We so f*cking need National Health Insurance!

Grrf. I’m very grumpy today. In the first nine days of 2008, I’ve spent more time on the phone giving various service providers a hard time, or online changing my services, than in most of the entire previous year!

Take my health insurance. Please. You know that nuisance that used to be called “slamming,” whereby your long distance phone carrier would be changed without you knowing it, or you could be slyly tricked into “approving” a change without realizing you were doing so? Some laws were passed to alleviate this practice, and telemarketing calls by long distance providers were a significant factor in the establishment of the “Do Not Call List.” Well, I feel like I’ve been “slammed” with my health insurance coverage–twice, now!

Since I qualified for health insurance with my previous employer, ten years ago, I’ve been with FCHP. When it comes to medical care, they’re okay. On the administrative side, they can’t find their own behinds with both hands and an illuminated scope. FCHP offers several types of plans, but the basic breakdown is between what they call “Select” and “Direct.” “Select” is more expensive, and as its name implies you have greater leeway to choose your own doctors. “Direct” has fewer doctors and you have to be referred by your primary care physician (PCP). But the premiums are lower for essentially the same benefits. I’m not particular about doctors. I hate ’em all (except my current PCP). :-p I’m so healthy, and so proactive and vigorous about maintaining my health, that I care far more about my budget than the bells and whistles offered by “Select.” But as you can imagine, FCHP likes you to choose “Select” because they make more money that way without actually having to do anything for it.

While I was still with my former employer, we occasionally had to resubmit our health insurance applications, because FCHP had “restructured.” One year, I got an information packet from FCHP–for “Select”. I got out the carbon copy of my application, and sure enough: I’d sent in the one for “Direct:” it said so right on it! I had to mess around getting that changed, and wait for a whole new insurance card and benefits packet.

Now it’s happened again! When I left my former employer in 2006, I kept my health insurance under COBRA (the law that allows you to stay under an employer’s group plan–and rates–for 18 months, paying the full premium). In 2007, two things happened to impact that. First, my former employer merged with another agency, and I had to sign up for COBRA through that company. Second, Massachusetts passed a law making it mandatory for every resident to purchase insurance. The new law meant that health insurance companies had to “restructure” again and offer a much wider variety of plans, and make it much easier for self-employed people and very small businesses to buy insurance. The state also offered some low-income plans. I suppose only a starry-eyed idealist would expect all that to go smoothly! Massachusetts put some serious teeth into this law. If you don’t document that you had health insurance as of December 31, 2007, you lose the personal exemption on your state income tax, which is not a small chunk of change. Next year, the penalty will be about five times as much.

I knew that my COBRA eligibility would run out as of December 31st, so in November I signed up with what I thought was a very similar FCHP plan through the state’s brand new group insurance administration; Commonwealth Choice. I paid them a big fat first premium. I got a letter confirming my enrollment and payment. I got a bill for February’s premium. They seemed pretty clear on the details. But…I didn’t get any information from FCHP. Then I got a bill demanding that I pay for a portion of the ultrasound I had in August. That seemed odd. I thought I wasn’t required to pay for “preventive tests” and this was a screening ordered by my PCP, which I had had twice before, and had never been billed for.

So, I called FCHP. They said that I had enrolled in a “high deductible plan” as of July 1, 2007–IOW, when I switched to that other agency’s COBRA. I don’t remember changing my plan. If I wanted a “high deductible plan” I’d take one that charged a smaller premium (which is the usual trade-off)! Maybe I wasn’t paying attention: the day I signed up with the new agency was the same day I was picking up my dad at the hospital after he had his defibrillator implanted, and was also my 51st birthday (which almost no one remembered). I was a bit preoccupied. Of greater concern to me, however, was that FCHP said they had no information from Commonwealth Choice–this was January 3rd, and my letter from Commonwealth Choice was dated December 14th. So, the rep at FCHP gave me a “case number” and said she’d mark it “urgent” because I have a pending appointment at the end of the month.

On Monday, January 7th, I got a form letter from FCHP saying that my coverage (via COBRA) was terminated on December 31st. So, I called them again. This time they told me that I was listed as “active” (not terminated), with the right PCP–but under a plan called “Select Premium Saver,” IOW, that’s the “high deductible” plan. That is not what I enrolled in via Commonwealth Choice, and I sure am not saving any money on my premiums! But that explains why I suddenly got charged for the ultrasound (which bill I paid). So I discussed this at length with the rep, and she promised to look into it. (The rep I talked to on the 3rd had gotten the information so garbled, I blurted out, “well, that’s completely fucked,” on the phone to Rep 2–who giggled, fortunately.) Supposedly, I had already been mailed a new card and packet–for the Select plan! I’d been “slammed” again!

Yesterday, I woke up to a phone message from FCHP saying I needed to talk to the “subconnector” (IOW, the people through whom I enrolled in the plan) but giving me what turned out to be the wrong phone number. FCHP gave me the main number for the state department that administers Commonwealth Choice. After some confusion, I talked to Commonwealth Choice, and they told me that they had me down in their records for exactly the plan I enrolled in. The mistakes were entirely on FCHP’s side. “Mike” promised to re-submit the information to FCHP.

As of today, I still haven’t gotten a packet for my new enrollment, wrong plan or otherwise. I called FCHP about another issue: I’m trying to get my taxes done ASAP, and I need information for my state income tax. I was not able to get that information–I even spoke to a supervisor, who said they’re “not allowed to give it out”–and the standard tax forms won’t be mailed until the end of the month. I wanted to get my taxes done sooner than that. I got off the phone absolutely furious with FCHP. It’s bad enough that health insurance is so expensive and has so many gaps and loopholes. It’s positively outrageous that even when you’re paying them money, you still get screwed!

It’s certainly been educational, though. When I had health insurance through my employers, all I did was fill out the forms. The premiums were deducted from my paychecks, and the Human Resources person took care of all these details and problems. Now I know exactly what they went through! No wonder they were always so tense!

I also completely changed my phone service–but that’s a whole other story. And I’ve been on the phone tracking down information for my income taxes. *sigh* Being self-employed has some down sides…because the system is rigged against you, for one thing. It’s very easy to start a business in Massachusetts. Running it is a whole different ball game! 🙁