Obamacare / Health Care

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mimi
Posts: 31131
Joined: Tue Jan 27, 2009 12:01 am

Obamacare / Health Care

#876

Post by mimi »

I shoulda asked CB my questions. I tried to get a navigator, but was unsuccessful. The online chat person told me to call the 800 number. That person was very nice, but told me I should go in person and gave me a phone number to make an appointment. I called it Friday, left a message, and never received a return call. Deadline was approaching and nobody was answering the 800 number or the chat on the last day. So I just signed up for a low level plan and figure I can change it next year.I just wanted somebody to help me choose a plan that wouldn't be too expensive and would cover me in two states. It didn't seem like a hard question. But I guess it was. :-? It's all good though. I'm covered. I just picked up a bronze plan, cuz I hate to go to the doctor anyway. I just don't wanna ever be in the position where I would have to file bankruptcy due to medical bills. You just never know what may happen.

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Foggy
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Obamacare / Health Care

#877

Post by Foggy »

I'm going to apologize to verbalobe for not being terribly helpful on Tuesday. We were being crushed by all the phone calls -- I don't think Wifehorn was off the phone for more than 15 minutes all day long until evening; I probably took more than 35 calls myself. She ate Christmas Eve dinner sitting at the table with a phone to her ear, chatting with a lady from healthcare.gov about why we couldn't enroll ourselves. When we put in our information, the system told us it couldn't verify our identities -- just like President Obama! Yay!But we weren't in any mood to research any questions that we didn't need to research in order to get our own clients enrolled. We managed to enroll almost a hundred people, but we never did run into a COBRA issue, so we never did need to familiarize ourselves with that. I'm glad CB had the time to read the statutes and answer the question in authoritative detail. CB rocks. When I have time to wait for the best answer, I'll ask CB before I'll ask my own agency that nominally is mentoring us. She's the real expert, as we learned on Tuesday morning.
We don't know what we don't know.

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ducktape
Posts: 5334
Joined: Tue Jan 12, 2010 5:09 pm
Location: RIP, my friend. - Foggy

Obamacare / Health Care

#878

Post by ducktape »

Well, the problems with deadlining.I have been trying to sign up with Covered California since Friday, 12/20. Website simply did not work, and phone waits were over an hour, but disconnected me sooner than that, so after trying on Sat and Sunday, I figured that Monday would have everything back. On Monday, it supposedly let me create an account (several times) but then did not know me when I tried to log in. (Don't get me started on the "you have to use the pattern ***-**-****" for your SS# but, in fact, it doesn't take that; you enter it ********* and then IT reformats it.)Then we got the news (nationally, at least) that there was an extra day, so I tried on the 24th. It finally recognized my login that it hadn't the day before, and I got all the way through uploading my drivers license pic as proof of residency. Nothing since -- when I log in, it shows me stuck on "Verification." So, seeing no change in my account and having received no emails, I tried calling. The 800# gave me two other toll-free numbers to call if I am trying to check the status of my application. Both of those numbers give me the same message, including the same toll-free numbers (including the one I was calling). And then when I tried to refresh, the entire log-in portion of the site is now in "maintenance mode."BTW, California is supposed to be one of the success stories.

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listeme
Posts: 5426
Joined: Tue Jul 14, 2009 11:09 am

Obamacare / Health Care

#879

Post by listeme »

I'm going to apologize to verbalobe for not being terribly helpful on Tuesday. We were being crushed by all the phone calls -- I don't think Wifehorn was off the phone for more than 15 minutes all day long until evening; I probably took more than 35 calls myself. She ate Christmas Eve dinner sitting at the table with a phone to her ear, chatting with a lady from healthcare.gov about why we couldn't enroll ourselves. When we put in our information, the system told us it couldn't verify our identities -- just like President Obama! Yay!But we weren't in any mood to research any questions that we didn't need to research in order to get our own clients enrolled. We managed to enroll almost a hundred people, but we never did run into a COBRA issue, so we never did need to familiarize ourselves with that. I'm glad CB had the time to read the statutes and answer the question in authoritative detail. CB rocks. When I have time to wait for the best answer, I'll ask CB before I'll ask my own agency that nominally is mentoring us. She's the real expert, as we learned on Tuesday morning.Foggy, you got nothing to apologize for! I hope you guys are getting some rest after the deadline rush, at least a little.This place is awesome and we are enrolled in some sorta plan :mrgreen:
We're used to being told it's our fault that men don't listen to us.

Curious Blue
Posts: 2462
Joined: Wed Feb 18, 2009 7:42 am

Obamacare / Health Care

#880

Post by Curious Blue »

She's the real expert, as we learned on Tuesday morning.I'm not an expert at all, I just remember how to do legal research -- there are only 3 "authoritative" sources:1. The written law2. The written regulations3. The reports issued in the federal register, as part of the regulatory process, which give some insight as to the thought process behind the regulations.A 4th source would be court rulings, but so far the only final and binding judicial determination that I am aware of is the SCOTUS decision upholding the law but invalidating the Medicaid provisions -- and that's one part of the law that no one needs me to explain. Anyway, the hard thing for me was to figure out the applicable code sections & regs -- once I did that, I linked to all the important ones from my [/break1]wordpress.com/]https://obamacareguide.wordpress.com/ blog - so now if a question comes up I can just go and try to find the answer in the applicable law or reg.I have found that my answers are often very different than the so-called "experts" -- like many insurance agents -- and I think that is because agents get their information from training material put out either by the insurance industry or from the agencies implementing ACA, often in simplified form -- so I've had some debates because someone insists that it says thus-and-so in their manual, even though I know that the regulation says something different.Because my answers are based on the law, I am more likely to be correct -- but that is assuming that the law is followed. There are many situations where agencies develop internal policies that are inconsistent with the governing law or regulations -- so in practice, if the agent at Healthcare.gov or CoveredCA.com insists on X, then X may very well be the way things end up being -- unless the "X" dispute is big or important enough to warrant someone going to court to force the agency to adhere to its own regs. (I know that people calling CoveredCA were being given different answers than mine on the COBRA question, but you can call CoveredCa 3 times on the same day, talk to 3 different reps, and get 3 different answers to the same question -- so that also is a question of training.)Anyway, the point again is that I am NOT an expert, but I AM a (former) lawyer - so I choose to look at the law rather than than all of the smoke and haze, such as newspaper articles, blog posts, and even information on the government web sites. (Which is good for guidance, but not something you can cite in court). I don't always have faith that the law will be followed, but I do have faith that the law as written is what governs. Obviously if the written law is ambiguous, there may be litigation down the line to interpret it in a new way.

Curious Blue
Posts: 2462
Joined: Wed Feb 18, 2009 7:42 am

Obamacare / Health Care

#881

Post by Curious Blue »

Ducktape - if you did not get to the "select a plan" part on Covered Cal -- then try to get through on the phone to 1-800-300-1506 to finish the enrollment. Try calling NOW, they are open to 8pm. If not now, call tomorrow a.m. You NEED to complete the application by tomorrow (Friday, Dec 27) for coverage Jan 1st -- and you cannot do it yourself. You need to have it completed either by Covered Cal rep or a private insurance agent.(I'd actually recommend getting a licensed agent involved -- it costs you nothing, and the agent gets a commission -- but it's kind of unfair to expect an agent to jump through hoops for you right now -- although if you want, you can go to the Covered Cal facebook page and read the comments. Lots of agents there still hungry for business. )Of course you will be able to get coverage in any event for February -- but if you are trying for January, the phone call is the way to do it. They should be able to pull your records from your social security #. If they have seen that you created an account before 12/23, they should be able to complete it for you.I was able to get through to the 800 number today after about probably a 45 minute wait -- I wasn't counting because I just use my landline and put it on speaker phone for these sort of things. I carried my phone around for awhile, and an agent came on the line just at the point when the egg I was frying was about done. So the egg ended up overcooked, but I was able to chat with the person about the question I had (not for myself, but for a friend).

ducktape
Posts: 5334
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Location: RIP, my friend. - Foggy

Obamacare / Health Care

#882

Post by ducktape »

Thank you, CB.I finally reached a person at Covered CA who advised me that it was showing that I qualify for MediCal, so it had been sent over there to them. I will call them in the AM (they're closed now). If it is true that I qualify for MediCal, then it can be retroactive.I was surprised to hear that. But she told me that the laws for 2014 have changed, and it matters on income but doesn't do a means test for assets (or at least not for a house or car). I'll let you know back once I have found out for certain.

Curious Blue
Posts: 2462
Joined: Wed Feb 18, 2009 7:42 am

Obamacare / Health Care

#883

Post by Curious Blue »

I was surprised to hear that. But she told me that the laws for 2014 have changed, and it matters on income but doesn't do a means test for assets (or at least not for a house or car). I'll let you know back once I have found out for certain.I'm kind of surprised that you didn't know that means testing was gone already -- I thought the Medicaid expansion was a pretty well publicized part of the law. If someone like you who is obviously attentive enough to public affairs that you spend time posting on Fogbow doesn't know... then there really needs to be more effort from the public agencies to get the word out to the communities. It's completely income based -- if your income is 138% of the FPL or less, you get MediCal, or Medicaid in any of the states that signed onto the expansion (about half the states overall). The bigger problem I'm seeing these days is people who DON'T want MediCal/Medicaid because their doctors don't accept it -- if you feed the system a Medicaid-qualifying income, you pretty much get locked out of opting for something else, and can't even go back into the site to revise your numbers. But the ACA also increases the payment rates for Medicaid, so it will be on par with Medicare payments -- so perhaps that will increase the number of doctors who take MediCal/Medicaid as well. In any case, if you aren't already regularly seeing a doctor for something, it doesn't really matter: you'll just pick someone who does accept MediCal. Medicaid is not so bad anyway. Yes, there are some doctors and some facilities that won't take it, but my 3-year old grandson is on Medicaid and he broke his leg 2 weeks ago and we are very, very glad that he had that -- my son feels that it is probably better that he had Medicaid than a paid insurance program, as he might have delayed taking the child to the emergency room if he had been looking at a $250 copay. It's a serious break (full leg cast), but also the kind of thing that is not that obvious, and there had already been two other false-alarm emergency room visits this year (once when the kid said he had swallowed a paperclip, another time when the kid's finger got caught in an elevator door) -- so my son thinks that if he had been on his old insurance plan with the big difference in copays for urgent care vs. emergency room, he might have opted to wait until morning, which would have been terrible for the poor kid. The leg was broken because the kid tripped over a toy and twisted his ankle -- so again, not something that would necessarily set off alarms in an adult mind. So I think that for many people, Medicaid has its advantages. My son is a grad student and had insurance through his university, but signed up for Medicaid himself come January. (As a student, he's got a negative income, living off of a part-time job and student loans).

Curious Blue
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Obamacare / Health Care

#884

Post by Curious Blue »

How many instances have you found where a specific instruction/advice on healthcare.gov, like "If you have COBRA continuation health coverage, you can keep it or decide to buy a Marketplace insurance plan", is not supported in the regulation?That statement on Healthcare.gov does not make it clear whether or not the COBRA-covered person is eligible for subsidies. As worded, it's a meaningless statement: ANYONE can enroll in a marketplace plan, but people who are eligible for other types of coverage are generally not eligible for subsidies.The wording of the application forms suggests that the COBRA coverage is disqualifying for subsidies -- hence Verbalobe's question, as well as the considerable discussion that was generated in the course of drafting the regulation.

ducktape
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Obamacare / Health Care

#885

Post by ducktape »

I'll qualify for Medicare in a little over 4 months, so I have to admit that I hadn't been paying close attention to my own situation because it's a short-term thing. Nevertheless, it will be very nice to not have to pay that huge bill to Anthem, and so I will be grateful. I'm hoping that I don't need it at all, but it will be very nice to have some coverage that is affordable.

Curious Blue
Posts: 2462
Joined: Wed Feb 18, 2009 7:42 am

Obamacare / Health Care

#886

Post by Curious Blue »

Kimba, I didn't come here to debate with you. Verbalobe asked a question and I spent some time giving him an accurate and complete answer, including anticipating the parts that weren't clearly stated. I also gave him legal citations, just to give him and other readers the ammunition to put to rest any dispute if someone else tells him something different. Sorry if that is offensive to you. I'm not going to play your games.

Curious Blue
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Obamacare / Health Care

#887

Post by Curious Blue »

I'll qualify for Medicare in a little over 4 months, so I have to admit that I hadn't been paying close attention to my own situation because it's a short-term thing.OK -- probably not an issue if its only for 4 months. There is a problem with going on Medicaid if you are over age 55, because of medicaid estate recovery provisions. See [/break1]com/html/localnews/2022469957_medicaidrecoveryxml.html]http://seattletimes.com/html/localnews/ ... ryxml.html and [/break1]hhs.gov/daltcp/reports/estaterec.htm]http://aspe.hhs.gov/daltcp/reports/estaterec.htmand [/break1]canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm]http://www.canhr.org/factsheets/medi-ca ... ry_FAQ.htmBasically these laws made sense when Medicaid was means-tested, and they were primarily aimed at recovery for long term care expenses. But it's potentially a huge problem for the 55-65 age group under ACA who may be essentially forced into Medicaid by virtue of the ACA structure, despite their ability and willingness to pay a subsidized premium rate. Until this is resolved, people in that age range who are low income but have significant assets may want to either pay full premium costs for a policy bought directly from the insurer, or do some more sophisticated estate planning.

Curious Blue
Posts: 2462
Joined: Wed Feb 18, 2009 7:42 am

Obamacare / Health Care

#888

Post by Curious Blue »

I'm not offended. I'm not playing games either. I asked a serious question because you expressed you're very concerned about the information people are using to complete applications, even that they may need the ammunition of legal citations for later, because the statute is going to govern regardless of what anyone was told when applying. I don't want to be responsible for misleading people. I hope you'll answer.You can read these threads to see the debate/disagreement about the COBRA requirement - read both the Q&A and the comments:[/break1]cahba.com/advice/2013/10/cobra_2.html]http://www.cahba.com/advice/2013/10/cobra_2.html[/break1]cahba.com/advice/2013/10/nearing_medicare.html]http://www.cahba.com/advice/2013/10/nea ... icare.htmlThe insurance broker who runs that site asserts that exchange subsidies are available only if the COBRA rate is "unaffordable" -- over 9.5% of income. I disagree. I can cite a regulation and commentary -- the people who believe that the affordability limit applies don't seem to be able to do that -- rather they seem to be asserting an opinion. The Healthcare.gov web site doesn't address that point -- it refers to people who "may" be eligible for subsidies, but "may" isn't something you can take to the bank.

SPen
Posts: 269
Joined: Tue Jul 30, 2013 8:50 pm

Obamacare / Health Care

#889

Post by SPen »

I'm glad Healthcare.gov is working better, now the only thing that's stopping me from enrolling is my own hesitancy. I'm currently on COBRA-continuation coverage (through a parent's employer, I myself have never worked there) but I'm worried that neither my specialist or my medication(s) would be covered under a marketplace plan (I have a pretty serious condition) so I have to wonder if enrolling would be a better option than the $450/month premium I pay now. My state (Virginia) didn't expand Medicaid so for right now it's either keep COBRA or enroll, and I'm not sure enrolling would be better considering I don't work/don't have an income/may not qualify for a subsidy.

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Volkonski
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Obamacare / Health Care

#890

Post by Volkonski »

The letters from my younger (and previously uninsurable due to a pre-existing condition) daughter's Obamacare medical and dental insurance companies arrived in the mail. --> The bills have been paid. --> On Jan 1st she will have insurance. \ :D / And our regular family doctor will take her insurance. :cheer: Our thanks to President Obama and to every member of congress who voted for it. :thunb:
Image“If everyone fought for their own convictions there would be no war.”
― Leo Tolstoy, War and Peace

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Addie
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Obamacare / Health Care

#891

Post by Addie »

Yay :cheer:
Don't do stupid shit. -Barack Obama

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realist
Posts: 35111
Joined: Fri Jan 23, 2009 12:33 pm

Obamacare / Health Care

#892

Post by realist »

The letters from my younger (and previously uninsurable due to a pre-existing condition) daughter's Obamacare medical and dental insurance companies arrived in the mail. --> The bills have been paid. --> On Jan 1st she will have insurance. \ :D / And our regular family doctor will take her insurance. :cheer: Our thanks to President Obama and to every member of congress who voted for it. :thunb: :-bd
ImageX 4 ImageX36
Image

ducktape
Posts: 5334
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Location: RIP, my friend. - Foggy

Obamacare / Health Care

#893

Post by ducktape »

And to my great surprise, I qualified for MediCal and should have my card and packet in 2 to 3 weeks. It is true -- the means test is only income-based now, at least in California, and there were no questions about assets at all.

ducktape
Posts: 5334
Joined: Tue Jan 12, 2010 5:09 pm
Location: RIP, my friend. - Foggy

Obamacare / Health Care

#894

Post by ducktape »

Thanks. I will look into it. It's basically for the next 3 months, so as long as I stay healthy during that period, I think I'll be fine. But it's good to be aware of.

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Addie
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Obamacare / Health Care

#895

Post by Addie »

[link]Associated Press,http://www.chron.com/news/texas/article ... sworldhcat[/link]





Medicaid growth creates gap of 5M without coverage





HARRISBURG, Pa. (AP) — About 5 million people will be without health care next year that they would have gotten simply if they lived somewhere else in America.





They make up a coverage gap in President Barack Obama's signature health care law created by the domino effects of last year's Supreme Court ruling and states' subsequent policy decisions.





The court effectively left it up to states to decide whether to open Medicaid, the federal-state program for the poor and disabled, to more people, primarily poor working adults without children.





Twenty-five states declined. That leaves 4.8 million people in those states without the health care coverage that their peers elsewhere are getting through the expansion of Medicaid, according to a Kaiser Family Foundation estimate. More than one-fifth of them live in Texas alone, Kaiser's analysis found.
Don't do stupid shit. -Barack Obama

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