ACA nightmare...what to do?

[Fermion]

I think I messed up but I argue it is not entirely my fault.

On the Washington healthcare site I logged on yesterday, the first day of open enrollment for 2016 policies. I tried to view our 2016 policy options but was unable to see the correct policies because it was using our 2015 status (relatively high income). I clicked what I thought was a button to update 2016 income and I changed it to $11,000 each person ($22,000 total) which is what I am targeting in 2016.

This incorrectly generated a special enrollment period for 2015 and wanted me to choose a new policy for 12/1/2015 to 12/31/2015. I already have a silver plan ACA policy that was supposed to run until 12/31/2015 and we have been making payments (already paid November). It also wanted proof of income paperwork submitted by 2/28/2016 so we could get a policy for this December


This morning I decided I would just submit a new form correcting the income back to a point where it didn't generate an open enrollment. It asked if my wife was currently employed and I checked no. It then instantly signed me and my wife onto Apple care (Washington Medicaid)!!!

Now I call customer service and they say I am on Medicaid and they can't do anything about it. They say I need to call Apple care and cancel it but I will need to then submit for new insurance by Nov 23 2015 for December coverage. Right now it seems I am double covered with my current paid Premera Blue Cross silver plan and this Apple care. If I apply for a December plan, I will lose the deductible money we have paid so far this year.

I wasn't even legally eligible for a special enrollment, so how can any of this be legal?

One click destruction.

 

[ivinsfan]

I think I messed up but I argue it is not entirely my fault.

On the Washington healthcare site I logged on yesterday, the first day of open enrollment for 2016 policies. I tried to view our 2016 policy options but was unable to see the correct policies because it was using our 2015 status (relatively high income). I clicked what I thought was a button to update 2016 income and I changed it to $11,000 each person ($22,000 total) which is what I am targeting in 2016.

This incorrectly generated a special enrollment period for 2015 and wanted me to choose a new policy for 12/1/2015 to 12/31/2015. I already have a silver plan ACA policy that was supposed to run until 12/31/2015 and we have been making payments (already paid November). It also wanted proof of income paperwork submitted by 2/28/2016 so we could get a policy for this December


This morning I decided I would just submit a new form correcting the income back to a point where it didn't generate an open enrollment. It asked if my wife was currently employed and I checked no. It then instantly signed me and my wife onto Apple care (Washington Medicaid)!!!

Now I call customer service and they say I am on Medicaid and they can't do anything about it. They say I need to call Apple care and cancel it but I will need to then submit for new insurance by Nov 23 2015 for December coverage. Right now it seems I am double covered with my current paid Premera Blue Cross silver plan and this Apple care. If I apply for a December plan, I will lose the deductible money we have paid so far this year.

I wasn't even legally eligible for a special enrollment, so how can any of this be legal?

One click destruction.

I feel for you and this completely validates my deciding to just go with a broker. You might contact a broker and see if they can help or have a suggestion about fixing this. This is my nightmare, I am going to have to use MNSure and their web is documented to be abysmal.

 

[easysurfer]

Sorry to hear about the nightmare Fermion. Surely would have been nice if there was some sort of warning ahead of time at the website that you were on the 2015 information before going all West World on you.

 

[rodi]

I would call back and talk to a different CSR about this. It should be resolvable.

I know on the covered california website - it's very easy to do that (and I had a similar, but not medicaid level) thing happen to me - and had to get a person to remove the change.

You might also try calling your current (non medicaid) insurer and see if there is anything they can do.

It sucks to have to deal with it - but I'm oddly optimistic that if you find the right help desk person, it can be resolved.... be aggressive about asking for managers.

 

[EastWest Gal]

I did something stupid with my original enrollment in January and calling healthcare.gov straightened it out. Try calling again and asking for help with your problem. They are really nice and helpful in fixing stuff; at least in my case.

Good luck!


Sent from my iPhone using Early Retirement Forum

 

[Fermion]

Can healthcare.gov help you with a state exchange problem?

I have now talked to one level of customer service on the Washington state exchange. They said they resubmitted the application and all I have to do is sign up for one month of insurance for December. This probably means I would lose any deductible I have paid so far in 2015, but it is only around $1000. If we (hopefully) have no medical problems in December that wouldn't end up being any loss since our deductible is $5000 total.

They also said I was not signed up for Medicaid but it still shows we are on the website, so not sure if I believe them.

I think I am done for today. I have used up 200 of 1000 minutes, mostly on hold.

 

[Fermion]

Just wanted to update this.

I *think* we are back on track now, after a ridiculously long conference call between Premera, myself, and the Washington exchange. I had to call Premera (40 minute hold) then the Premera lady and I had to wait for about 70 minutes on hold with the state exchange. Finally we all got together and they issued a ticket to somewhat fix the database and get my old policy to run to the end of December 2015 like it originally did.

Now when I log on to the exchange it shows my original policy active and good until Dec 31 2015 but it does still show us enrolled also in Apple Care (Medicare) but pending dis-enrollment.

So it is somewhat fixed. Total minutes used on cell phone = 310

I am not touching my income or 2016 policies until mid December!

 

[easysurfer]

Glad you got that fixed. Sounds like phone minutes well spent.

 

[bingybear]

Just wanted to update this.

I *think* we are back on track now, after a ridiculously long conference call between Premera, myself, and the Washington exchange. I had to call Premera (40 minute hold) then the Premera lady and I had to wait for about 70 minutes on hold with the state exchange. Finally we all got together and they issued a ticket to somewhat fix the database and get my old policy to run to the end of December 2015 like it originally did.

Now when I log on to the exchange it shows my original policy active and good until Dec 31 2015 but it does still show us enrolled also in Apple Care (Medicare) but pending dis-enrollment.

So it is somewhat fixed. Total minutes used on cell phone = 310

I am not touching my income or 2016 policies until mid December!

Don't you need to have the application done by Dec 15th to get coverage by Jan 1?

 

[EastWest Gal]

Yikes. That's a lot of minutes! I didn't know you were dealing with a state exchange.

 

[Fermion]

Don't you need to have the application done by Dec 15th to get coverage by Jan 1?

I am unsure, but I think that may be right. I was thinking of doing the application on Dec 13th or 14th. I just know if I do it on Nov 30 or Dec 2 they will cancel my December silver plan again. I am more afraid of the exchange now than I am of my mining company junk bonds that are paying 29% interest.

 

[gardenfun]

I had a similar thing happen to me the end of last year, Fermion, only with CoveredCA.
Had to report an income increase in September of 2014. Went on the website as instructed. Had to sign up again for my Bronze plan. Something went wrong and it didn't go through, although I did not know it at the time. Then came open enrollment, and BS of CA wrote to me saying "just keep paying your premiums and you'll be covered in 2015".
wrong. I had to make a panicked phone call to both parties in January to get reinstated--like you spent over an hour on the phone with both CoveredCA and Blue Shield reps (or supervisors--always ask to talk to a supervisor).
Also in there was a change of address, which I'm still working on getting Blue Shield to recognize. I was getting two bills for a while there, because somehow the CoveredCA info was not getting to Blue Shield. Many many phone calls to get the old policy deleted.
Any time you make the slightest change (like moving less than a mile away), you have to sign up again, at least in California. It opens up all kinds of opportunities for the computers not to talk to each other. And it makes for headaches at tax time. I finally got the correct 1095 form for 2014 the other day.
I got a resolution of the duplicate policy thing--BS wrote me and said my refund of $2300 was being processed. huh?? I wasn't paying both bills--I can't figure out what needed to be refunded. ugh. I have to call these people yet again.
I think I will go with a broker, on you all's advice. I am healthy and am considering going off the exchange.
BTW, my premiums with the Bronze Blue Shield PPO policy are increasing 11% for 2016, as well as the deductible.
Sorry this is so long--just wanted Fermion to know that others have had the same experience!

 

[lawman3966]

Using Broker for ACA plans (Washington state)

I feel for you and this completely validates my deciding to just go with a broker. You might contact a broker and see if they can help or have a suggestion about fixing this. This is my nightmare, I am going to have to use MNSure and their web is documented to be abysmal.

I am reviewing ACA plans in Washington state, hopefully for enrollment starting Jan. 1, 2016. Your mention of a broker got my attention.

I searched this, but the web site I found require browsers to enter personal information to learn anything significant about using a broker.

Thus, I have a few questions based on my limited success in getting information online.

(1) Can you use a broker for a subsidized exchange type plan? (I read somewhere that some brokers work with people who aren't getting subsidies).

(2) Did you in fact use a broker? And, did that approach work well for you?

(3) How exactly did you select the broker. Did you start with an online ACA resource, and then select a broker by geographical area?

Would appreciate input from anyone regarding the above, not just from the poster who raised the issue of brokerage.

 

[ivinsfan]

I am reviewing ACA plans in Washington state, hopefully for enrollment starting Jan. 1, 2016. Your mention of a broker got my attention.

I searched this, but the web site I found require browsers to enter personal information to learn anything significant about using a broker.

Thus, I have a few questions based on my limited success in getting information online.

(1) Can you use a broker for a subsidized exchange type plan? (I read somewhere that some brokers work with people who aren't getting subsidies).

(2) Did you in fact use a broker? And, did that approach work well for you?

(3) How exactly did you select the broker. Did you start with an online ACA resource, and then select a broker by geographical area?

Would appreciate input from anyone regarding the above, not just from the poster who raised the issue of brokerage.

The MN experience is a little different, you must go thru MNSure to get a ACA subsidized plan. The MN site has a list of MNSure trained and approved brokers and agents, which you search by zip code. I don't know what the process to find a broker would be in other states, sorry.

 

[RockyMtn]

You can buy your ACA plan through Costco if you like. They have a broker that they have contracted with.

 

[MBSC]

Thus, I have a few questions based on my limited success in getting information online.

(1) Can you use a broker for a subsidized exchange type plan? (I read somewhere that some brokers work with people who aren't getting subsidies).

(2) Did you in fact use a broker? And, did that approach work well for you?

(3) How exactly did you select the broker. Did you start with an online ACA resource, and then select a broker by geographical area?

Would appreciate input from anyone regarding the above, not just from the poster who raised the issue of brokerage.

Yes, you can use a broker for subsidized exchange plans.

Washington Health Plan broker search: https://www.wahealthplanfinder.org/...kerNavigatorSearch.action?brokerNavigator=BRK

National Association of Health Underwriters Search by zip code: https://www.nahu.org/consumer/findagent2.cfm

 

[spncity]

Our state website allows one to search for a broker prior to login or creating an account. I searched for someone nearby.

I had called one broker, had a good discussion, created an account and connected her to my account, then we exchanged a couple more emails. But over a couple of weeks I could never get her to commit to an appointment, and I did not want to go through the application process without guidance (and I wanted a chance to ask questions during an in-person meeting).

So, I removed her from my account and called a different broker who responded to my plea by granting me a meeting on Black Friday. He was knowledgeable and helpful. He walked me through everything up to the final choice of plan (two are in the running). I want to call the insurer with a couple of questions and then the decision must be made.

It sounds like the brokers are swamped. I feel fortunate to have snagged an appointment.

I am very appreciative of the information that folks have shared on this forum.

Kindest regards.

 

[MBSC]

It sounds like the brokers are swamped. I feel fortunate to have snagged an appointment.

Indeed. October-December is to health insurance agents like tax season is to accountants.

After this year, many agents will stop offering assistance to new clients wanting on-exchange plans. Those folks will have to rely on 'exchange navigators' for help but they can't offer an opinion. If anyone needs assistance from a navigator this year, you can find one at the website below.

https://www.healthcare.gov/glossary/navigator/

 

[Fermion]

I am getting ready to try again to get a 2016 silver level PPO health plan from the exchange. I am hoping that by waiting so long that they will be unable to screw up my 2015 current plan, but don't underestimate their tenacity!

The problem is you can't change your 2016 income, you can only change your current income, yet you are supposed to sign up in 2015 for a policy that starts in 2016.

The Washington site needs a tab for 2015 income and another tab for 2016 income.