been cancelled by “helpful” Marketplace employees. I’m waiting to hear back from Arches about when those applications came through – because if application #3 got there before I talked to freaking-out lady, and the Arches caseworker just didn’t let me know, then maybe I have someone to blame. Rather than just an “automated system.”

There are about 10 days left until we supposedly have health insurance. What do you think the chances are we’ll actually get it?