In What World Is This Okay?

In What World Is This Okay? October 5, 2015

Update: We were put in touch with an insurance broker who will be able to get us coverage for Jan 2016. We will hopefully never have to deal with the incompetent mess at Maryland Health Connection ever again. The broker told us that she has heard many horror stories about the problems at MD Health Connection and a lawyer friend said he heard there may be a class action lawsuit against them at some point. I hope so. The way that people are being treated is really unacceptable. And I say that as a liberal Democrat who really wants to be in favor of the Affordable Care Act! But this situation is not working and I think the blame for that goes on both sides as we seem unable to compromise and work together to do what is best for ordinary Americans. 

I am pregnant and an American citizen in the U.S. and yet despite health insurance being legally required here, I am unable to get any.

This is the third time since that law took effect that my husband and I have been screwed over in a major way by Maryland Health Connection health care exchange. They treat the citizens of Maryland horrifically and I am amazed that there have not been reforms yet. It’s completely unacceptable in this supposedly great nation.

I ask you to spread the word, to spread this post, to talk about this, to make some noise. The only way I see for us to be treated fairly is if these people are shamed into action. 

I will be contacting our congressman to talk about how badly we are being treated.

For our district it is John Sarbanes, phone number (410) 295-1679 and website with more contact info:

I beg you to help me get the word out! This is my only hope at this point.

I have come to the end of what I can do working with Maryland Health Connection. I can see no way for us to get insured and this is a very stressful situation as I have not been able to see a doctor for my pregnancy.

Here is the whole gory story…

We first found out we would need to get private health insurance when Brad accepted a job contract that did not come with insurance and I work for myself. We called Maryland Health Connection and got set up. They told us to watch for a bill at the end of August (I thought it was 2013, but I realize now it must have been 2014). I waited but by the end of August there was no bill. So I called to see what was going on and I was calmly informed that they had sent the bill at the beginning of August and since we didn’t pay it they canceled our coverage.

No warning, no way of knowing. When I said they told us to expect the bill at the end of August they told us that was wrong but not their fault. I told them we never saw a bill and they informed us we should take that up with our post office.

We were pissed, but we waited until the open enrollment period and got on insurance again. We were set up, we paid that very important first bill. Brad set us up for auto-pay. Or so he thought. Apparently it hadn’t gone through. When I started watching our budget more closely I noticed that it didn’t seem to be coming out. So we called to get it straightened out. And we were told that they had cancelled us for non payment.

Again, no warning, no bill, no attempt to contact us. Whoever it was just shrugged and canceled the health insurance that we are legally required to have.

So we’ve dealt with not having insurance for the past year. We’ll pay a penalty for it at tax time but we have no choice.

I saw on their website that pregnancy was listed as both a qualifying event for a special enrollment period and as not a qualifying event. So we called them to find out which it was (Please remember that EVERY time we call we are on hold for at least forty-five minutes to an hour). We were assured that pregnancy would give us a special enrollment period.

When I got pregnant we called again and a special enrollment period was opened. Brad signed up at the website and we noticed that it really didn’t seem like I was attached to the plan at all. It appeared to be just him even though we’re in the system as a family unit. We called yet again (do remember this is another hour of waiting on hold). They tell us it’s totally fine. I’m on there, it’s okay that we don’t see it.

I watch like a hawk for that bill to come in the mail. This past Friday it arrives and….only Brad is on it!

We try calling Care First, the insurance company, but they tell us we can only make changes through Maryland Health Connection. So we call them yet again. This time someone tells my husband that no we don’t get a special enrollment for my pregnancy and the previous two people were wrong and he shouldn’t have insurance at all. They also say that they will not insure us because of the previous non-payment.

Apparently we are never allowed to have health insurance ever again despite the law mandating it. It is horrifying that this is the only game in town. We have no choice but to continue to deal with these people. Not only do they do everything in their power to prevent us from getting insured but we feel extremely disrespected that we have to wait such incredibly long times to speak to anyone. Even calling five minutes after they open will not get you to a person quickly. We have wasted hours and hours and hours just waiting for someone to pick up and tell us we’re screwed. Major reform needs to happen. More people should be hired and also trained a lot better.

This cannot be what the President had in mind when he required all American citizens to have health insurance.

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  • The health care industry is not really an industry. It’s a racket, call it the Health Mob henceforth. See if you can sue them for damages under RICO (Racketeer Influenced and Corrupt Organizations) Act. The worst elements of Western civilization owns and runs the Health Mob. The politicians are not likely to stand up to them because of the lobbying money. You would have to take matters into your own hands. Try to organize 10,000 people and surround these two companies and summarily shut them down. You need the number of protestors to shut down the facilities and have the majority protect the ones moving the workers out and shutting the facilities down from interference from the police. There’s going to be rubber bullets, gassing, and clubs involved. This is the time to do apad dharma, since the time for pad dharma has passed a long time ago.

    You need to stop and think about why these insurance companies are doing this. Do you remember the cry and hue when health care legislation came up for consideration? Now, they thumb their nose at the law by willfully treating you like they did. They’re hoping that you’ll complain to the lawmakers and make them bring the old system back. A warning to the first-line workers who work for companies like this and still don’t make any decisions at the managerial level; you are considered part of the problem, the Health Mob, by hiding yourself from the ethics of working for companies that do this to people like Ambaa and family – remember, “I was just following orders” didn’t save the Nazis, even the soldiers caught committing war crimes.

    I wish you the best of luck on this matter, as it is happening EVERYWHERE.

  • Jeramy Hansen

    This is their Facebook page:

    Light their asses up!

  • J N

    can see many victims such as you in USA these days, and insurance is becoming expensive year on year, and some cant afford it.
    In some states, begging is illegal, sharing veg seeds is illegal, feeding homeless is illegal, owning veg garden is also illegal, no idea where USA is heading to

  • Amar
  • OMK

    You need to get your story straight. The exchanges weren’t implemented until October 2013, so not sure what you were doing in August 2013.

    They would also give you at least 30 days to pay the bill so doesn’t make sense that they sent it out at the beginning of August and cancelled it at the end of August.

    You’ll get special enrollment for your child’s birth, not your pregnancy. That’s a “life event” and you need to report it so they can change your coverage, you go from couple to family plan and get your child enrolled (and your premiums will go up).

    You may want to consider working with a broker who can help you navigate the process. Usually it doesn’t cost more and often they can save you money. If you and your husband are making decent money and do not qualify for subsidies then there is no compelling reason to go through the exchanges.

    • Ambaa

      My story?! I’m sorry that my actual life experience doesn’t sound believable to you.

      I may have some of my dates confused because I wasn’t recording it all thinking that I was going to have to explain this all to people. But the August thing is definitely true. I remember completely clearly being told to watch for a bill at the end of August and when I called in early September (as stated above) they said the bill had been sent in early August and I should have known that. The fact that I never got a bill at all didn’t matter to them.

      I have now found a broker. I didn’t even know that was an option. That’s how poor the communication about health insurance is. I was not aware that I had ANY option other than this shitty exchange.

      The broker told me she has heard many, many, many horror stories about the Maryland Health Connection and how badly they do their job.

      I tell this story to share what the experience of one normal family in Maryland has had to deal with being unable to get insured. It’s not a political thing, there’s no agenda, there’s no spin. This is simply and purely my personal experience and it sucks.

      • OMK

        So are you off on the year? Based on what you are saying in other comments, sounds like you are currently pregnant, so did this situation occur this year?

        Also, how can you say that it’s not political, no agenda, no spin? You’re asking people to write to politicians. Of course it’s political, and of course you have an agenda.

        But anyway, sounds like it’s all resolved now, so that’s the important part.

        • Her agenda is to get health care for her and her baby. If a mother and child getting health care is offensive or suspicious to you, then you need to examine your life priorities. Next time, try educating without being a jerk (if that’s possible for you)

        • Ambaa

          It sucks that I’ve had to tell this story because I’m a Democrat and extremely liberal. So I did not want to have to say that the health insurance system is not working. But it’s not. It’s failing people who want to believe in it.

  • Maya Resnikoff

    Pregnancy does have some impact when signing up for health insurance- certainly if you make little enough to get government-subsidized insurance, it is relevant (also, when you check income caps, your family will already count as 3 people, not 2, as it was explained to me, when we were getting insurance while I was pregnant).

    I never got to wish you well on your pregnancy earlier (holiday craziness here- we’ve just finished the most intense period of holidays of the year), but I’ve been thinking good thoughts for you!

    Also, as a reassurance- I didn’t see a doctor until 9 or 10 weeks in to my pregnancy, and it was totally fine, and within the regular range for first appointments. That’s apparently also a normal point in some European countries, although that part is hearsay. Unless you’re puking miserably, or have other reasons to need to see a doctor early (which you may, given things you’ve written about before, I don’t know, and don’t want to presume), you’re likely not in a bad place…

    Planned Parenthood will work with your income, etc, in providing prenatal care, even without insurance. Is there one near you? That or a hospital clinic could maybe get you started with affordable care while your insurance situation is still being straightened out, I think.

    • Ambaa

      Thank you!

      I have an appointment for week 11, I think. So yeah, that’s pretty normal from what I understand. Not much for them to help with at this point!

      I’m very attached to the idea of going to this birth center but if I have to the planned parenthood is a possibility. Thank goodness they still exist!

      • Amar

        I support planned parenthood, that’s the last resort for women.

        • Ambaa

          They provide a lot of good and important care. I would be much worse off in life if they didn’t exist. I’m sad that people associate them only with abortions.

          • Amar

            de-funding Planned Parenthood which is GoP’s dream isn’t a smart idea, a women has every right to take care of her body, physically, mentally. with abortion women too isn’t happy, she too suffers, but “making her deliver” a baby shows feudal mindset.

          • Ambaa

            Exactly. I think it’s so important to trust that women know how to make decisions about themselves and their bodies. We don’t need to be protected from ourselves, you know?

          • Amar

            the ironic part is she is made to deliver a baby just because “Bible says so”.
            these are just my views, I do not mean in any manner either to offend either Christians, or undermine their faith.
            if I did I in advance am apologizing, but the fact or views will remain so.

  • disqus_oEjlWEXJRS

    In what world is it okay to simply make-up a lie and post it on a blog calling for people to ‘make noise’? It is very clear your story is made-up and embellished because it is entirely inaccurate about the actual functions of the Maryland Health Exchange (MHE). I suppose it is entirely possible you simply are not literate enough to understand the origins of your correspondence. Let me point out just a
    few of your inaccuracies. First the MHE didn’t launch until October 1, 2013 so in August 2013 whatever insurance mess you found yourself in because you failed to pay your premiums didn’t have anything to do with the exchange. Incidentally
    not paying your bills and having coverage canceled isn’t an advent of the
    exchange – people who don’t pay their bills are deadbeats and providers stop
    providing services whether it is insurance or your cable. Second the MHE doesn’t bill you. They enroll you and send that information to the insurance carrier you picked. The insurance carrier then bills you and you pay them. The MHE doesn’t make the decision to cancel you for non-payment. That is requested
    by the insurance carrier you stiffed. Third it is 100% impossible that the MHE
    had you sign up for auto-pay. Let me say it again the MHE doesn’t bill or collect your payments – that is the insurance carrier. Fourth, special enrollment
    periods are available for qualifying events such as the birth of a child. Fifth, except during peak periods during open enrollment the wait time at the call center is generally under 10 minutes. Sixth, if you were actually incorrectly denied coverage you do have the right to appeal and have coverage reinstated. Seventh, the exchange is not the only game in town. You can directly enroll with an insurance carrier but I suspect you wanted a government subsidy. If you don’t like the exchange you don’t have to use them – you only need to have insurance.
    Eighth, you could have always gotten help through a Navigator or
    Broker. Ninth there is no such thing as banning you from an exchange for life even though you are a chronic non-payer. So as you see your ‘story’ is riddled with blatant factual errors and your ‘call to make noise’ and shame those evil bureaucrats is a ludicrous as your story. Bottom line you are responsible for yourself and for paying your bills. You have many options including low-cost,
    quality plans through the exchange and many avenues to get help, however, in
    all scenarios you do actually have to pay your premium.

    • It is possible to educate people without being awful about it.

      You are a bad person. Shame on you.

      I hope that one day you learn empathy and/or compassion for those going through difficult times; until then, you are no different from the men wielding guns on children in this country and only a step away from doing it yourself.

    • Ambaa

      I think part of the point of this post is that ordinary every day people have a very hard time understanding this system and it is hurting us.

      There is nothing made up here. No lies. I may have some dates confused because I wasn’t writing everything down as it happened thinking I would have to get some attention to get help having insurance in a country where it’s required by law.

      I’m a loyal Democrat and fiercely liberal so I didn’t really want to have to say the health insurance system is not working.

      But it’s not.

      It’s a mess and this is our real and actual experience as regular American citizens to the best of my recollection and understanding. Our wait times have consistently been at least forty-five minutes every time. We timed them. That we wrote down. We were told twice by people at MD Health Connection that pregnancy was a qualifying event, though apparently only birth of a child is. There website also said that pregnancy was.

      I’m not saying that we did nothing wrong. We should have followed through about the billing much more quickly. The first time there was no bill from anyone, not from insurance, not from the exchange, not from anywhere. The exchange were the ones who gave us incorrect information about when we should actually see that bill and that was a part of what led to us not knowing we were late. The second time was our fault but it’s hard to imagine that an honest mistake like that should lead to us not being allowed to have coverage.

    • andrew123456789

      “Deadbeats” is a derogatory term with zero empathy regarding
      poverty or even the harrowing task to keep one’s finances on keel in
      this crappy economic climate.