Sign Up Procedures for Obamacare Contrdictory and Baffling for Some

Updated 4 years ago Special to HuntingtonNews.Net

Have you heard concerns and praises about the Affordable Care Act? Whether the health care bill's objective will enter the red zone stays undetermined.

Several interviewed by HNN experienced procedural dysfunction, especially when details were requested.

Since insurance information is  private,  interview subjects will not be named.

One individual warned, "now is not the time to change health insurance . Keep what you have."

However, in the mandate of the Affordable Care Act, some companies have and/or will discontinue service. How are those policy holders faring?

Despite the "options" hype, generalities are prone to the statements of by non-well informed  used car salesperson, one  potential purchaser said.

"We have 18 options in all premium categories," a representative said on the phone. When asked to provide specifics, the representative read an explanation of "preferred provider network." The line went dead. That scenario was repeated in other instances from "hold drops" awaiting a licensed agent or a licensed agent to provide plans available. A call back routed to the same receptionist found that the individuals name and caller ID were remembered.

"The same woman asked me my height and weight three times in five minutes," one insurance inquirer said. That led to an endless hold, a reschedule for a licensed agent to call, and after more phone calls a sweeping barrage of questions.

One agent said, "You do not have to state a pre-existing condition," yet two questions later asked what it was. "What prescriptions do you take?" was often requested.  "What's the dosage per day?" Inexplicably , the validation operator disclaimers screen for a litany of  pre-existing out patient diagnosis. However, the representative specifically asked about diagnosis degree. "What happens if the condition worsens," a would be transferee inquired?

In another instance, an  agent guaranteed keeping the interviewee's current physician. The price was  33% less, but it restricts visits to near the current status quo.  The co-pays and outpatient visits are geared for a "relatively healthy individual," the representative said. However  hospitalization benefits were  like handicapping a horse race. Plans and premiums climb as the amount per day in the hospital increases. No advice was provided concerning what an average stay might cost.

"You can have two tests a day," the agent stressed.  Unless its an emergency , one can generally push the third test to a second day. If it is an emergency, well, you pay in full.  No specification if the patient is unconscious.

Aside from the call backs that were erratic  for specifics (how much coverage, which doctors, does the applicant qualify for the subsidy), the terms of "validation" had contradictions. Some specifically rule out dangerous sports --- like sky diving and rodeo --- but also ask if you have been to a physician in 30 days and, if so, what was the diagnosis.

All of this seems muddled, since the agent (not legal tape recorded interviewer) told one prospect, "If you had insurance, for which the lapse has been less than 90 days," well, all conditions covered on it and/or treated with it are not deemed pre existing exclusions.

An agent told one applicant that due to law changes related to pregnancy coverage --- men are now not required to be covered. However, the agent indicated that originally not covering "pregnancy" (even of males?) would mean the insurance did not receive freedom from the  penalty mandate. The agent said, "say yes," to the question,  legally there's no penalty.

Logging on to one or more insurance provider websites allowed glimpses of the premiums, but what is a "co-share" or a "savings" and a to be determined premium of $0 to $605 is a wide range of ambiguity.

One individual who has had stellar insurance said, "Now I feel a bit what it's like to be uninsured. I don't know what happens if I get sicker than a mild or moderate illness."

The tax subsidy causes confusion too. Calculations of "household income" swing to "individual income," which complicates  one member of a family dependent on the other for coverage.  An  online qualifier for some income levels indicates possible  Medicaid qualification. Expanded Medicaid is not described.

Anyone think of deadlines? One website asks for the first months premium before seeing the policy, although there's a 30 day money back guarantee for all costs. You can also increase coverage if you like it. "It's month to month," the agent said.

To find out "if you like it," the policy arrives in the mail in 14 days after the premium has been removed from your checking account or charged to your credit card, one insurance purchaser said.

Since that insurance purchaser contemplated possible "fraud," HNN researched the company and its individualized insurance which is sold in all states. That one is an established provider, but separates a portion of the health premium into one  for "accidental death."

Although this represents a tiny sample,  the enrollment extension appears justified.

Another horror awaits --- beyond the much publicized "faith" objections ---- what happens when/if the health care provider disagrees with the agent and verification? 

Will those enrolling find themselves suffering from health care anxiety syndrome or chronic health care fatigue frustration?

Editor's Note: Some applicants whose data fits some apparently established parameters may have less  issues investigating coverage. Late nights are often good.

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