Shallow Thoughts : tags : health care

Early expirations: A surprise-a-minute with a ACA/CoveredCA health plan

I went to the pharmacy to pick up a prescription a few days ago. The pharmacist said "We don't seem to have any insurance on file for you." I said "That's funny, I just gave you my new insurance card about a week ago, at that window right over there." That would be my shiny new hard-won Blue Shield card with my Obamacare/ACA/CoveredCA plan number.

The pharmacist went into the back room and came back a minute later with a printout. "Looks like that insurance expired on 1/18. Was that a temporary plan number or something?"

"Well, if so, they sure never told us about it, and we've paid through the end of February."

He went to the back room again and got someone to call Blue Shield. And in 10 minutes (whew, I was worried they'd hit the same hour-long queue we individuals have to wait through ... I tried calling them with a billing question last week and had to give up when my phone battery ran out long before I got through the queue) they came back and gave me the prescription for $5.

Does that mean that the problem is solved and the early expiration date was just a mistake? Or did they do some one-time override, and I'll have to argue every time I go in using this card?

As it happens, I'll never know, since I'm about to leave the state. So I get to go through the ACA application process all over again (oh, joy!), this time in a new state using the federal Healthcare.org website, about which I've heard so many wonderful things. It'll be interesting to see how Healthcare.org stacks up now compared to the CoveredCA site back in November.

Tags: ACA, obamacare, health care, coveredca
[ 20:04 Feb 07, 2014    More misc | permalink to this entry | ]

Verification woes on California's health exchange site

I wrote a few weeks ago about my difficulties in signing up for a California health exchange (CoveredCA) plan. At the time, they said I should be hearing from the insurance company by the following day. I didn't believe that, of course, and indeed, it was a little over two weeks before I finally got something in the mail.

What I got in the mail was a letter from CoveredCA saying that we qualify for coverage for 90 days, but that they want to verify some things.

First, they need to verify citizenship. Fair enough. They want a birth certificate, passport, or INS form. No problem.

They they say "We are unable to match the Social Security number you gave us to our records. Please send us a copy of your Social Security card."

That's a snag. I had a social security card once ... maybe 25 years ago? but I've long since lost it and haven't had any need to go stand in line to get another one. Do I need to do that now? During the holiday season along with the thousands of other people in the same boat?

But the next part is the real kicker:

We are unable to verify that you do not have health insurance through your job or a government program.

• If you have insurance, we need a letter from your job or the deferal/state program. The letter should be on official company or program letterhead. The letter must state the names of the persons who qualify for now, the type of coverage that ended, and the date it ended.

If you do not have insurance, please call the Service Center for assistance.

Neither of us is currently working at a regular W-2 job, let alone one that provides health insurance. So, let me get this straight: it looks like what CoveredCA is telling us is that we can't get ACA coverage unless we can prove that we don't currently have employer coverage. How the heck do you prove that?

Looking at the list of documentation they'll accept, a letter from each of our nonexistent employers, on nonexistent company letterhead, would work nicely.

Right.

Uploading documents (forget using Firefox)

I went to the website, logged in and clicked on the verification link at the lower right. (It's a little hard to find given that there's a bunch of other text on top of the link. Nobody seems to be checking the website layout.)

After clicking through a few more screens, I ended up at a page where it listed two items for each of us: Proof of Citizenship, and Proof of Minimum Essential Coverage.

The citizenship part had a long list of acceptable documents -- much longer than the list in the letter they had sent me (though nothing about social security cards, so I'm not clear where that part comes in). But a passport seemed the easiest thing. So I scanned the photo page from each of our passports, clicked on the link for proof of citizenship, clicked Upload, clicked Browse, found the link to the JPG I'd made of my passport, and clicked Upload.

And I got:

The connection to the server was reset while the page was loading.

I tried again, several more times. I tried making the file smaller (640x449, 128k), using tif and pdf instead of jpg (following suggestions I found on the web -- lots of other people are also having this problem). But it was no use -- I still got the same message every time.

Finally I found a thread where someone had discovered that it didn't work with Firefox, only with IE and Chrome. So I tried logging in with Chromium, and sure enough -- the upload worked.

It's sad to see how marginalized Firefox has become, when major sites like this don't support it.

Minor aside: there's no way to remove an upload once you've made it. I uploaded both our passports in the space for my documents, before realizing there was a separate link for his documents. I hope that doesn't get my application thrown out.

Okay, on to the next part.

Proof of Minimum Essential Coverage

Under the "Proof of Minimum Essential Coverage" category was this list of documents:

• Notice of Action of discontinuance from Medi-Cal
• Notice of Action of discontinuance from Medicaid
• Confirmation of disenrollment from employer sponsored health insurance plan
• Confirmation of disenrollment from health insurance plan

None of them seem at all relevant to someone who isn't an employee and therefore isn't covered by insurance.

Well, the letter did say "If you do not have insurance, please call the Service Center for assistance." So let's try that.

Online chat

I have trouble finding time when I can stay on the phone for the 30-45 minutes it apparently takes to get through the queue to a live operator at CoveredCA: I've tried several times, but always got called away to deal with real-world issues before I got to the head of the queue. The live chat link didn't do anything for me a few weeks ago, but this time I got a notice from the pop-up blocker and was able to get the window to pop up.

The chat window tells you where you are in the queue (I started at #47) and counts down, along with wildly varying time estimates of how long I had left to wait. After just over half an hour, I'd finally made it to position #1, and the page changed to say:

Status: Canceled

There are no agents available to chat with you right now. Please try again later.

The only option was a button labeled Request email response. So I clicked it. It took me to this page:

https://coveredca.custhelp.com/app/error/error_id/4

Permission Denied

You do not have permission to access this document.

Honestly -- does anybody bother to test any part of this website? It's been live for two months now, and so much basic functionality doesn't work at all.

I tried it several more times (the nice thing about chat, as opposed to phone, is that you can go off and do other things while you're waiting in the queue), in both Firefox and Chromium, but got exactly the same results every time. Googling suggests that lots of other people are seeing the same thing.

Makes me wonder if anyone is getting through ... or are there just a bunch of employees sitting there at their keyboards at CoveredCA headquarters, wondering why no one is asking for help via chat.

I really wish they'd offer email assistance. That seems like it should be a no-brainer, given the long wait times for interactive help either by phone or (ha!) by the nonexistent chat. But there's no such link on the website.

Well, there is a space for comments in the Verification Request screen. So I typed in a question about how they want us to prove we're not employed. At the bottom of the verification page, the button options are "Close", "Save and Exit", "Withdraw" (greyed out), and "Submit". I wonder what the difference is between "Save and Exit" and "Submit"? I crossed my fingers and went for "Submit", and now my verification status is "Submitted". I guess that's good.

Check your messages

Another thing I learned along the way was that there was another copy of the letter in my "Secure Mailbox" in the links at the top of the page after logging in. They apparently don't send any notifications that you have messages -- I wonder why they bother asking for email address, if they're not going to use it for anything -- so if you're waiting for any step of the process, be sure to log in periodically and look for that "Secure Mailbox" link.

When you do check your messages, they're in PDF! Not only that, but there's apparently something odd about their MIME type, because Firefox doesn't display them inline like other PDFs. They display okay in an external viewer, though.

So I'll be checking messages to find out what happens with the verification process, wondering whether it will all be finished by December 15, which is apparently the (unpublished) deadline for enrolling in a plan if you want it to be active by January 1.

Meanwhile, I'm trying not to think about the ominous coda in the letter they sent:

It's time to choose a plan. Your coverage starts after you choose a plan and pay your first premium (monthly cost).

Would that be in addition to the plan I supposedly already chose two weeks go? Or did they throw all that away, and I need to go through that step again when and if they decide my verification is complete? I wonder how I would know?

Phone to Blue Shield

A friend who's been having similar problems signing up for a plan suggested I call Blue Shield to see if they'd gotten any signup info for me. Unfortunately, I got the letter during the Thanksgiving holiday, so I had to wait until Monday to call Blue Shield, and just called them today.

I got through after a 15 minute phone wait, and got a very helpful person who, unfortunately, informed me that they haven't gotten anything from CoveredCA about my coverage.

After establishing that, yes, CoveredCA still has their usual 30-plus-minute phone wait, he suggested that I put in a request on the CoveredCA website for them to contact me. I said, What? I'd love that, but I haven't been able to find any way to get feedback except the phone number and the non-working live chat link. He said he'd walk me through it.

We both logged in at the same time. He said, "See the tab in the row across the top that says Resources?" Me: "No, there's no Resources link. The four tabs at the top say Learn, Preview Plans, Apply, and Maintain." He continued to insist that I should click on Resources. I did a Find in Page -- the word Resources only appears once in the page, as a header down near the bottom right, and under it are a couple of things like links for where to download a PDF viewer. Clearly not what he was talking about.

I'm guessing he was logged in as an agent/provider, not as an individual customer like I was. Anyway, he used the page they offer to agents to put in my info and a contact request. I'm not holding my breath.

But just now, after CoveredCA timed out my log-in session and put me back at the home page (what's the point of the home page, anyway? You can't even log in -- you have to click on Start here before they'll give you a Log in link) I tried clicking on the Contact us link at the bottom ... and on the page that took me to, there's a Click here to request information or provide comments link that I suspect is the same form he filled out for me. Why they offer the non-working Live Chat link on every page, but not the Request information link, is another mystery.

(Oh, I think I've figured it out now. The start page is there because the real site is at v.calheers.ca.gov, not coveredca.com, and their website designers don't know how to make a website redirect automatically, so they make everybody click through an extra button to go to the real site.)

Meanwhile, time is ticking away. Nobody seems to know whether the deadline to sign up for Jan 1 is actually December 15 or December 23 (the Blue Shield rep wasn't sure either), but either way, if it takes more than two weeks for CoveredCA to submit any information to the insurer, it's hard to see how it will be possible to get signed up by the deadline if anything goes wrong and needs to be resubmitted.

Fortunately my existing health plan is still active (never mind that it costs $1000/month more than a subsidized plan). So I'm luckier than many. My friends whose existing plans have been canceled may end up with no coverage at all come Jan 1.

Update: success! At least, I think so. On Dec 12, I got an automated call from Blue Shield saying they'd gotten enrollment info, and giving me a number to call to make a payment. I paid and got a confirmation number, and they said I should expect an information packet in the mail in 5-7 working days. A friend who's been trying to sign up since Oct 1 when CoveredCA opened got the same Blue Shield call a couple of days earlier. Then we both got the same automated call a few days later; we both checked and BS has a record of both our payments, so the repeated calls are apparently just a glitch.

Tags: ACA, obamacare, health care, coveredca
[ 17:32 Dec 02, 2013    More misc | permalink to this entry | ]

Signed up for a California Exchange plan (I think)

I signed up yesterday for a health care plan on California's health insurance exchange, CoveredCA. It wasn't pretty, but I signed up for a plan in the end. Or at least, I think I did.

The process was full of hilarity, a several hour haul involving pages that didn't work, pages with mistakes on them, and of course, timeouts and restarts.

Brief thought before I begin: California's healthcare site is CoveredCA.com. That's dot com. I keep seeing articles in the newspaper warning people not to get confused by imitator sites, as there are several with names similar to the official site (Update: see, for example, Kamala Harris shutters 10 fake Covered California websites and State shuts down bogus health care websites) , and I always wonder -- why don't government sites take advantage of dot gov domains? You see the same thing on the national credit-report-check website: there's a dot com website where you can get your official government-sanctioned free credit report, and then there are about twenty imitator sites with names that any normal person would confuse with the real site, which are basically scams that try to suck you in to paying for various products in the guise of giving you your free credit report.

Government folks: the whole point of dot gov is to tell us it's a government-sanctioned site. Please use it.

Anyway, back to CoveredCA.com. I had already been on the site a few days earlier. CoveredCA says that you can browse plans without signing up for an account. That's sort of true -- but that's not really true. You can browse plans, sure ... but you can't find out any useful information about sorts of subsidies you might qualify for. The site asks you questions about your location, your income and the age of everyone in your household, then deposits you on a page that chirpily informs you "You may be eligible for ..." a list of every possible type of plan, from Medi-cal (California's version of Medicaid) to regular exchange plans to ... aid to mothers and infants? When I've already filled out a form saying that there are no children in the house?

At the bottom right is some small print saying that you have to create an account to find out what you're actually eligible for. Then why ask those other questions?

Okay, so I guess I need to sign up even to browse. With trepidation I began the sign-up process.

Signing up

The first hurdle came only a few screens in, when I typed in my address. 123 Mystreet Ave, San Jose, CA, 91234. I got an error screen.

Confirm Your Mailing Address

The address you've entered is different from those on file. Please confirm which is correct.

The address you entered
•	123 Mystreet Ave,
	San Jose,
	CA,
	98765
Possible Address 1
	123 Mystreet,
	Ave,
	San Jose,
	CA,
	98765

See the difference? It took me a minute, but they have a comma between my street name and "Ave".

I don't normally put a comma there, and I don't think most people do. So I left "The address you entered" checked. I probably shouldn't have: later in the process, it asked me my address again (don't they have, like, you know, a database, so people don't have to enter the same address multiple times?) and it showed me the exact same screen.

I stubbornly stuck to my guns and continued to insist on the version without the spurious comma, whereupon the site stopped responding at all, and fifteen minutes went by without any pages loading. I tried reloading, going back, etc. but I finally had to give up and reload CoveredCA.com. Fortunately, it had saved at least some of my work so I didn't have to start from the beginning.

Accepting the commaed version might not have helped, anyway. These 10 or 15 minute delays were fairly common throughout the process. Two or three times, while I was waiting for a page to load, I got an amusing (I just accidentally typed that as "abusing" -- talk about a Freudian slip!) popup saying that my session was about to time out, did I want to continue?

Garbled pages

The next snag (aside from timeouts) I hit was the Household Authorized Representative Information page. I was out of the room when it loaded, since it took many minutes to get from the previous page to that one, so I didn't see it load, but when it did, this is what I got:
(click on the image for the full screenshot). Um? Did we time out and only load a partial page?

I crossed my fingers and hit the browser's Reload button. I watched a page full of questions come in -- whew! Except that about a second after the page finished filling with questions, they all vanished, to be replaced by the same thing I'd seen before.

I'm not entirely sure what this screen is for. Of course I would want my husband authorized. But I can always give him the password I used to log in, and I'm not sure he isn't automatically authorized anyway. Maybe this screen is for authorizing someone else. Anyway, let's just hope the default is okay and I'm not agreeing to anything I don't want, and click Continue.

And the end of the process was a statement to read and sign, under penalty of perjury. It included this amusing paragraph:

I know that I must tell the (Co-Brand Application Name) if anything changes from (and is different than) what I have provided on this application.

I'll be sure to notify (Co-Brand Application Name). I promise. Meanwhile, do you have anything to tell me about Lorem ipsum?

Choosing a plan

I finally got through the signup process, about two hours after I started. Whew! It said I could now choose a plan. But when I clicked on that button, no page loaded. I waited 15 minutes, gave up and clicked Reload, waited another 15 minutes, and then had to leave for a meeting. So I clicked Stop, hoping that the site had saved all my info and I'd be able to look at plans later that afternoon.

When I returned to the computer, of course my attempt to click on the button to choose a plan took me to a Server Error page. I expected that, after letting the computer sleep for several hours. So I loaded CoveredCa and logged in again.

This time I was able to get into the "Find a Plan" part of the site. (Less traffic in the afternoon? Or was the button from the signup page taking me to the wrong place? I'll probably never know.)

The user interface on the plan comparison page is horrifying. You're shown three plans at once (no, resizing the browser window doesn't increase that number). Then there are two nested scrollbars: the outer one scrolls the page that includes the names of the three plans, while the inner one only scrolls the part you can see below the big rectangle describing each plan. Assuming there is anything you can see below that part: I had to maximize my browser window to my 1680x1050 monitor and scroll the outer page to where I could just barely see the names of the plans, and then I still could only see a tiny fraction of the available details at once. To really compare plans, you have to expand all the categories, then scroll up, down, up, down, up, down, taking notes on paper since you can't see more than half a category at once (and of course, only for the three plans you're currently viewing). Don't even bother trying this on a laptop.

If you want to see more than the first three plans, there are the amusing scroll tabs. On the left of the three plans is a tab with a symbol that looks like an equal with dots above and below it: that scrolls left (if not already at the first plan). On the right is a tab with the symbol alpha; that scrolls right. Why those symbols? I have no idea. Maybe the UTF-8 codes correspond to right-arrow and left-arrow in some Windows-based design tool.

It took me quite a while to figure out how to tell which plans cover which doctors. It's under the Summary category, My doctors, Search.

Eventually I gave up on trying to compare plans intelligently, and just picked the silver plan from our current provider which I was pretty sure would cover our current doctors. Amazingly, it let me sign up, and told me we were enrolled -- though it wouldn't be official until the provider had contacted us about billing and we'd made the first payment. It said we should expect them to contact us by November 15. (Checks calendar) ... Why ... that's tomorrow! And it was about 2:30pm already. That seems awfully quick. It's the 17th as I'm writing this ... maybe there'll be something in tomorrow's mail.

And in case you're counting, the deal we'll be getting through the ACA is stupefyingly better than the individual plan we were paying for before. Like $10,000 a year better, with a $500 deductible instead of the $4000/person deductible we had before. So don't get the wrong idea from this snarky blog post -- I'm a big fan of health care reform. It's just badly done websites I object to.

Survey: How are we doing?

Finally done! Wahoo! And at the end, there was a chance to fill in a little survey about my experience on CoveredCA. Of course, I wanted to tell them about the problems I'd encountered, so I clicked the button. I filled out the survey and clicked Submit.

You know how if a form on https directs you to a non-SSL page, Firefox gives you a warning about it? I got that warning here. But it didn't concern me -- I'm not worried about whether my survey results are encrypted when I'm sending them. So I clicked Continue.

And got this: you must use ssl to access this resource. I about died laughing. A fitting end to hours of hilarity.

So as you read coverage of the problems with the national healthcare exchange, and all the chirpy reports about how the states with their own exchanges, especially California, are doing so much better, keep this in mind. Especially when the articles mention things like not having gotten much negative feedback or heard about problems their users are having. (Is this a good time to mention the helpful "Online chat" link at the top of the CoveredCA site that just reloads the main page?)

You have to admit, a survey page that doesn't work is a great way to reduce the amount of negative feedback you get!

Update: it's half a week later now; no word from the insurer. I went back to CoveredCA and logged on to verify that I'm really enrolled. On the main screen, it shows me a timeline with six steps: Summary - Household - Personal Data - Income - Eligibility - Enrollment. The first four have blue squares with checkmarks in them; Eligibility has a blue square but no checkmark, and Enrollment is white and un-checked. I have no idea what this means, but it doesn't look good. The squares with checks are clickable; the others aren't.

Clicking around in desperation, I discovered by accident that if I clicked on "Income" (the last clickable step), on the Income page it added a checkmark under "Eligibility" in the timeline at the top, making it clickable. If I then clicked on Eligibility, it didn't add a checkmark for Enrollment, but it did give me a "Choose a plan" button at the bottom, so I clicked on that. That took me to a page titled "Household Enrollment Summary" which showed me the plan I'd signed up for. There's a link over the "Carrier Website Address" but it goes to a nonexistent page on v.calheers.ca.gov. Meanwhile, in the top timeline, Enrollment is blue though it still isn't checked.

So am I really enrolled in a plan? Wish I knew.

Tags: ACA, obamacare, health care, coveredca
[ 18:25 Nov 17, 2013    More misc | permalink to this entry | ]