ACA, Affordable Care Act, buyer beware, government, health, health exchanges, health insurance, health insurance assistance, Health policy, Insurance, kentucky, Kentucky Kynect, Kynect, Obamacare, October, Patient Protection and Affordable Care Act, premiums, state insurance exchanges
I want to share my experience with the state run health exchange in Kentucky that is known as Kynect. Lately, it seems Kentucky has turned into the darling of the media to be used as spiteful rhetoric by those who are for the ACA (Affordable Care Act), and want to rub it in the faces of those who aren’t. While I find such things amusing at times, I am a citizen of the state of Kentucky, and I tell you right now, their exchange is very, VERY, tricky and full of loopholes. Frankly, when the auditors come around in a year, there are going to be a lot of angry residents when notices of benefit reductions and possibly fraud warning letters hit their mailboxes.
Now, to start off, I want to make it very clear that I am not against the ACA. I think the idea is a good one, though there are many tweaks and improvements that need to be made. I really wish we were converting to a single payor system, but you have to start somewhere. With that said, I was very excited to get into the insurance market places. Unlike some, I have a very real understanding of how health insurance competitiveness would actually play out. Pretty much, it will be just like the car insurance industry, and the home owner’s insurance field as well. Early prices are attractive, but there is always a bottom line none of them will go below. Ever.
My goal? Pretty reasonable. See if I could get a decent plan for what I would normally pay an employer for a decent plan. A decent plan is a $500 deductible per person, $1000 per family. $10 $20 $30 scale for RX. $25 copay for doc visits, max. Naturally there are no longer the issues of lifetime and yearly limits, so I don’t factor those in. This type of plan would normally cost me between $60 and $70 a week out of my pay check. I realize to some this might seem not the best, but this level of a plan always handled all my issues and didn’t break my bank. So the monthly premium amounted to $260 – 270 a month for me on average. This is a typical family plan in my life. I had to check out the exchanges after my employer made it clear they would not upgrade or change their policies to meet the ACA standards. Basically, they refused to remove the lifetime and yearly caps. On top of that, I was notified I would be laid off prior to the beginning of the new year, so I needed to get a plan.
Shouldn’t be so hard to find something comparable right?
Well, it all depends on how you go about filling out your application. Depends is the key word here. My family structure is a complicated one. I’m living with my ex-husband and our son. Our son has health insurance via his father’s union benefits and we have already decided I don’t need to double down on insurance for him. Additionally, most of the plans on the exchanges do not offer doubling up. On top of all this, I also have another son from a previous relationship who currently lives with his father. I pay support for that son, and when cost effective, am required to purchase health insurance for him, as does his father.
So, I need insurance for me, and insurance for my son who lives outside of my home. With this in mind, I begin my application. First thing they ask you is who is in your household. I assume they mean who do I claim on my taxes, and I just enter my own information and that of my son whom I have to buy insurance for. The next few screens are just general income information and such, then the website asks me if any of us already have insurance. Well, my boy does through his father’s work. So, I enter in all that information.
The next screen throws me into my first loop of confusion. The page I am on now is the “Absent parent” information screen, meaning my son’s father is considered absent according to the state of Kentucky because he is not listed as a member of my household. Forget the absolute marriage bias that is screaming across the screen at me when I see this, but I have to now back track and make my ex-boyfriend part of my household to avoid his getting letters from child support to pay money for a child’s healthcare policy that is living in his home! There are no options to state who has custody on any of these screens. The software just assumes that because the other parent isn’t listed in the household that he is absent. They do not take into account the mandated health insurance policies within the state’s child support framework at all. Brilliant!
So after entering in my ex-boyfriend’s information, guess what? Now his income must be counted towards mine. Even if I choose for him to not be enrolling for insurance. Is there a brick wall around here to bang my head on yet? Realizing there isn’t any logic to this madness of a website, and because unless you are all one big happy family under one roof you cannot just skate through this, I broke down and decided to call in to the customer service line. After pushing “1” for English, I am on hold for roughly six or seven minutes. Now, I am calling in mid October at this time, so the call volumes weren’t overly high yet, and I wasn’t disappointed with a long wait.
Pleasant voice greets me, I tell the representative what my issue is, and she says,”Yeah, that is a glitch we have. There isn’t a fix for it. I will just push your application on through (doesn’t explain what that entails), pick a plan and then disenroll. Then we can start you up a new application, okay?” Naturally, I agree because she knows the in and outs better than I do with this program. She has me go back online to Kynect and sign in, shows me the new application she started (the old one is still listed on the screen), and has me upload my employer information and pay stubs. She asks me if I have insurance through a job or spouse, I explain I am divorced and that my employer notified us that their policy doesn’t meet the ACA standards, and that by the beginning of the year I would be laid off. She tells me it won’t be a problem and will help me find some insurance. Then she advises that I won’t be able to get an accurate plan price for a few days while they verify the information I sent up. I don’t have a problem with that. Sounds reasonable, so I hang up.
Three days later I log back on to the Kynect website. There are two ongoing applications still, but I remember which one is the new one and open it back up. My income verification isn’t complete yet, so I still cannot get an accurate price plan. I decide to check in with the customer service department, and after another short wait, I get another pleasant greeting, I rehash the previous call’s events, and wait for her to tell me what to expect to happen next. She places me on a short hold, and when she returns to the call she sounds confused about what is going on and why I have two applications going. I explain the previous representative had said something about pushing the application on through, enrolling then disenrolling me from a plan, and that is why she was able to start a new one. The new representative falls quiet for a few seconds and asks me to hold again. I waited a good ten minutes before she got back to me on the line. “M’am, it takes up to two weeks for the income verification to be completed. I would recommend you try back then.” I didn’t like hearing this, but it is mid October and I figure another two weeks won’t matter since I couldn’t use the insurance until the first of the new year anyway, so I agree and hang up.
At this point, I want to point out I, personally, have not signed up for any insurance. Nothing. As far as I was concerned, I hadn’t even finished the application so nothing is in stone at this point. Later that day, I have some alerts in my email saying I have messages waiting for me to read at the insurance website.
(Then it gets confusing again)