update on healthcare drama, or can you hear me screaming

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I don’t really drink but dealing with health care in the advent of the Affordable Care Act otherwise known as Obamacare is enough to make you start.

Actually that’s an excellent idea! Somebody should invent the Obamacare drinking game.

I have tried everything to try to get Aetna to talk to me about my issues as an existing subscriber and over the past couple of days I even have been resorting to tweeting at their chairman and Aetna in general. (@mtbert and @aetna and @aetnahelp)

Anyway I took a look at the calendar today and realized on top of all my other issues with Aetna I had not received an invoice. After all you need an invoice to pay your next month’s healthcare premium.

So I took a big deep breath crossed my fingers and made another call to the member services number. Remarkably for once I got a stateside call center. The Philippines must’ve been on vacation. (Do you sense sarcasm? Good! I meant it.)

I got this really nice lady who confirmed my worst nightmare fears: that I had been put into a plan by Aetna that after being told by Aetna all my doctors were in it, to find basically none of them were in it.

Yes, seriously. At this point I was silently screaming in my head. so this lady promised she would send this up the food chain and call me tomorrow.

I got off the phone and my head was spinning and I was filled with what can only be described as a sense of pure panic. How could I have spent all those hours with Aetna representatives going over plans to ensure I have the coverage I needed only to pay for a plan that had none of the coverage I needed?

So as I sat in my family room trying to absorb the craziness of everything involving my healthcare all of a sudden the phone rang. it was someone from Aetna, someone from the Nashville office who had originally put me in this plan that has caused nothing but problems since I paid the premium to bind it.

Almost 3 hours later I think I have a new plan. And what I learned is I never should’ve been shown the plan that I have started 2015 in. What I also have learned is basically if you’re a breast cancer survivor and you need a certain level of care most HMOs are not gonna do it anymore. I have had to switch to a PPO. And yes it’s considerably more expensive. But I don’t have a choice I can’t play Russian Roulette with my health.

I think this is set, but this guy said he is going to call me back early next week.

I am exhausted after this whole ordeal today. It boggles my mind that I’ve always kept myself covered by health insurance and,well, I thought it was a hassle before, it is worse now to deal with I feel. And why is it that we as Americans have to go through this? It’s crap.

My answer to my somewhat rhetorical question of course is politics and corporate America. I will say it until it changes, if it changes. There is no point to “reforming” healthcare in this country if they are not also going to reform the actual insurance companies themselves. I also think politicians need to keep their political agenda out of our healthcare as well.

Like everyone else I know, I am not asking for a handout, I am only looking for the healthcare I need to maintain at a price that allows me to breathe and pay for everything else in my life.

Personally, I feel that for what Aetna has put me through in the past few weeks that I not only deserve good customer service, they should be throwing me a bone and knocking some money off my premium for aggravation and time wasted. But that won’t happen and basically I will just be lucky to get insurance that gives me the coverage I need finally.

It shouldn’t be so god damn difficult to get sufficient to your needs healthcare coverage as a breast cancer survivor or anyone else in this country. In a nutshell it’s bullshit. And I know I don’t normally curse on this blog, but enough is enough already.

Needless to say I’m holding my breath and won’t relax until I know this mess is all straightened out with Aetna.

Thanks for stopping by.

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About carla

Writer, blogger, photographer, breast cancer survivor. I write about whatever strikes my fancy as I meander through life.
This entry was posted in breast cancer, health insurance and tagged , , , . Bookmark the permalink.

2 Responses to update on healthcare drama, or can you hear me screaming

  1. Amanda Perrin says:

    Thank you for sharing your story! I’ll share a bit of mine. Even then, it’s not short. I have had Blue Cross Blue Shield (or Florida Blue, as it’s called down here) for years now and have had a rollercoaster ride myself just trying to *pay* for my new marketplace plan in January, which therefore means that I haven’t had coverage yet this year.

    After hours on the phone back in October and November, trying to find the correct plan for the providers and services I need covered, the marketplace rep told me I was eligible for a healthcare marketplace plan starting January 1st. Cool! Let’s do it. The transition was set up early enough it should be seamless. We went through the application process over the phone (because the online app got stuck ‘in progress’ for months–with no explanation as to why) and she pushed it through and signed me up for a plan through the marketplace. The monthly premium was close to $500/month. But what about after the tax credit? She simply said I was not eligible for a tax credit, just a marketplace plan. What?! We’d been on the phone over an hour, not to mention all the waiting time before I ever got to her. WHY?! The rep simply said the IRS said ‘no’ to a tax credit and she couldn’t see why. The reason would be too personal, she said. They (Florida Blue) just seek advice from the IRS and take the ruling from there, no questions asked. Offering no roads of help to change this premium I could not afford, I said (being self-employed) “Ok, then let’s adjust the income portion of the app and see what happens.” We did, and low and behold, all of a sudden, not only was I eligible for a plan, but now with an almost several hundred dollar tax credit per month! Now the IRS just said ‘yes,’ she said. It all went through, application was complete, first month’s premium was paid (with a confirmation number and everything), and things seemed fine.

    This was until I also realized several weeks later that I hadn’t received any documents in the mail or a new insurance card or a receipt for payment or anything. Not from Florida Blue and not from Healthcare.gov. Then I got an email, beginning of January, that my *new* marketplace plan was cancelled due to non payment of first month’s premium! What?! This was my first communication from them. I grabbed my notes and confirmation number and called them. They don’t let you to respond to their emails anyway. The man who answered said that, yes, indeed my new plan had been cancelled and that he didn’t see any attempt of a payment being made in the system and that the confirmation number I had for payment was actually just a reference number of the original phone call. After some bickering back and forth about something that I absolutely knew happened I realized there may be a way to get to the bottom of this, I asked “Aren’t all the calls recorded?” He put me on hold. When he came back on the line he said he’d spoken with his supervisor and they had reinstated the new plan and would accept payment for it now. Since he couldn’t find any record of the first attempt of payment, his suggestion was to try and run the payment again, with the same card. Then everything would be in order. So, we did. He then gave me a *confirmation* number (assuring me it was quite different than the reference number the first woman had given me) and that the payment would go through in 24-48 hours. Two days later? Nothing.

    On the third day I got another email stating that my plan had been reinstated, but that the *last* step was to make a payment by the end of the month. They had no record of payment. What?! I called again, for the third time now.

    This time the man said that he also couldn’t find any payment made, but that he did see two attempts now. They had both failed and there was no reason given as to why, for either of them. What about the last CONFIRMATION number I got during the second phone call? Well, evidently, that # was never cut and pasted and was actually a confirmation number of *attempted payment,* not actual payment itself. OMG!! All I’m trying to do is pay my premium so that I can schedule doctors appointments! What is the problem?! He said ‘this happens sometimes,’ and then asked me if I’d like to try and use another card to make the payment? No! I’m not about to share another set of personal information with you. You’re going to get this entry right. Why are you giving me confirmation numbers or reference numbers or any numbers that simply don’t mean anything anyway?! I’m not going to give you more of mine. Just then, the man said he’d found *it*: the problem. The expiration date on the credit card was incorrect. It had one ending in the year ’99.’ What millennium are we in?! Was that 1999 or 2099?! Did that last guy do that on purpose?! Either way, it seemed we’d found an issue and the man felt confident he’d found the ‘reason’ why at least the last one hadn’t gone through and suggested I give him the numbers to the SAME card AGAIN because he couldn’t see or change information on an already completed transaction, failed or not. So, I did. And he carefully reviewed every detail, including my name and spelling on the card vs my plan, etc. and said that he made special side notes in the system about our call, including the bogus numbers I’d been given before, and told me it was done. Complete with a new *confirmation* number and all!!! Aargh! I wrote it down, hoping it would mean something.

    Being ‘nice’, he said instead of hanging up now, he was going to take the extra step and make sure that the new confirmation number was in the system — after he cut and pasted it properly into the payment screen, of course. Surprise, surprise: it wasn’t there. He went back to the payment page and asked for the numbers again, so we could review. AGAIN, the expiration date was wrong. This time it was the month. Is there a glitch in their system or something?! He didn’t know why that happened and was sure he’d entered it correctly and said we just needed to try it AGAIN. That was our only option. Reluctantly, I did. I read the numbers, one by one, to him AGAIN. This time, when he gave me the *new* (4th) confirmation number, he found it as processing in the system. Great! Let’s hang up. We’re finally done, right? No. Not right.

    He then had to tell me that both of those confirmation numbers were now showing up and there was a strong possibility the card would now be processed twice! What?! You can’t do it once if you don’t do it twice?! He assured me though, if that did happen (which he didn’t think would, because of the expiration date being wrong again for the second time, of course), I could rest well knowing that it could be corrected with a simple phone call back to Florida Blue. They would write me a check or make a direct deposit to a bank account I’d like to give them the information on, because they don’t reverse credit card charges.

    That was yesterday. This morning I checked online, and there were two deductions for my new healthcare plan on my credit card. It’s Friday night. Think the lines are busy?

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