Health Insurance Confusion 2017

I’m happy to thank Jasmine, Joe, Adrienne, Christine, Glenn, Kathleen, and Bill. Oops. Sorry. That Bill should be a bill, but we’ll get to that. Thanks to their efforts, the efforts of folks in the industry, and an orphaned bill I have a plan that looks better, my health insurance costs dropped ~40% while my premiums went up ~ 33%. Look strange? That isn’t the strangest part, but at least I’ve navigated the system to something that looks like an improvement – which I doubt is sustainable. I’ll take it.

If you missed the news, here’s an update: Open Enrollment began on November 1st, the deadline for January 1st coverage is December 15th, and Open Enrollment ends on January 15th. You have a great excuse for not hearing about it this year. The budget for announcing it was cut 90%.

I knew about it, but didn’t do anything about it until November 26th. With the chaos in DC, I wouldn’t have been surprised to find the system changing within the open period. The thing that prompted my action was receiving a bill from a health insurance company I’d never dealt with, Kaiser Permanente.

For weeks there were emails and letters from my current insurance company, Premera. A glance told me what I’d heard from friends. Our county was only going to have one provider. The letters and emails were details about the cessation of coverage. I set them aside to see if anything would change in the political landscape.

Then, there was a letter from Kaiser Permanente; but it wasn’t a letter. It was a bill. It was a bill with a premium that had risen to within 1% of my mortgage payment. Health care has become so expensive that I see health insurance as a cost without a benefit, as long as I stay healthy. At least with a mortgage I get a house and am building equity while decreasing my debt. With the plan I had in 2017, a major medical issue could bankrupt me, even with insurance. High deductibles are like that. Increasing expenses at the time of decreasing income meant I would probably cancel my health insurance. I’d be living at risk, but I was doing that anyway. The benefit would be appreciated by my credit card company because I’d accelerate the paydown of my credit card balance. Waiting until the December 15th deadline left no room for options, so I gathered my courage (by calling a friend and venting, first), and scheduled some time to dive into the morass.

First stop, wahealthplanfinder.org, the health insurance marketplace for Washington State. Every year I contact them, sometimes online, sometimes on the phone, sometimes both. After the usual username password guessing game, I got in and hit the first bit of confusion. The bill from Kaiser was for about the same amount as the low-income assistance I’d been receiving. Were they billing me for that? Even more reason to cancel. But, no. That was the total bill due, and it wasn’t due until January. Cautiously, optimism crept in. Sure enough. If I kept my old plan with the new provider, my monthly bill would drop 40% while the total premium went up 33% which meant the assistance more than doubled. I appreciate the assistance and won’t turn it down, but the math left me confused. How is it sustainable? That’s far more than the government collects from me for taxes, and while I am considered low income (at least temporarily) I’m doing better than 20%-40% of American households. The world is weird. I shrugged and said thank you.

While I was there I used the site for what it was designed for, to compare plans. To simplify, there are three levels of plans: bronze, silver, and gold – as if they were Olympic medals. For the last few years, silver has been the balancing act between premiums and deductibles. Cheaper premiums had deductibles that were so high that they’d bankrupt me. Higher premiums had lower deductibles, but it would be too onerous to spend that much per month. How is it this year? The cheaper option, bronze, cost less than $7 per month because the assistance almost completely covers the cost. That was astonishing. The deductible was high enough for caution. I resigned myself to keeping the silver plan until I noticed that the gold plan dropped the deductible to less than one month’s premium, the total out-of-pocket to only a few month’s premiums, and only cost $5 more per month. Why stay with sliver? I went for the gold.

Such low premiums were unbelievable, so I waited until Monday morning, 8AM, to call the folks at Washington Healthplanfinder to verify my conclusion. Within ten minutes they confirmed my perception and executed the change. Cool. And surprising.

Good news can evaporate quickly, so I hung up and dialed Kaiser Permanente to confirm the confirmation. Uh. Oops. They couldn’t find any record of the transaction. They couldn’t find any record of me. Subscriber IDs, social security number, phone number, birthday, – they even checked my name (astonishing in a world of ID numbers). Nothing. And yet, I had a bill from them with most of those IDs, as well as an invoice number from their system and a file name from their computer. We bumped it up a level, they called in experts – nothing. We agreed that I should read every line of the bill to them over the phone, from the header to the footer, including trademark marks, icons, everything. Nothing. If nothing else, I thought they’d like to know that their accounting system was sending out invoices that called for payments, but were invoices they couldn’t track. If they can’t track their invoices, why would I expect them to track me, my health care, or my payments? Maybe it was a temporary glitch.

Two days later I called again. Again, they couldn’t find me. And then one of them decided to kick it to the side instead of up. From what I understand, they have a unit called the Health Benefit Exchange. Someone over there broke through the fog. I existed, I had a new plan, and I owed them money. They couldn’t figure out which plan I’d signed up for, but the number owed matched the gold plan I picked. A bill was on its way. That was good enough for me.

Rather than wait until the bill arrived, I decided to write and publish this post now for others who may be in a similar situation. If something goes amiss, I’ll try to post it here.

In the meantime, I’m looking forward to scheduling a few doctor appointments in 2018 (Molly, that’s a heads-up.) 2018 has the potential to be a much healthier year, and thanks to so shifts in my business (including passing my real estate exam) I might get to deal with the mixed reaction to making enough money to pay for health insurance, health care, and a healthy life style without any assistance. If that happens, maybe there won’t be a sequel called Health Insurance Confusion 2018.

About Tom Trimbath

consultant / entrepreneur / writer / photographer / speaker / aerospace engineer / semi-semi-retired More info at: https://trimbathcreative.wordpress.com/about/ and at my amazon author page: http://www.amazon.com/-/e/B0035XVXAA
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