Plan B Forum

I learned, to my regret, that having joined an insurance programme thru .gov (thank you very much) there are certain wrinkles which may or may not be to my disadvantage.

If you need to make an address change (and, I suspect, almost any other) it means submitting a new application and choosing the plan all over again. So having "moved" from Twinsburg OH (ahem) to Kent OH one must re-apply. Fortunately the forms are repopulated from the first application - and one can change bits. At the end you can "stay with your current package, if offered" or choose another one. Since our premium went down (Portage county cheaper than Summit?), we chose another - same provider; less deductible and o/o/p, starts 7/1

What's nerve-wracking is that one doesn't know for 7-10 days (ahem) if the "change" (even if you kept the exact same policy) has actually been accepted and linked to the provider's system.

Today I called my provider (which for the sake of privacy may only be referred to as KP) to find out where my invoice is for June on my current policy. "Oh the invoices haven't been issued. Everyone's in an uproar. You should send us a check because without an invoice you can't pay on-line or by phone" Why no invoice? "Oh it's the dot-gov system - not KP" Really?

We made our first doctor visit last week - after telling dotgov on the phone of our new address ("you must re-apply") - and learned we have a "Silver Sneakers" membership to any fitness center in the area (Kent State here we come). My wife went to find out details and was told that we couldn't actually use the fitness center because our insurance could not be verified (via dotgov) - and that's because we told them our new address. All went into suspended animation I guess.

Maybe we're OK - maybe we have insurance and all is well. Maybe we don't (or won't). I need medication for stress

As a cost and quality-of-care control measure KP requires that you live in one of their service areas so that clinic and emergency care are at one of their facilities. If someone moves they have to check to be sure if you're in the area.

yrs,
rubato

Welcome back to the States - when did you leave South Africa?

MajGenl.Meade wrote:Why no invoice? "Oh it's the dot-gov system - not KP" Really?

Back in the '60s, '70s, and '80s--before computers became ubiquitous--almost every bureaucratic snafu was routinely blamed on the "new computer system". I suspect that healthcare dot gov has become the scapegoat du jour for anything connected to healthcare or health insurance.

Hello again, (naturally)

We left SA on April 30 and arrived in the USA on May 2 (just about) thanks to an unscripted layover of 12 hours in Philadelphia airport.

While that's correct about KP service areas, no-one at KP can change or even acknowledge (other than verbally) that our address has changed. Only HC.gov can do that - and it's not just service but also premium. Obviously if one moves from Fubar, OH to NY city there's going to be a change in cost.

No-one at KP can issue a premium invoice to any of their happy new customers (several billion according to rubato ). They say it is so (and of all things why lie about that?) until HC.gov gets the transfer of information completed - not just on changes but on the very first effective May 1 policy. Oddly enough, insurance companies are not in the habit of being slow about collecting money from their clients.

So far my experience of HC.gov is very mixed. I found the application process and offerings of HC choices to be very smooth and efficient. It was a bit harder to get HC.gov to actually let KP know I was a member and pay the first month's premium in advance (for which no invoice was issued of course). Re-applying was relatively painless because the system automatically completes all the sections, copying the first application but permitting the necessary changes to be made. However, the system crashed about seven times during this process and, if you haven't reached the end of a section, when you get back on it reverts to the beginning again.

I did like it that the re-app showed that my monthly premium went down from $198 to $2.22 or something like that.

Speaking to HC.gov phone support personnel was interesting. They seem eager to help and accurate once you get used to the accents. Overall, the programme offers a lot but delivery is a little bit hiccupy and I'm in fear of not having HCI come July 1.... I check with KP every couple of days and they still have no idea that a new policy has been initiated and (once again) I can't pay the initial premium).

Welcome to the US of A - the land of the free healthcare

MajGenl.Meade wrote:"...

I did like it that the re-app showed that my monthly premium went down from $198 to $2.22 or something like that.

Speaking to HC.gov phone support personnel was interesting. They seem eager to help and accurate once you get used to the accents. Overall, the programme offers a lot but delivery is a little bit hiccupy and I'm in fear of not having HCI come July 1.... I check with KP every couple of days and they still have no idea that a new policy has been initiated and (once again) I can't pay the initial premium).

Welcome to the US of A - the land of the free healthcare

$200/ mo is amazingly cheap. But if you don't like .gov just apply directly to KP.

btw Kaiser has about 9 million members. The UK National Health has copied a lot of KP practices to improve delivery of care and cost control.

"KP HealthConnect

In 2002, Kaiser Permanente abandoned its attempt to build its own clinical information system with IBM, writing-off some $452 million in software assets. This information technology failure led to major changes in the organization's approach to digital records. Under George Halvorson's direction, Kaiser looked closely at two medical software vendors, Cerner and Epic Systems, ultimately selecting Epic as the primary vendor for a new system, branded KP HealthConnect. Although Kaiser's approach shifted to "buy, not build," the project was unprecedented for a civilian system in size and scope. Deployed across all eight regions over six years and at a cost of more than $6 billion,[40] by 2010, it was the largest civilian electronic medical record system, serving more than 8.6 million Kaiser Permanente members, implemented at a cost exceeding a half million dollars per physician.[41]"

My wife was a leader in implementation of this system in Calif. since it was developed in Ore-Wash where she was practicing before. Large complicated software systems are difficult to design. Kaiser took 6 years implementing it AFTER it was written and had been live-tested in Oregon.




yrs,
rubato

It seems odd rubato that out of what I wrote you manage to parse "if you don't like .gov". But then again, it's not so odd I suppose. As to KP direct, that would be about $900+ per month so for such savings I will put up with the hiccups.

MajGenl.Meade wrote:It seems odd rubato that out of what I wrote you manage to parse "if you don't like .gov". But then again, it's not so odd I suppose. As to KP direct, that would be about $900+ per month so for such savings I will put up with the hiccups.

I used ".gov" as shorthand for the aca signup system which is what you were complaining about. I think that is fairly clear.

So you're complaining about getting a $700/ mo subsidy? I see.


yrs,
rubato

Reading comprehension much?

Meade - it's prob'ly too late but... I'd imagine that if you printed out the screen on your computer where it showed you your premium and sent it to KP with the check, that would be something that would suffice in lieu of a premium notice? (Just a thought.)(Not necessarily a good one.)

Econoline wrote: Reading comprehension much?

It is noteworthy, ain't it? And not just once but twice.... still, what can one expect.... t'isnt odd at all really. Yes, KP also suggested mailing a check with a note to explain what it was. Unfortunately you only get to see your premium after you process the app and then it goes away. You have to resubmit the app, right from the start, in order to get back to a screen that shows (actually) the entire selection of plans you can choose. After that, yr toast.

In case rubato still has trouble reading English, I will say again that I'm pleased with the "subsidy" which in actual fact is the application of anticipated tax credits that I would otherwise be pocketing at the end of the tax year.

MajGenl.Meade wrote:...I will say again that I'm pleased with the "subsidy" which in actual fact is the application of anticipated tax credits that I would otherwise be pocketing at the end of the tax year.

Quit complaining, Meade. Just don't get sick, wait patiently and sign up for Medicare when you're 64.75 yrs old.

Some people don't seem to be happy unless they have something to complain about...

Joe Guy wrote: Quit complaining, Meade. Just don't get sick, wait patiently and sign up for Medicare when you're 64.75 yrs old.

To late for that, he's already 199 years old!!

Then ..... I qualify already???? Damn!