by Marlene Berlin
I decided to join the Obamacare ranks after my husband, our household’s health insurance provider, went on Medicare last year. I was actually looking forward to it. I was ready to roll up my sleeves and dive into the vagaries of the system.
It turned out to be a long, trying experience, but the barriers were not where I thought I might find them.
My previous insurance coverage was set to expire on December first, so about two months prior to that, I visited the DC health exchange’s web site, DCHealthLink.com, to sign up. I decided to go with the Kaiser Permanente plan.
I had some questions during the enrollment process, so I phoned DC Health Link. Though I always had to wait on hold for 10 to 15 minutes, I found the representatives provided great customer service. If the rep did not know the information, she would take my number in case we got disconnected while she was tracking it down.
I spoke to about a half a dozen DC Health Link reps throughout this process. They were always courteous, well trained, they took great notes on my queries, and got me the information I needed. When I completed the online sign-up process, I called to make sure they got my online application. They assured me they did.
They told me they would have to review my information, and I would be sent an email about the status of my application. About a week later, I got it. The email sent me to my Health Link account, where a message acknowledged my application was complete and they were processing it. On October 27th, I received a letter that said my application had been accepted for the Kaiser and the Delta Dental plans and to expect invoices in the mail. Once I made my first payment my health insurance would be activated. In early November, I got an invoice from Delta Dental. I sent my money in. So far the process had been painless, and I assumed the invoice from Kaiser would soon follow.
In the middle of the night on November 30th, I sat bolt upright in bed with the realization that Kaiser still had not invoiced me. Within a few hours, I would not be covered by health insurance. My daughter was defending her dissertation the next day in Baltimore, and I had limited time to work on this. My anxiety settled down enough to fall back to sleep when I realized all I had to do was call Kaiser the next morning, explain the problem, and pay for the health insurance. Or so I thought.
I called Kaiser first thing in the morning only to be told they had not received my information from DC Health Link. I thought this a bit curious because the dental plan had it. So I called DC Health Link. They said they would send my information to Kaiser, and that I should check back with the insurer in three to five business days. Now I was really anxious. We were driving up to Baltimore. What if something happened?
[quote_right]I was feeling very exposed, not having my insurance in place.[/quote_right]The very next day, I was to fly to North Carolina with my other daughter. I talked myself out of feeling my life was totally out of my control, and into enjoying the trip. I would deal with this when I returned on Friday, December fifth. Luckily I succeeded in compartmentalizing, and I got through the trip without any mishaps.
I called that Friday, waiting what was to become the usual 20 minutes on hold, to find out that Kaiser now had my information. I was told I could pay online or by phone.
“Great!” I thought. “I will give them my credit card number or bank routing number and be done.”
I went online to pay, but the system could not find my membership number. I called again and was told to pay by phone. Again, when I pounded out my number, the automated payment system could not locate it. So I called again. I was told I would have to send my check to Pasadena, California and was given the address.
At that point ready to tear out my hair, I asked to speak to a supervisor. I was of course put on hold again, but not for very long, and a supervisor got on the line. I told him I was feeling very exposed, not having my insurance in place. He said they could send me a letter that I could present in case I needed service. I would get it the following week. In the meantime, I sent my check to Pasadena, California.
The following day I got the formal invoice from Kaiser, so I knew Kaiser had processed my information enough to bill me. The check was cashed on the 23rd of December. I called on the 26th to make sure my account was activated. After again waiting the obligatory 20 minutes, I was told that my account had not yet been activated. Not only that, but they had not received my information from DC Health Link.
I told her I did not understand this because I had been invoiced and my check had been cashed. She put me on hold to check this out, and somehow knocked me back to the main menu recording in the process.
I was back to square one. I punched in the same numbers yet again, and waited 20 minutes, only to be disconnected. I tried another time, waited another 20 minutes, and got shunted back to DC Health Link. The DC rep wanted very much to help me and took my number in case we got disconnected, but we both understood this was between Kaiser and me. She was able to provide a number for Kaiser’s billing department. I called, waited another 20 minutes, and got disconnected.
[quote_right]Was mine a special case? Or was Kaiser’s enrollment system broken?[/quote_right]I sat back to ponder my situation. What could I do to move this system? I thought of calling a neighbor who heads a trade association of health plans, but decided against this for the time being. Then, I had an idea: I would email the president of Kaiser and tell him of my problem. With a little digging online, I found his email address and described my frustration of now going almost a full month without health insurance despite multiple attempts to sign up. (I also mentioned that I would be writing about this here.) I got a return email by the end of the day saying someone would be getting in touch with me to follow up. That was Friday, December 26th.
Then I read over my hard copy communications to see if I could find a direct phone number for anyone at Kaiser. I hit paydirt – the number for Cathleen Moreno, a communications specialist whose name was on the letter I’d been told to carry with me in case of a medical emergency. I called her and left a message.
The following Monday I got a call from Ms. Moreno, who told me Kaiser has a “Believe Me Policy” under which they could activate a temporary account for 90 days. The secret passwords for this to happen were, “I need care.” I asked what would have happened if I’d had an emergency this month. We both agreed that it was better to be enrolled before there was an emergency. She enrolled me under the “Believe me Policy.” I also left her with a list of questions to which she promised to find out the answers. On the list: Why wasn’t my account activated after my check was cashed?
After I hung up with Cathleen, I got a call from Bonnie Humphries, an appeals and correspondence supervisor who informed me that my account had been activated as a regular enrollee. I thanked her and also peppered her with my list of questions. She assured me that the company would be investigating my experience and they’d get back to me with a report. I followed up with an email to both Ms. Moreno and Humphries with my questions. Later, I got a letter in the mail from Ms. Humphries, again promising a report would be coming.
Both Cathleen Moreno and Bonnie Humphries were professional and courteous, and they gave me what I needed in the end. But I hope to learn soon why the process so difficult. Was mine a special case? Or was Kaiser’s enrollment system broken?
What is your experiences with DC Health Link and your health insurance plans? I’d like to hear your stories.