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The poor design of healthcare.gov directly impacted my family. I hope it is all just minor, but the possibility for significant effects remains. Explanations follow.

This is a follow up diary promised in an earlier one in which problems with healthcare.gov were laid out in detail. This diary is a personal account of realized and potential impacts of the poor web site.

I considered addressing why a highly educated and experienced person needs government subsidized health insurance, but that is a micro and macroeconomic diary for another day. Most of the points have been covered in stories about the recession and reports about difficulties for older people like DarkSyde, myself, and others.

This story starts back in December, 2013, when the greenandblue family began applying for insurance through the ACA marketplace. At the time, we had no reason to think that there was any special need for insurance. A month or two probably wouldn't matter. Our healthcare.gov application was completed on time for insurance starting Jan 1, or so we thought (see part 1 for details), but we were willing to be patient for this new and highly used system.

I am willing to call responsibility for missing the deadline for insurance starting Jan. 1 a tossup between us and healthcare.gov. Missing the deadline for February 1 was entirely due to healthcare.gov and its contractor(s). Making the deadline for insurance starting March 1 was due to our diligence, in spite of healthcare.gov.

Since December, our son has had two issues. One was a pretty harsh flare up of eczema on his hands. He could barely move his fingers, and there was constant itching and pain from dried and cracked skin. We should have been more proactive, but he has had minor cases many times, and never lost use of his hands.  The other thing was pain in his lower abdomen that started in recent months and has persisted.

We ended up taking him to a doctor in early February. If healthcare.gov was working correctly, then we would have had insurance. Fortunately, the kind doctor gave us a discount and provided nonprescription remedies. The stomach pain may be lactose intolerance. We cut out his milk, and it seems to be helping. If the pain flares up, we might cut out all dairy. Beyond that, we would need further diagnostics. For the eczema, we initially tried natural oil, primarily castor, and gloves. The oil bothered him too much, so we switched to over the counter hydrocortisone cream, and wrapped the worse hand in bandages for about a week. His hands are now healing. The cold winter may have been a contributing factor, so spring will be welcome, but the eczema might be an issue he has to be aware of for the rest of his life.

Now for Mrs. greenandblue. She sometimes gets dizzy and has blacked out about every 1-2 years. She checked with a doctor years ago, with no high confidence diagnosis produced. It could be anemia, blood sugar, or some other issue with potential dietary solutions. Or it could be worse.

Then, in late January or early February, Mrs. greenandblue experienced discomfort around her right shoulder and noticed that the bone on that side seems to be bigger than the one on the other side. Plus it hurt to press on the area.

It could be something benign, like a cyst, whatever that is, or it could be something worse, like lymphoma or another type of tumor that impedes nerve signals or blood flow, which can explain the dizziness episodes.

Our need for medical attention suddenly increased in urgency. After debating for a week, we paid out of pocket for a doctor visit. The doctor recommended a CT scan to be scheduled as soon as possible, preferably the next day. We put it off until March due to a lack of funds and no health insurance until then.

The CT scan was performed on March 3. I was going to wait for the results to post this dairy, but it will be another several days for the doctor to report the results to us. I wanted to post this part of our insurance story sooner than that. I will follow up with CT scan results if there is interest here.

In short, there was a delay of 3+ weeks in healthcare for Mrs. greenandblue. The delay in insurance to cover this treatment is largely due to problems with healthcare.gov. If her issue is serious and spreading, it will be a costly delay in treatment. Hopefully, it will not be serious and her treatment will not be impacted.

Before closing, the ACA must be credited. Without it, we could not have gotten any decent insurance, and we would likely have been dropped as soon as we used it for the CT scan. I would have also been very hesitant to write this diary for fear of the insurance company. Now, I have some comfort in knowing that we can get healthcare we deserve, and can talk about it in public too.

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Comment Preferences

  •  I Share Your Pain, Sort Of (1+ / 0-)
    Recommended by:
    greenandblue

    I had some serious issues signing up myself, but not on Healthcare.gov. I live in California and the CoveredCA.com website might be even worse than Healthcare.gov. It's a miracle that CA is doing so well with signups.

    As a result of my signup difficulties I have been carrying three redundant policies most of this year. I finally managed to get one canceled and I'm hoping to have the last remaining wrong policy canceled before the end of March. Oh, and to make matters more interesting, they canceled the wrong one last time and I was left without a valid policy that I already paid double for.

    The exchange process was so problematic for me that I just ended up signing up directly from Anthem Blue Cross while my Exchange application was hung up by red tape and gaffes. That was a big mistake because I then learned that Anthem Blue Cross was just as much a part of the problem. I should have just hung in there.

    As a result of my lack of patience, I ended up double enrolled because for some reason, after I paid for my direct signup, my zombie exchange application suddenly was approved even though the problems with it were not fully resolved. This set off a comedy of errors in which neither I nor Anthem had any idea which plan was the correct plan and how to apply my payments. Consequently, they canceled the wrong plan and reallocated all of my payments to the plan that was supposed to be canceled, effectively leaving me with no insurance after having paid double my premium.

    If you'll believe it, I actually had three active plans for most of this year. The third one was entirely my fault for not reading my mail carefully enough. All three were with Anthem and all three were for equivalent plans with very similar names that confused the hell out of everyone who tried to help me.

    After months of wrangling and too many hours on hold, I think I've finally got it under control. The whole ordeal was massively frustrating, but my insurance premiums went down by over $300/month (no subsidy either) so I'm a bit more willing to deal with the growing pains. I'm lucky that the nightmare that I've had really constitute only a huge inconvenience for me.

    Among the more bizarre exchange based issues I ran into was an evil twin issue. I seem to have a double in the government's systems. This evil twin has the exact same information as I do. Anytime I enter an address, it looks me up and asks me to clarify which of the two matching addresses are mine. They're both identical.

    Probably for the reason that it can't tell which version of me I really am, I ended up having to first prove citizenship with a Social Security card. Then I had to prove I was actually that person with a birth certificate because they couldn't seem to authenticate my SSID. That made me real paranoid for a few days... I was thinking, what if my parents snuck me in undocumented while I was tot?

    Then I remembered... you idiot, you know the hospital you were born at. You get frazzled and stop being able to think logically.

    I'm with you... awesome law... awful execution. Next year needs to be better... and not just on the government side. The insurers are no better. The whole system is leaky from top to bottom.

    •  This is ridiculous (1+ / 0-)
      Recommended by:
      smirking

      Most of my problems were with the government registration. I would hope that CA would be better on that side.

      On the market side, I wonder how much insurance companies are mucking up the works in order to maximize revenues. For now, I will give them the benefit of the doubt and chalk the problems we have had on the insurance  market side are the result of implementing a big, new law. Their actions should be reviewed anyway, and if it continues next year, then they should face some consequences.

      We also chose Anthem Blue Cross. Their different plans were difficult to decipher. It only took us a few calls and careful review of on line documents to make a decision. On the phone, the agents were a bit condescending in that we simpletons should know how to interpret their plan names and details. That's ok, I don't mind playing simple and getting them to explain things fully and carefully. First, you have to get past the marketing phrases to figure out what the plan really is.

      •  correction (0+ / 0-)

        For now, I will give them the benefit of the doubt and chalk up the problems we have had on the insurance market side to implementation of a big, new law.

      •  Benefit of the Doubt (0+ / 0-)

        I have no love for the insurance business model, especially since I was massively gouged with premiums of up to $850/month for having a couple of mild pre-existing conditions despite being in very good general health. That said, I also give them the benefit of the doubt and I do believe that they're trying to make this work.

        Ironically, the worse my situation got, the more I believed that they were doing everything they could to rectify the situation. Without counting the hold time, I've spent hours on the phone with with one of their representatives. Some of the people I talked to don't appear to have been just regular customer service reps who don't have much power to do anything. I talked to all sorts of people and all of them seemed genuinely bewildered at how to get my situation resolved and most of them ended up consulting with a higher up while I was on the line. You add up all the time spent on just me alone between the person who answered the phone and all the people they had to interrupt to review my case with and you've gone one hell of an expensive administrative error.

        I'm sure there are people who are eating up even more of their time than I was and many of those people are likely paying smaller premiums. Also, the more I dealt with them, the more I started noticing really sloppy use of their technology. I do tech work so I recognize these kind of things as things that happen when all of their IT people trying to keep the house from burning down.

        One of my calls to them was in mid-February, their hold message was still repeating a message that expired on January 30th.

        I had to get a prescription manually reimbursed because the pharmacy wasn't getting the right information back. I couldn't find the form to download because the form disappears once you login as a member. The form only appears when you're not logged in.

        I was getting emails and letters asking me to pay my premium online. I tried, but their payment gateway would be down... But those messages were an error anyway, because they already had my payment information. I gave it to them on Dec. 10th. It didn't get charged until Jan 25th. That's how I ended up double enrolled.

        The deal is that to date healthcare insurance was not a consumer focused industry. I mean that in the sense that they're focused on institutions and there's a lot of infrastructure you can skip over if you're doing your sales a few hundred to a few thousand people at a time. Most of these companies probably also are lacking sufficient in-house expertise to become consumer focused businesses in such a short period of time. All sorts of crazy things happen with individual customers that don't happen on an institution by institution level.

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