Healthcare Fairytale

You guys wanna hear some crazy stuff that makes me hate this whole Health Insurance Marketplace thing even MORE than I already did?

Well then sit down children. I’m gonna tell you a story.

Once upon a time there was a Genteel Widow and her Loin Fruit. They applied for insurance through the HIMP/Obamacare. They received coverage. In January. They sent in all the papers (it was A LOT of papers!) and their income was verified. Everything was a bright gloriosity and there was guacamole flowing from the faucets and everything you’d need to be in some sort of fabulous wonderment.

In January.

There were even confirmation letters and official documents saying “You have insurance and everything has been done on your side AND our side to make sure of that. Feel free to go forth and break arms, cut your leg off, and get the hell out of that Hantavirus thing. ‘Cause we got that stuff covered.”

Life was good. In January.

THEN, in early July, the big bad HIMP sent a threatening letter about how their insurance coverage was denied because income was never verified. “CALL THIS NUMBER OR THE OBAMA MONSTER WILL FINE YOU ALL OF THE MONEY AND REBREAK YOUR ARMS, CUT OFF YOUR LEG, AND GIVE THAT HANTA STUFF BACK TO YOU!!”

It was very scary. (Not really. It was more like exasperating and annoying as hell….but I wasn’t scared.)

The Genteel Widow called the number and was told “Everything is fine. We have all of your information. No one knows what you’re talking about.”

The Genteel Widow, who had worked with insurance and government before, knew better. She pressed harder, “There was a letter. I will give you the code thing from it, (she left out the word AGAIN here because she was rockin’ that whole genteelity thing), and you will tell me some new news.”

This caused the voice on the end of the phone to say “There’s been a miscalculation. It looks serious. I don’t know how it could be because this says everything’s taken care of. However, this is obviously a serious issue and it could cause stuff like..kidney failure.. or something really bad if you don’t fix it.”

Genteel Widow, “Yeah. That’s why I called you. To fix it.”

Voice on the phone, “Wow. That looks complicated. The only way to fix it is to have these people from this other department call you. You can’t call them. And I can’t give you the number. But they will call you in 7-10 regular days. (As opposed to business days.)”

Genteel Widow, “I can’t be the only one that thinks it’s weird that you send me a letter telling me I have to call this number in an **URGENT** manner..and then you can’t tell me why or resolve it in any meaningful way. I mean..that’s weird, right?”

Voice on phone, “I have no response because this call is being recorded for quality assurance purposes…but you can tell from my inflection that I think it’s asinine too.”

The Genteel Widow hangs up and waits for that super important phone call that is supposed to take place in 7-10 regular days.

Fast forward to mid August. A.K.A. six weeks later. (Which is neither 7-10 regular days *or* 7-10 business days.)

The ever important phone call happens. The lady on the other end has a name that rhymes with “Angela Edward.”

(Mostly because that is her actual name.)

Angela Edward tells Genteel Widow “The household income issue has been fixed.” But she also says “I need to fill out a form to ‘Report a Life Change’ because of a reason I am never able to properly clarify in a satisfying way…but I will insist this is a thing that needs to happen to resolve the income verification issue…that I have already told you is resolved and is not an actual issue. I know it sounds confusing. That’s because things weren’t calculated correctly and we need to do everything again. Even though I just told you it WAS calculated correctly and everything was fine.”

Angela Edward goes on to say “Why are you asking if I’m on ‘The Crack?’”

Whatever.

The Genteel Widow goes along with Angela Edward because she can tell that’s what has to happen or she’ll lose insurance coverage. Since the Genteel Widow has a heart medicine that costs roughly $5 GaJillion dollars a month…she complies.

Everything goes smoothly. If “smoothly” meant “takes TWO AND A HALF **FREAKING** HOURS and causes the Genteel Widow to miss her hair appointment.. so now she’s got roots showing and bangs in her eyes.” “Whatever” the Genteel Widow thinks to herself, “It’s not like I’m dating anyone or have a reason to look nice other than vanity. I can deal and it’s not a big deal.”

And it wasn’t a big deal.

Until Angela Edward tells Genteel Widow “You have to go BACK to the Social Security Administration (SSA) and get that one letter from them again. Even though we have it already. Twice. And it’s been accepted and verified and all of the things. We still need it. Oh. And you also have new lower premiums now. You say you want all that extra money back? Well you’ll have to file an appeal if you want your new lower insurance premiums to be retroactive so you can get back the over $200 that you’ve paid that you shouldn’t have… (On account of our mistake calculating your income…which is weird because …you know… we verified it and stuff.) Otherwise you can just start paying the new lower premium. Ok. You want to file an appeal? That’s an “Exceptional Circumstance” because of… HARD!.. and it has to be escalated. I am doing that now. I will now also transfer you to that department.”

Genteel Widow, who is used to these sorts of statements, “Can you please give me the number in case the call is dropped or something?”

Angela Edward, mystified that that would ever happen, “Sure. I am saying the number to you right in this spot here. And then I am transferring you.”

Twenty minutes of being on hold later..and…you guessed it. The call gets dropped.

Genteel Widow calls the number Angela Edward gave her. A guy whose name rhymes with “Rod Henderson” answers. He tells Genteel Widow “I can’t tell who this Angela chick is because we have no way to track that. Also there are not a lot of notes here. We just tell you our first and last names to make you feel more secure…but they’re probably fake names as you will see when you call back tomorrow and hear the name of that phone voice. The only way to get your money back is to call your insurance company and ask them for it. But to do that you’ll need a paper telling them there’s been a miscalculation….and to do that you have to file an appeal so we can do a ‘Hix Investigation.’ An appeal takes 30-90 days. Here is a lot of information about that. If you get it wrong your pancreas will explode and you’ll start to grow exterior mucus. I know. Super gross!”

(A lot of this wasn’t actually said verbally….. in the strictest sense…but Genteel Widow felt it and knew it was in there.)

Upon hearing these words, Genteel Widow did a full body eye roll and whined about it a bit…then those hours on the phone, and future time at SSA, started to bug her in a real and meaningful way.

Even so, she tried to let it go.

Because stress is bad for your hair.

And she was already living in a less than ideal hair situation.

The next day…. Down to SSA Genteel Widow goes. It’s a room filled wall to wall with humanity and it’s a total time suck. At one point a guy yells out with excess passion “IT’S SUPPOSED TO BE SEVEN! IT’S NOT EIGHT!”

It should be noted this guy wasn’t talking to anyone but himself, as he was still waiting in the queue, and he wasn’t looking at his phone or anything.

He had just spent too much time here.

This place changes you. And that’s how it manifested.

Eventually Genteel Widow gets up to the counter. The SSA lady can’t print out half of the needed papers. Ever. There is no way to do it. Because it is impossible. SSA lady prints out other papers and Genteel Widow goes home feeling slightly anxietious.

On the way home, Genteel Widow goes to the pharmacy to pick up a prescription for Loin Fruit. BUT BEHOLD!! The pharmacy tells her LOIN FRUIT DOESN’T HAVE INSURANCE COVERAGE ANYMORE!!

W! T! HELL! RIGHT?!?

Genteel Widow calls the insurance company, not HIMP, to inquire as to why Loin Fruit is no longer covered. “Insurance Mitch” replies that coverage ended on the same date Angela Edward called.

There is no way to add Loin Fruit back. It is more impossible than printing out the other half of those SSA papers.

Genteel Widow calls HIMP again and tells them to go f….I mean…she relays the whole story plus the newest issues and asks the operator, whose name rhymes with.. and I am SOOO NOT MAKING THIS UP…”Malakia Superstar.”

Hearing this confirms Genteel Widow’s previously held belief that these people make up their names on the spot.

(How does someone get “Superstar” for their last name and how can I get signed up for that?!?)

Malakia Superstar talks to Genteel Widow for over an hour. Genteel Widow has to go through the whole “Report a Life Change” thing again.

It takes FOREVER!!

It sums down to basically this “Loin Fruit cannot get coverage. You cannot add her on because it’s not a ‘Special Circumstance’ or an ‘Open Enrollment Period.’ Yes, come tax time, you will be fined if she doesn’t have coverage.”

The frustration is too much for Genteel Widow and she starts to cry. Malakia Superstar becomes worried. So worried that she puts Genteel Widow on hold for a long time, but Malakia Superstar keeps coming back every couple minutes to let Genteel Widow know Malakia Superstar’s still there and can she put her on hold again?

Malakia Superstar comes back on and tells Genteel Widow “You might qualify for CHiP and so you have to call them TODAY to get coverage for Loin Fruit. I know you don’t want to bother with that because you’ve been turned down for that before and you’d rather have the insurance you had before and not have Loin Fruit uninsured for the 30-90 days I’ve told you it takes CHiP to decide on coverage…but that is impossible. Because we are the government and most of what you are asking us to do today is impossible.”

Genteel Widow ends the call with Malakia Superstar and calls CHiP.

Of course CHiP is closed.

Genteel Widow will call them tomorrow. Because Genteel Widow is not a quitter. Even when she should be.

This thing is not the only life stress Genteel Widow has going on right now. And because of that, Genteel Widow will be drinking 100 proof rum tonight. (Who wants to bring her some?) She’d go on a bike ride instead, but for some reason Iva’s not working today and a bike ride would cause her heart to explode if she attempted it.

Thanks for listening to me bitch. I’m sure you didn’t read the whole thing..because it’s longer than Les Mis…but it feels slightly better just to have it all written down and complained about.

The one highlight in this whole mess? I got to speak with someone who told me their name was Malakia Superstar!!

That gives me hope I can someday marry into her family and have “SUPERSTAR” for my last name. (I will always spell it in all caps.) WOOT!!

I’m out! It’s time for Buffy with The Kid!

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