Health Insurance Confusion 2016

photo-on-2016-12-20-at-18-53A toast, to paying for something I don’t quite understand yet is in my second highest expense category: health insurance. Yet again, I’m enrolled. It only took hours and days of effort to pay for something I haven’t been able to use for years, and only rarely before that.

A bit of repetition: I have health insurance. That does not mean I afford conventional health care.

I’ve always had health insurance, first through my parents, then through college, then from Boeing and spousal coverage, then from monthly premiums that seemed reasonable at the time. Until my Triple Whammy, my perfect storm of bad luck, I enjoyed, yes enjoyed, going to the doctor because I appreciated the value of good health and the efficiency of preventive care. Since my bad luck hit I haven’t been in a “western” doctor’s office, have even developed an anxiety reaction to the concept, and have relied on “unconventional” medicine, and my best attempt at healthy eating, exercise, and general lifestyle. Working seven days a week has made me miss my goals, but I suspect the lapse is temporary. So I keep telling myself.

If you’re having trouble sorting out health insurance options, you aren’t alone. I’ll skip the suspense. I have health insurance. It’s probably similar to what I had before (One Confused ObamaCare Applicant), except more expensive. No surprise there, and the lack of surprise is a sad statement. What I can chronicle is the time and effort required to keep what I had, health insurance that has helped society by contributing my share, but that hasn’t and possibly can’t help me – at least until I am richer.

Over the last few months the emails and letters have arrived telling me to make sure I sign up. About a month ago, my financial situation was looking dire enough that I realized I might not be able to afford health insurance. Finding enough money for insurance, taxes, and other bills was more important than any particular package. My life is evidently remarkably frugal because many people have remarked on how frugal my life is. All of my other non-insurance bills provided some direct benefit: housing, food, heat, water, etc. Insurance is an expense greater than everything except housing and taxes.

Without insurance on the house, I’d probably lose the house. Without insurance on the car, I couldn’t legally drive making work difficult at least. Without health insurance, I’d, well, I’d, well, I wasn’t going to the doctor anyway, so what difference would it make? From what I understand, with Obamacare visiting the doctor is far more affordable. As long as I was healthy and only had to pay for the visit, the visit would be affordable. If I wasn’t healthy, then the insurance would kick in – after the deductible, and if they approved the expenses. The last time I relied on doctors, the diagnostic tests alone totaled over $7,000. Treatment for whatever would be additional. For a while, that was enough to bankrupt me if the insurer decided not to cover the tests.

Walking Thinking Drinking Across ScotlandThe story of how I reacted became a walk across Scotland and yet another book, Walking Thinking Drinking Across Scotland. It looked like most of my symptoms were stress-related. Walking, thinking, and drinking my way across Scotland cost half of the potential diagnostics bill. I’m glad I did it. Since then, however, the stress level in life has gone up.

Several bits of good news have hinted at making 2017 a much nicer year, so I decided to at least continue my insurance. Maybe I’d actually make enough to do more than pay the premiums.

I sifted through the various communiques, found a few that suggested contacting my insurer, and decided to give them a call. But first, more mail arrived. It was a bill for the old amount and mentioned 2017. Great! The same old plan, continued into a new year, and maybe I could skip the paperwork and online maze that I feared. I paid the bill and relaxed.

Why not give them a call, just to make sure? With a day to go before the deadline, I placed the call that should be a quick confirmation. One hour of being on hold was bad. Every thirty seconds they’d spend about ten seconds telling me that my call was important. Those thirty seconds were thirty seconds of the same harpsichord music repeated – forty seconds of both repeated for an hour. So much for my mental health.

I live tweeted my frustration. Surprise! I got a response. They offered to have someone call me directly. Such service! It was already late because I work from about 8am to 8pm, which meant it was almost 10pm. I suggested they call after 4:30pm the next day.

The next afternoon, maneuver my schedule so I can be somewhere convenient for the call. Wait. Wait. Wait. Over an hour later I had to leave, let some folks close their shop, while I headed for a dinner engagement. The call finally came in at 5:45pm, while I was outside in mid-twenty degree weather. They got points for calling back, but lost a few for timing. The good news, the deadline was extended to December 23rd. I tried calling later that evening, but again couldn’t get past Hold.

Work until after 8pm several more evenings.

Oops. I went to try again, this time in the middle of the day. Before the call I sorted through those months of mailings and found that I’d missed a payment. Now I had two things to resolve, or was it three, or more? After yet another hour of Hold, begin to wonder if the Customer Service number was really out of service. At least the harpsichord music was gone.

The next day, pick up the mail and find my New Card! as if nothing was wrong. Maybe I did something right and didn’t know it. Hey, it happens. Try to call again, this time before dinner. Only thirty minutes on Hold and I’m caught by surprise. Someone answered. It took me a minute or so to remember my string of questions.

It turns out that they thought everything was fine and all I had to do was pay my new premium (~15% increase) by the end of December. Evidently, I paid the bill at the old rate so early in December that they took it as the November payment. No fines. No fees. While I had Customer Service providing a service, I asked about cheaper coverage options, but nothing made much of a difference. All I had to do was go to my online bill pay system and pay the bill. Which I did, and I hope I did it right, or did it wrong in a good way – which seems to happen.

The cost of trying to figure out how to give my health insurance company money for benefits I may never be able to comfortably use was three and a half hours on hold, and one week of calendar time as the holidays approach – time that could’ve been used for making the money to pay the bill, finding better employment, or maybe even baking for the holidays.

At this point, I have lost track of my deductible, restrictions, and possible benefits because the only number that is important is the premium I pay.

At this point, I also realize that the people I should talk to aren’t Customer Service, or Washington Health Planfinder, or doctors in their network, but the people in my network of friends.

Many of my friends have lived through expensive medical conditions. The vagaries of descriptions of health care options aren’t as valuable as the real life experiences of people who have had to rely on health insurance to access health care. So I ask you, if you’ve experienced relying on health insurance while barely being able to afford it, what did you learn about which plan to sign up for? Between the people with more than enough and those with no insurance are the people who face bankruptcy to pay for staying alive. What do you differently now? What do you wish you’d done then?  You’re the experts I want to hear from. Help clear the health insurance and health care confusion.

About Tom Trimbath

real estate broker / consultant / entrepreneur / writer / photographer / speaker / aerospace engineer / semi-semi-retired More info at: and at my amazon author page:
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1 Response to Health Insurance Confusion 2016

  1. ideaworth says:

    Tom, my experience hasn’t been much different than yours with Blue Cross in Texas. In 2016 I signed up for a gold plan with only a $500 deductible because I planned to have a colonoscopy and a cardiology work up etc. Which I did. Having met the deductible in January, most of that stuff was covered, which was great.

    I had hoped to continue the same plan in 2017 (which is quite expensive, just about $150 less premium than my mortgage). But…… wait for it …… my new premium would increase 44% for the same plan. OUCH! Ergo, I went to a lower tier plan with a $3,000 deductible, but it still cost $100 per month more than my 2016 plan. Now, it is only about $50 less than my mortgage, and a lower quality plan (at least much higher deductible). Texas does not have its own exchange, so I work with and the wait times on hold don’t seem too terrible.

    That’s my story!

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