Insurance company greed on one side – government indifference and incompetence on the other. My client? He’s stuck in the middle with me.
You were introduced to R.S. in last week’s post. Quick summary – R.S. purchased a health insurance policy for himself and his son on the exchange. The date was February 27th. He was sitting in my office. The coverage would, by law, begin on April 1, 2014. Weeks later he discovered that the insurer, one of the big ones, issued the policy with a January 1st effective date. Getting three months premium for nothing, the insurer told the client and I that this was our problem not theirs.
Would the government jump at the opportunity to save over a thousand dollars?
April 2, 2014 – My first stop was, of course, healthcare.gov, a website that wasn’t designed to create unsolvable problems, it just does that naturally. Once I had verified that this situation could not be addressed on the site, I reluctantly called the national frustration number, 1.800.318.2596.
I was talking with an exchange representative in just a little over fifteen minutes. It took another ten minutes, but I succeeded in getting her to admit that yes, R.S. did complete an application on February 27th. And yes, his policy was somehow pre-dated to January 1st. BUT, she couldn’t talk to me since this had all happened more than 14 days ago and I was no longer authorized to help my client. Since he wasn’t sitting next to me, she couldn’t (wouldn’t) do anything about the screw up.
“You don’t need an authorization to do the right thing,” I said to the woman invading my profession. This thought, this idea that we are here to solve problems, was totally foreign to her. Dead end.
April 7, 2014 – 10:30 AM with R.S. in my office
Spoiler Alert – If you want a Happy Ending you’ll need to visit a different blog.
This started out promising. My phone timer showed that we were talking to a helpful rep in only sixteen minutes. He took our info, added me into the system for the next fourteen days, and acknowledged our issue. He then explained that he would need to transfer us to a specialist. Not a problem. We looked at the timer. 27 minutes. Then we heard the dial tone!
Round Two – Our second foray wasn’t nearly as fruitful. It again took over fifteen minutes to get through the system to reach a live person. Unfortunately, the woman we reached resented our intrusion into her naptime. She decided to punish us by asking a long series of irrelevant questions. Disappointed that we hadn’t hung up, she finally asked why we had called. We told her and she agreed to transfer us to a specialist.
Hold music! We have achieved hold music.
And we waited.
R.S. had only allocated an hour for this little task. He stayed till noon, 30 minutes extra. I’m still on hold.
We all have certain challenges. Much of the Patient Protection and Affordable Care Act (PPACA) has seemed like nothing more than an endurance test. And when you are on hold for over an hour, chained to your desk, unable to leave, unable to use your phone, this devolves to nothing more than a test of wills.
Hour and a half on hold – still here.
Two hours – still here.
I was about to give up. I really had other stuff to do. It had been three hours since we had made the first call. Five more minutes. I had decided to give that damn hold music just five more minutes when the music stopped and a recorded voice came on the line.
“Your call can not be completed at this time. Please call back later.” CLICK!
Now what? Do any of us really believe that R.S. is the only victim of this particular glitch? How many months’ of unearned premiums are the insurers collecting? How many thousands’ of dollars are we, the taxpayers paying for nothing? And how many Americans will lose their coverage when the insurer terminates these policies because the people can’t pay these unnecessary charges? But you can’t answer those questions, you can’t even acknowledge that there are even problems, unless you actually care. AND THEY DON’T. Not the insurers. Not the people locked in some cubicle farm near Washington, D.C. And least of all, not the politicians of either party who are equally responsible for the mess we now have.
And the client? He’s stuck in the middle with me.