So, today I went to the doctor for the first time since I re-signed up under Healthcare.gov for insurance. I had selected the same plan I had last year even though my rate went up a whopping 260%! Why did I chose that plan even though it went up so much? Because I spent hours comparing what the plans paid by printing them out and going through line items of the payment benefits especially related to certain services I knew I would be needing due to ongoing issues. Based on details found at Healthcare.gov, this plan still offered the best cost savings in the end.
One thing in particular I paid close attention to was the co-payments for specialists because I had tests already lined up and visits anticipated for that kind of care. I also had my policy from last year out and noticed none of the important things, like the specialist co-pay had changed. GOOD! (Oh little did I know...)
Imagine my surprise today when I was asked for a $90.00 co-pay instead of a $35.00 co-pay.
I came home and got right on the phone with Florida Blue. Long story short, according to their plan as I can see it online at their site, this is what I bought! I was told there must be an issue with the information at Healthcare.gov.
I hung up, took a deep breath and called Healthcare.gov. After a ten minute wait and fifteen minutes on the phone with the first representative who was no help at all, I was referred to a supervisor. Additional to my issue with not getting what I expected in benefits, on the website I also found that: 1. Clicking the button that is supposed to go to where I can review the benefits, didn't work. 2. In one place my enrollment in the program showed active. 3. In another place it showed in progress.
After thirty minutes with the supervisor, this is how things ended up. He also couldn't get the benefit button to work. He also saw conflicting issues with the status being in progress in one place and active in another. At least he confirmed I am active. He was by other means able to go into the account and see the benefits, and guess what, they reflected not what I saw to make a decision to purchase, but instead the same details as what Florida Blue confirmed!
Luckily, I had already asked him, what if, I can eventually use the benefit button and I find that the details are not what they were when I shopped. And he had provided an answer to send the case to CMS for investigation. (Oh yeah I feel much better now. NOT) In up to thirty days from now I will hear from them, what if anything can be done. (I'm not holding my breath for this to turn to my favor!)
I can only say what I believe happened because it was only a month ago I did this and I recollect quite well pulling out the calculator and wagering the costs of benefits vs the plan costs to determine the plan I would purchase. I think Healthcare.gov was negligent in updating the Florida Blue plan, if not Florida Blue being negligent to send them updated information. But who do I trust more, an insurance company or the government? HA! That's like asking do I trust a hungry lion or a hungry tiger more to allow me to pet it.
Bottom line, I expect to get screwed over on this deal with no recourse. So people here's my recommendation. If you shop Healthcare.gov, print out the benefits and SAVE THEM! Also do a webpage complete save while you are on the benefit page, because yes indeed, some day you may have to prove that you didn't get what you paid (TOO MUCH) for!
But all is not lost. I was told that I did an excellent job of explaining the problem and in relaying the situation several times during the conversation with the supervisor. At one point he said, "If only everyone does as well as you that I talk to tonight, my night will be awesome!"
GREAT just great. I'm left stressed out, frustrated and screwed over, but patted on the head for good communications skills!
Copyright 2016 Wanda Hope Carter, all rights reserved, no duplication, excerpting, downloading, framing, copying or other type of use other than by the sharing of a link to this article permitted without express written permission.
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Still praying....