Kevin Knauss: Health, History, Travel, Insurance
Some individuals and families who enrolled through Covered California have received a letter notifying them they are at risk of losing financial assistance in 2016. The letters being sent out include three reasons why a household might lose the premium assistance to lower their monthly health insurance bill. They are also frightening consumers who actually compiled with all the conditions they list in the letter.
American Indians and Native Alaskans have access to special $0 cost share health plans that are available through Covered California. A recent enrollment by a member of a federally recognized Indian tribe was offered four different Anthem Blue Cross PPO $0 cost share plan where each one had a different premium rate. This is odd since regardless of the metal tier level of the $0 cost share American Indian-Native Alaskan (AI-NA) health plan, they all have the same exact benefits: zero dollar cost share for all services.
Anthem Blue Cross, following internal policies to protect agents, prevents their members from selecting their preferred health insurance agent through Covered California. The Blue Cross policy of not recognizing an agent delegation made by a household in their Covered California account prevents the selected agent from properly representing the family members and being compensated for his or her time. The Blue Cross agent of record policy occurs when the Covered California member originally enrolled with another agent or without an agent and the member is considered a house account.
Covered California has sent Certified Insurance Agents information and links on sensitivity and sales training for the Lesbian, Gay, Bi-Sexual and Transgender community. The sensitivity training presentation and social media icons were developed by Out2Enroll a national organization encouraging the enrollment of the LGBT community into Marketplace health insurance. While the overall information is good, there is underlying sales element that reduces the community down to dollar signs instead of human beings.
On a weekly basis I get calls from people telling me they can’t find doctors who will accept Covered California health plans. The prospective patient is told that the doctor will only accept off-exchange health plans and not Covered California health plans. This is after the health insurance company shows the physician as in-network. Are doctors really discriminating against Covered California consumers or do we just have a failure to communicate?
Both the health plans and the doctors practice subtle and overt forms of discrimination against people with Covered California health insurance. Some of the discrimination is legally built into the health plans. Other discrimination takes place in the form of denying health care services because the prospective patient has a Covered California health plan.
Consumers, agents and Covered California representatives have been flummoxed over how to change the household health insurance plan after the account has been automatically renewed by Covered California for 2016. It may have come as surprise to Covered California that not everyone wants to renew their current 2015 health plan. After Covered California automatically renewed the health plan there is no visible way to change the plan…unless you know the trick.
In the last week as I’ve been bombarded with feel-good press releases from Covered California about their grand and glorious bus tour across the state promoting themselves and open enrollment, I’ve also been working with several cancer patients trying to find a health plan. From a person who is in the trenches working to enroll consumers in the best fit health insurance, the Covered California road show displays how their bus has taken a wrong turn down Marketing Lane. Californian’s need help finding health plans that include their doctors, hospitals, and cancer drugs. They could care less about a bunch of people riding around on a bus promoting their selves.
Covered California is cancelling the Advance Premium Tax Credit subsidy that lowers a household’s monthly health insurance premium for 2016 for some consumers. Through Covered California’s automatic renewal process I’ve seen several families’ tax credits disappear for 2016. Without intervention or explanation, many families who had their health insurance automatically renewed may receive a bill for the full premium amount because the tax credit subsidy was eliminated by Covered California.
At some point you get tired of dealing with idiots. At some point you need to complain with the full understanding that nothing changes because government bureaucracies and private corporation sucking off a government contract never change. As my phone showed I had been on hold for over four hours with Covered California’s agent support Pinnacle Management, I was able to finish writing the following complaint forms to Covered California.
