I am at my wits end with the healthcare exchange and I feel like my story needs to be told.
I have a family of 4. I work as a staff accountant at a local CPA firm and my wife is a stay-at-home Mom who substitute teaches 1 or 2 days a week.
Since I work for a small firm, I have had to have an individual health insurance policy for my family. We were paying more than we wanted to be paying (isn't that true for everyone?) but we were getting by.
So the affordable care act became law and, with our income level our insurance policy (at least one SIMILAR to the policy we had previously) went from $650 a month to $1,100 a month. So we signed up (well, tried to sign up) through the healthcare exchange.
I say tried to sign up because we tried for over a month to sign up before we actually were able to complete the process. When we finally did complete the process, we were told that my wife and I could sign up for a plan through the exchange (and we would get a subsidy also....yippee.)
However our children "may qualify for Medicaid," we were told.
I was fairly certain that wasn't true. It didn't make sense to me. I make an "ok" living for a family of four and as I mentioned, we were getting by with a health insurance policy until the rules changed and our policy price doubled. But I digress.
We dutifully did all that was required by Medicaid in Nebraska to get our kids "signed up" or to determine their eligibility. We "fast tracked" everything because by now, it was January and my kids were no longer covered by any health insurance policy.
So we finally received our denial letter on Jan. 17 from Medicaid. Since that time, we have tried everything short of writing a letter to Santa Claus to get someone to look at our health insurance policy and "fix" our account so that we can add our kids.
We even managed to get a 3-way call with a Medicaid case worker and someone at the health insurance exchange. The Medicaid worker confirmed that our kids did not qualify for Medicaid due to my income. So, we proceeded to go through the whole application process again with an agent at the healthcare exchange.
Can you guess what she said after she submitted our "new" application? "Your children might qualify for Medicaid."
But they don't we replied, you just had someone from Medicaid confirm that they don't. The result of that phone call was that our case has been placed in an "escalation" queue and someone will contact us within 30 days.
In the meantime, my kids have no insurance at all. I have been told that if this all works out, their coverage would be retro-active to the time our new policy started, Jan. 1. But I have no choice but to sit and wait and hope that someone calls me back.
I had a health insurance policy before the affordable care act (which promised that things would be better). Now I have no insurance for my kids and a hope that someone will actually use a bit of common sense and see that my kids do not qualify for Medicaid so that I can add them to my individual policy.
Sorry for the small novel, but no one will help and no one will listen. Maybe if enough people share their experiences, something might change.
By Scott Odle Jr., North Platte