Board 8 > Health Insurance - A...Comedy?

(+) Yeah! (+)

-April, 2018-

FD: I'm signing up for health insurance, yippee!

Covered California : Your combined income is too high for Medi-Cal (free insurance), but here are the plans we can offer you! (lists plans)

FD: Okay great, I'll take that one! (selects a plan)

Covered California: Okay great, here you go! (gives FD the Blue Shield plan he selected)

.

.

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-May 31st, 2018-

Medi-Cal: OH WHAT THE?! YOU DON'T QUALIFY FOR US ANYMORE? AND YOU SIGNED UP FOR A PLAN THAT DIDN'T INVOLVE US IN ANY WAY? WELL HOLD ON JUST A MINUTE. YOU NEED TO SEND US PROOF THAT YOU DON'T QUALIFY FOR US, BUT LIKE YESTERDAY. WE"RE JUST GOING TO GO AHEAD AND CANCEL YOUR COVERED CA / BLUE SHIELD PLAN WHILE WE WAIT FOR YOU TO PROVE THAT YOU DON'T QUALIFY FOR US. BUT WE'RE NOT EVEN GOING TO TELL YOU THAT'S WHAT HAPPENED, YOU ARE JUST GOING TO RECEIVE A LETTER IN THE MAIL LETTING YOU KNOW YOUR NEW HEALTH INSURANCE ISN'T ACTIVE ANYMORE AND YOU WONT KNOW WHY. GOOD LUCK, SUCKER.

Fin.

As near as I can tell that is a completely accurate retelling of what happened. And over the past couple weeks i've had to call everyone and their mother to try and diagnose what caused the insurance to stop working.

I still can't for the life of me figure out why no longer qualifying for something unrelated has caused it to stop working or why I need to submit proof that I no longer qualify for the unrelated. I fully understand having to prove if I did qualify and was trying to receive benefits, but this is just to show that I don't.

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Edit: Oh and it still isn't even resolved yet. I've submitted proof to the unrelated medi-cal that they requested, but I still need the other parties to get the greenlight to restart my services.
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As someone who signed up for his first plan on his own this past year, this terrifies me.

Also how can an unrelated company cancel a plan that has nothing to do with them?
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Well it apparently is only a problem because i signed up for Medi-Cal in 2015-2016 when my income was low enough that I qualified for it.

And as far as I knew medi-cal has been out of the picture for the past 2 years. Until it decided to emerge from the shadows for reasons I still can't wrap my head around.

But if you've never been on the free insurance then it should be a non issue? Otherwise I guess you have to pre-emptively cancel your free insurance before you start paying for insurance, but I'm not sure how you are supposed to know that in advance.
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I had a Kaiser plan and was switching to a Kaiser plan on Covered CA this year.

There were issues with the cancelling and signing up conflicting and I ended up in limbo and at one point on an Anthem plan without my consent for a month.

It took until April to get it all sorted out properly.
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Forceful_Dragon posted...

Otherwise I guess you have to pre-emptively cancel your free insurance before you start paying for insurance, but I'm not sure how you are supposed to know that in advance.

Ahhh, you ran into a similar problem to me I see.
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Sorry I should clarify, I'm not in CA, I just meant in general that something going wrong to this extent in health insurance is terrifying.
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I was like, "you know, I want to make sure I have an insurance plan before I cancel my current insurance plan" because that would make sense.

And then they were like "lol no" except they don't inform you via phone or email or anything and instead just do random shit.
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red13n posted...

I was like, "you know, I want to make sure I have an insurance plan before I cancel my current insurance plan" because that would make sense.

And then they were like "lol no" except they don't inform you via phone or email or anything and instead just do random shit.

1 billion percent this.
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I'm at the step of trying to get Covered Ca / Blue Shield turned back in.

I call in.

I spend 25 minutes trying to get the poor guy on the same page as me. He has to put me on hold like 6 times while he figures it out. It takes much longer than it probably should, but at least he's finally on the same page.

"Okay, we can try to turn it back on now I just need you to confirm-" *call drops*.

I wait a few minutes expecting him to call back, because that's what you are supposed to do in a call center when the call drops. But nothing. I'm sure he just didn't want to deal with my issue, but now I have to go through the whole thing AGAIN with the next person.
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Yep, they will never call back. I actually got a call back 3 weeks after i called once to check up on an unresolved call that i had called back and fixed my issue on the next day.

Emeraldegg posted...

Also how can an unrelated company cancel a plan that has nothing to do with them?

I imagine it was because entities in insurance tend to be awful at communicating. FD had a plan through the BCBS, who does not receive any government money for individual plans. "Free" insurance does generally receive government funds, based on how many members they enroll. So in trying to consider their member and identify the cause of lapse, they likely identified that he transferred to a BCBS plan.

Then they must have contacted the BCBS, and said "hey we think you have our member! He should be with us!" The BCBS didn't check their records and just said "ok fine take him then". But since insurers can't exchange PHI (personal health information), they couldn't send the records over.

That's the only chain of events i can see causing this, but I'm no expert on the individual market. I guess there could also be some mixup if the first company is a subsidiary of the BCBS, since companies under the same umbrella are sometimes even worse at communicating than competitors.
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Peace___Frog posted...

That's the only chain of events i can see causing this, but I'm no expert on the individual market. I guess there could also be some mixup if the first company is a subsidiary of the BCBS, since companies under the same umbrella are sometimes even worse at communicating than competitors.

They definitely have mentioned multiple times that they are at least partially connected.

So it registered with Medi-Cal when I signed up with Covered CA and it registered that I was listing a different income than I listed in 2015.

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But at that point there should be some logic involved. It should have been something along the lines of:

"Oh his income is too high for us, and he signed up for a plan that doesn't involve us. So we can just close our book on him"

Because that would make sense given the circumstances. The only scenario in which it would require follow up would be

"Okay, well his income is too high now, but he's used our service a bunch of times so we need to find out when his income changes because that could affect the amount we've paid out."

But I never used their services so that's a moot point :/
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I remember when I got health insurance through my employer and I had to keep telling Covered California that I have my own insurance because they kept telling me "you know if you have your own insurance that you need to cancel your Covered California plan" but they wouldn't listen to me.

The whole thing is a mess.
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So it has to do with how the state-run insurance structured themselves. The BCBS likely didn't have much of a choice, if the state-run marketplace was telling them that you might qualify for a medi-cal plan.

I'm not trying to dismiss how fucked up that all is, I'm just wondering aloud how on earth they got it that bad.
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Yeah I'm sure there is some sort of inherent "logic" that dictates things getting handled the way they did, it's just frustrating being a victim of it.

New information:

-We entered a certain amount of income when we applied, it qualified us for some nice plans.

-Medi-Cal "fixed" our income to some other amount for some reason.

-Now upon refixing our income to the correct amount it is not giving us nearly the same plans as options as we had before. Because apparently instead of just starting us back with the plan we had we have to "buy" health insurance again instead of just reactivating the plan we were previously on.

Whyyyyy
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Yeah, it seems like the way that Medi-Cal and Covered California interact is awful. They basically don't talk to each other at all and will send you stuff in the mail that's dated 6 months in the past.

From what I can tell CC works okay as long as you never interact with Medi-Cal, but once you do...well...
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Yeah CC was a breeze to get set up and i was very pleased with the plans available.

Then Medi-Cal showed up and torpedoed it.

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I think its "resolved" now.

But thev resolution is that i purchased the same plan i had before at nearly the same price i had before. But that's not exactly the same thing as "reactivating" the plan i had before. I guess ill find out if i have the same policy number i had before when blue shield processes us in 7-10 business days.

But to see the right plan as an option i had to switch from last year's exact financial figures to 'close approximations' based on our checks so far this year. Hopefully i won't get screwed in reconciliation come tax time -_-
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Were you covered by the free insurance? If you didn't cancel a plan even if you don't qualify for it then I could see it causing problems.
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CoolCly posted...

Were you covered by the free insurance? If you didn't cancel a plan even if you don't qualify for it then I could see it causing problems.

I didn't think so.

I knew I was covered in 2015-2016, because I applied in 2015 to be covered to 2016.

And I allowed it to lapse from there because I knew that I was already going to be personally out of range just from my own income, and I was engaged and knew that jointly we would not qualify as well.

So I had every reason to believe that I was done with Medi-Cal and they were done with me.

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Even so though, if you have a phone plan with company A and you start a new plan and transfer your phone number over to company B then your plan with A gets cancelled (and you pay early termination fees if applicable). Plan A doesn't show up and cancel B for no reason. Clearly you were done with A if you were starting something new with B. Especially if the information from plan A is several years old, they would have even less reason to interject.
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I'm going to estimate I've spent at least 5 hours on calls/holds with various agencies regarding this. Really hoping it resolves with the new (old) plan starting successfully.
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