The American Health Care System Has Issues

The American Health Care System Has Issues October 1, 2014

If you’re outside America you’ve probably heard that our health care system sucks. Since I’ve told you about how we’re encountering fertility issues in trying to expand our family, I thought you might be interested in hearing the saga of how the American health care system is fighting against us.

This is one personal and true story. There are many other stories of people getting screwed over by the American health care system and it could be so much worse. Take, for example, my friends who are exhausting all their financial resources trying to keep their daughter alive.

In my last post on infertility I mentioned PCOS as a possible diagnosis. The update is that I have been diagnosed with both PCOS and an underactive thyroid. The thyroid problem is what has caused me to gain a lot of weight in the last couple of years very rapidly. It also contributes to depression and exhaustion which I’ve also been experiencing. If I get the thyroid corrected the symptoms of PCOS become manageable. I need to get on medication to correct the functioning of my thyroid, but the doctors are quite booked up.

I’ve been waiting since June for an appointment to see an endocrinologist who can help with this and finally my appointment is coming up.

However I’ve also spent the last four months trying to secure health insurance and despite strenuous efforts, I’m not insured yet.

I want to tell you the story of the Maryland Health Exchange (Connection) and Care First. I don’t know which is more to blame for the mess that we are in (particularly since they are fond of blaming each other).

It’s hard feeling like our little voices don’t matter. They can continue to say that they are doing great work while squashing the common people they are supposed to be helping.

So let me tell you the whole story…

Ha Ha, just kidding!
Ha Ha, just kidding! No Coverage for You!

There is a fairly new law in America that says that every citizen must have health insurance. I believe that the Maryland Health Exchange was set up to help process everyone for that initiative. No longer can people be denied health insurance because of pre-existing conditions which is great.

There’s an “open enrollment” period in November for anyone who doesn’t have health insurance through work or other means to get on it. You can also get on it during life changing events such as marriage, children, and change of jobs.

We qualified for new health insurance when I left my job in June of this year.

I called Maryland Health Connection and they told me that I should turn down the Cobra extension that was offered on my work insurance. They then put in an application to Blue Cross/Blue Shield’s Care First and told us to expect to get our insurance card and first bill in the mail in mid to late August but that I would be covered as of August 1st. In plenty of time for my October doctor’s appointment.

Sounded perfect.

I waited for the bill to arrive. And waited and waited and waited. Mid August came and went. Late August came and went. When I hadn’t gotten a bill by September, I called Care First to find out what was going on.

They said that I hadn’t paid my bill in time and so the policy had been cancelled.

I explained that I never got a bill and they said I should have checked on it. I said that I was doing that now and they said I was too late. I said I was told late August and they said they sent the bill at the end of July so I was way, way, way too late to pay it. No matter how much I tried to explain that we were told not to even expect a bill until the end of August, they were insistent that this was all my fault and the whole thing had been canceled. It shocked me that no one would even try to get in touch with me about it. Did they just assume that I no longer wanted health care? I have money set aside ready to pay them!

I called Maryland Health Exchange to try to get it sorted out but the only thing they could do was send another application. This means that I am not covered for August and there’s no telling if I’ll be covered by October.

Every day since then we have called both Care First and Maryland Health Exchange so that we can make that critical first payment immediately.

Each one continues to blame the other for the issues we’re having. A week later still no new application had gotten to Care First. One person said it could be expedited and we asked to do that (at that point we’d be lucky to get coverage for October). Two weeks after that, still no sign of the application at CareFirst.

A call to Maryland Health Connection has someone telling us that we’re now too late to get enrolled at all. Care First says this is untrue and says, “You’re in Maryland, aren’t you? Don’t listen to them, they don’t know what they’re talking about.”

Lucky us, we’re apparently in the State with the worst service on this new health care initiative.

My husband has now called both Care First and Maryland Health Connection 18 times over three months and we somehow STILL don’t have health coverage.

This last time the Maryland Health Exchange said that they sent the application and Care First says they haven’t got it. So apparently it disappeared into the ether and my eligibility period is over.

It is the law that we be covered, but the Maryland Health Exchange is making it physically impossible for us to get covered.

Guess whose fault it will be if one of us gets sick? Not theirs! We’ll get in trouble for not following the law and having insurance.

I want to like the new health care system. I am a democrat and I believe in Obama. But as much as I want to like it, I hate the current health plan. I’m required to have it and to pay for it and I’m willing to pay for it, I’m trying to pay someone, and yet I still can’t get insured.

At this point I have no idea how we’re going to get health care. Neither Care First nor Maryland Health Connection seem to have an application for us. Between them they’ve managed to lose it, it seems.

Americans are supposed to be covered, so Maryland Health Connection…where is my coverage?!

(To be fair, when I complained about this on Twitter, the people who run the Maryland Health Connection twitter account said they would help. We’ll know in the next day or two if they actually can)

UPDATE: the people from Twitter were actually able to help and it looks like we are now covered. Apparently complaining on social media is the best way to get someone to listen!

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  • I’m really sorry to hear bad news like that, and I hope you will find a way to solve the situation.
    It has always been puzzling to me that the U.S., the supposed to be “leader” of the so-called First World, lack such a basic structure, a working Health System.

    • Ambaa

      Yes. And how dare we question whether we are in fact perfect and number one at everything. That would be lack of patriotism. 🙁

  • This is so ridiculous! They need to get this straightened out for you. What absurdity.

    (Side note: It upsets me when so many people have to hold fundraisers to pay for their medical care. Really? We have to hold basically popularity contests and hope we have enough friends to pay help us pay for cancer?!)

    • Ambaa



    There are time I’m glad I’m not living in USA. We Brit complain a lot about our NHS ( National Health Service ) and it’s budget cut, but one thing I can still say that we are still lucky, when it comes to your scenario. When there is something seriously wrong with you in UK then they will do their best to address your concern straight away, and when I say that, I mean within a week or so, and people still complain and say it’s not fast enough. I hope and prey you can sort your problems soon. BTW is there no way you can apply on line where there is no parers but rather electronic application and then they can never say that they didn’t get the application. I wish you all the best.

    • Ambaa

      Thank you!

  • Meenakshi

    I really hope this is straightened out for you soon. As a military veteran, these are the exact scenarios that comprise our Veterans Affairs health care, as well. For example, having to wait 8 months to be put on the waiting list to make an appointment for a basic female wellness visit, only to be told you’re not “in the system yet” to be allowed to attend said appointment made for you by the administration…(sigh)

    • Ambaa

      So true! Everyone seems to have a story, too. But it sounds like complaining on Twitter worked and I think we’ve got it now!

  • Madhu K Agnihotri

    avoid salt visit some yoga ashrams near by too something like this and be peace in mind and surely doctors will show up in some time be connected to nature all izz well and will surely will pray to maa

  • Madhu K Agnihotri

    pls do try some home remedies from auyrveda consciously why not just try pursue medical just give it try i think Baba Ramdev is best at it just contact him or go to you-tube videos and also just try videos on “ayurvedic home remedies” on you tube she is also best i too follow try those are simple…

    • Madhu K Agnihotri

      pls try and see whats big deal just give it a try

  • I am so sorry you are going through this. What an ordeal. Prayers are with you. Hugs