All I want for Christmas...

Hope you enjoyed the video!  I absolutely love it!!  As I initially wrote this, I still didn't have insurance in place but I hoped that this video would represent the feelings I would soon be having if I could just get things finalized.

So here's the DL:

When I completed my application on Healthcare.gov, I was deemed eligible for Medicaid because of how I put in my estimated income for 2014 based on 2013 figures.  I have been going back and forth between Healthcare.gov and Medicaid ever since.  I knew that I didn't qualify for Medicaid because Utah did not accept the expansion of Medicaid benefits (neither did NC).  However there were two BIG issues I missed:

1. Because of the income amount I put in, I fell in this ridiculous gap that exists between federal and state coverage.  If you make $11, 500, then you qualify for lower premiums in the Healthcare.gov Marketplace.  If you make less than $11,500, you may qualify for Medicaid but only if your state accepted the expansion.  If you live in a state that did not accept the expanded coverage of Medicaid then you unfortunately have to select coverage from private insurance companies and pay the full premium rates (which only normally happens, for an individual, if you make more than $49,500 a year).  Does this seem as counter intuitive to anyone else as it does to me?

2.  Once you've been deemed eligible for Medicaid, the Healthcare.gov people will tell you that there's nothing they can do to change or remove your application until after you have been accepted or denied by the state agency.  RED FLAG:  The state of Utah has not received any information for ANYONE who has been deemed eligible for Medicaid by Healthcare.gov.  The two systems apparently do not communicate so the Utah Medicaid office only has record of my application with them from back in October, nothing from when my Healthcare.gov app was submitted.  And again, there's supposedly nothing that the Healthcare.gov side can do, no master reset button that will allow the consumer to withdraw their application that has been deemed eligible for Medicaid.  I know that I do not qualify for Medicaid, why you make ask?  Basically because I'm young, have no disability (even though Wilbur could potentially be considered a disability according to some documents you read), and am not pregnant nor do I have dependents.

So you may ask, where does that leave you Anita?
The answer:  Up the proverbial creek without a paddle.

On Dec. 23 (what was supposed to be the last day to enroll if you wanted coverage to start Jan. 1), I walked into the offices of the Utah Health Policy Project.  Even though this was an extremely busy day for them, they were able to fit me in.  At 10:30 a.m. or so I sat down with one of their certified application counselors, code name Maverick because he was my wingman throughout the day (though I guess that would make me Iceman...I may have to rethink this code name).  By this point I had already figured out Issue 1 and together Maverick and I figured out Issue 2.  I think we were both in agreement that it made absolutely no sense and was beyond ridiculous how this was set up.

Me with Maverick at UHPP

We tag teamed getting through to the Healthcare.gov people.  After an initial 40-minute or so wait (this was the second or possibly third time we had call them at this point with similar wait times each time), we got in touch with a lady who kept saying their system was down and there was nothing they could do.  I told her okay, but I was not hanging up and calling back and she just needed to put me through to a supervisor, I was willing to wait because I had no other option at this point.  I finally got to speak to the supervisor only to be told Issue 2 again and I was like that's not acceptable.  Then I tagged Maverick in.  After a 15-minute or so conversation, the supervisor was convinced to create a new application for me.  Yay team Maverick!!  It took forever to resubmit and I'm pretty sure the lady was mad at me and Maverick by the end because we were so insistent and persistent but whatever, I ended up with a new application ID.  I let the lady off the phone because I wanted to be able to check through the system and make sure that the plan I chose was one contracted with the University of Utah Healthcare system for 2014. She said it would take 30 minutes for my new application to show up in the computer system.  I used that time to figure out the plans that Utah accepted that I thought I should be able to get through Healthcare.gov.

Only the new app didn't show up and the insurance company couldn't sign me up for that plan on their side so I had to go back to the drawing board and call Healthcare.gov again.  After an hour on hold, my call was DROPPED!! I was mad as a wet hen!! And completely exhausted because by this point it was 4:30 p.m.  Maverick and I had been at this for 6 hours!! And while I'd been on hold he'd been helping other people sign up for insurance.  I told one of his coworkers that I didn't know how they did it.  It has to be so frustrating for them on a daily basis trying to navigate a new system that people (consumers and employees of Healthcare.gov) don't always understand.  I've got mad respect for the people who work at UHPP and other agencies who provide similar services, that takes a whole new level of patience on their parts to not be ready to pull their hair out on a daily basis.

So I left UHPP, tired, hungry, slightly dejected, knowing I'd need to call Healthcare.gov one more time and praying that if I called them late enough by East Coast time that I would actually get through.  I admit I stopped at IHOP for cinnamon hot cocoa and pumpkin pancakes.  I just wanted a little holiday cheer which seemed in short supply.  Then I got home and there was a Christmas present from Aunt Gladys waiting on my doorstep.  Somehow she knew all I wanted to do was cuddle up and rest for a bit because there was a beautiful plush holiday blanket with poinsettias and cardinals on it!  So I got comfortable and after a little break, I called Healthcare.gov again.  I called them at 7:30 my time and two hours later I woke up (yes, I'd passed out in my chair) with a start to realize that someone had actually picked up.  What happened next is quite frankly my Christmas miracle!!

I managed to wake up before I was hung up on though who knows how long she'd been waiting for me.  Her name was Mary...how perfect is that two days before Christmas.  She was kind and competent (I mean like really seemed to know what was going on and how to navigate the system fully!).  I gave her my information to verify my identity and low and behold she could see the new application.  I told her I knew what I wanted.  I was after a Silver plan whose parent company was BCBS that had a full contract with UUMC.  We found a couple of other options first and then she found my plan.  She agreed with my assessment that the plan was a good one and GOT ME SIGNED UP!!!!!  I told her she was my Christmas Angel and broke into tears.  I think she started crying too and told me it made her Christmas to be able to help me.

I am BEYOND relieved!! I can't even express how happy it makes me to know that I have a plan in place that will begin January 1.  I still need to follow-up after Christmas and pay my premium with the insurance company directly but things are FINALLY in place.  I can get off the merry-go-round now and move forward!! HALLELUJAH!!!

Just wanted to share one more flash mob treat for everybody, this one with bagpipes and drums!!  I wish everyone a Happy Holiday season!! As the story goes...Merry Christmas to all and to all a Good Night!!!!