posted on Mar, 14 2017 @ 05:19 AM
The monthly premium is very expensive with a high deductible. I've never had a break in health insurance. I am in good health.
But...in the last three years every time I go to the doctor for something minor, the doctors offices and insurance companies find a way to code it so
that the visit isn't covered at all. For example... a recent doctor visit, the doctor office coded so that my doctor visit isn't covered and they
sent the lab work to a lab that doesn't even participate in the plan. I called both the insurance company and the doctor office to get it straight
but both parties pawn it off on the other, neither taking responsibility. The insurance rep even mentioned to me on the phone that the Doctors
Offices are manipulating the system. The insurance company offered to call the doctor office on my behalf, put me on hold for less than a minute and
came back stating they could not get through. They then informed me they would continue calling until they could reach them, to this day, more than a
week later I have heard nothing back. Immediately after my phone call to the insurance company, I called the doctor office and got through with no
problem but again was met with resistance and refusal to code my doctor visit correctly.
So not only do we have the issue with steep increases with Obamacare, but we also have the Doctors offices and Insurance companies playing games and
manipulating the claims in a manner that pins the full bill onto the patient, even in cases where it should be covered.
& let me point out that open enrollment is extremely difficult as well. They don't have it together. I have zero faith in them and zero trust due to
this process. I had to "Re Sign Up" about five to six times, over a 4 month period. I started getting emails to re enroll back in October of 2016,
so I began enrollment as soon as I could. I fully signed myself and daughter up for coverage, even had email confirming we were ready to go on the
new plan. But on their end they removed my daughter without a word to me. The next time I logged back in, they tell me my daughter is eligible for
medicaid so she can't be on the plan. I am confused because she was not eligible for it in 2016. So they can't help me with any answers on how the
medicaid process works and I have to call my local Social Services. After speaking with them, they inform me that she still is not eligible and the
only reason it spit her out was because her case wasn't closed from 2016 when she was denied. So they close it and send me a letter showing she is
denied so that we can move forward with the insurance sign up again. I called the govt marketplace back and the rep walks me through sign up over the
phone. All is complete and I have email confirming such. I am now waiting on the process to pay the first bill.
When I receive the bill in the mail from the insurance company, it is for the wrong $ amount. I call them and they say it is only me on the insurance
plan (not my daughter) and that they can't help me, I need to call the govt marketplace to have it fixed. So i call the marketplace back. We go
through the sign up process again to add my daughter again and I am told the issue will resolve and when it does the insurance company will bill me
the difference in premium amount since my daughter is added into the plan again.
Finally I think all the issues are resolved. By now it is early in January and I cut my finger really bad. I log into my insurance to print my ID
card so I can go to the doctor. When I log into the plan it is in CANCELED status. I'm sitting there bleeding out really badly so kinda panicked. I
call both the insurance and marketplace back and both parties are saying they can't help me and pawning it off on the other. I blow ! I've already
paid my premium but they say I have NO insurance ? How can this be ? I refuse to get off the phone and the insurance rep does a conference call with
the marketplace. They can't explain why I am showing canceled in the system. They say its going to take a while to get it fixed and they don't have
a member ID for me yet. I am told by the insurance rep to just go to the doctor and give my name and the insurance company and they should be able to
look me up in the system. I do this but the doctor office refuses to do it. The doctor office tells me I will have to pay $300 out of pocket to be
seen. I walked out without care.
About mid February the account is finally active again, but not until I called back again to inquire into why it is still showing Canceled. I was
finally able to print a card from the Insurance company website but there is a new problem. The plan states there are 3 people on it, but there
should be only two. They have my daughter listed twice. I called them to point it out and the insurance company is telling me they can't help me,
that only the marketplace can fix it. I called the marketplace again and they say my account is still mixed up in the other CANCELED status issue and
until that issue is resolved they can't fix the new issue.
To this day on my marketplace account they show us as CANCELED, and on the health insurance they show three people on the plan. They assure me that
this won't affect us being covered by insurance and that it didn't falsely increase my rates being that it should only be two people on the plan. But
I have zero faith in anything they say or do.
Between the Marketplace, the Insurance company, the Doctor offices and Social Services... none of them are working together. I did all the work
calling back and forth between all of them to point out all the errors and discrepancies to get them fixed. & they still are not fixed. Its a sick
game. I think they have fraud going on within... and why would I not think like that after the fiasco that has played out and continues to this