Poll: Healthcare Insurance

[Rev BS]

Kaiser Permanente vs the All-Stars in Southern California.

http://www.ocregister.com/articles/h...vity-care.html

"Unlike traditional HMOs, however, both the insurers and the health systems will be collectively responsible for all the risk of overspending on patients and therefore will share a common goal of providing the most cost-efficient care possible, avoiding unnecessary tests and treatments and ENGAGING THEIR PATIENTS TO KEEP THEM AS HEALTHY AS POSSIBLE.

So don't laugh or get mad at Michelle Obama when she tells you to eat your veggies, and Michael Bloomberg tells you to skip the jumbo size drinks.

[Tres3]

Just right at 10 and a half months to get things complete and correct under the Affordable Care Act.

Esten would find nothing wrong with your travails. He would say something like 10 and a half months should be expected from a new system.

Tres3.

[Dickhead]

Today was the first day my bill finally showed up correct in CIGNA's system. So it was July 10 when I first noticed their error. 10 weeks and 14 phone calls to fix it. I still have not gotten the insurance commissioner's report, but I got CIGNA's mandatory response, which they mailed one day after the deadline. It stressed the health insurance exchange's (many) errors while failing to mention their own, and all the misrepresentations and false promises they made. They said the claims they denied were "pended," when they were flat out denied. I did get a mealy-mouthed apology and assurance that I am a valued customer. Oh uh huh. So the situation is far better and I was able to get some tests run last week. I did not skate on a month of premiums as it looked liked I would at one point. I will post again when I get the results of the regulator's investigation.

Just right at 10 and a half months to get things complete and correct under the Affordable Care Act.

[Dickhead]

I did request as my remedy that my July and Aug premiums be refunded since I couldn't use the insurance. As I said, the investigator isn't finished yet. But the one time in recent years I did go to an ER, I got seen virtually right away. It was around 9 AM the day after Thanksgiving so maybe I just got lucky.

Monday I puked for ten straight hours so waiting in an ER compares somewhat favorably with that.

[Dccpa]

I just tried to suck CIGNA's mistake back into my checking account but I could not. < : (

And don't get on my ass for it because even though this has all been "straightened out," I paid for coverage in July and August and I couldn't use it. It's not like these fucks can go back and refund me for being sick and not being able to go to a doctor, despite having paid for the coverage. I would have been in the ER once in July and once again in August if all this bullshit hadn't happened.

Among the more heinous results of this whole ordeal was learning that my "personal physician" had delayed arranging a fairly urgent test due to waiting to see whether they would get paid for my previous visit. Needless to say, she is fired.

Dickhead, get your premiums refunded for those two months through your insurance commissioner. It may not work, but it is worth a shot.

As much as I dislike Obamacare, CIGNA was a terrible insurance company to deal with years before Obamacare was passed.

ER should be renamed extremely long term waiting room. If you survived without going to the ER, you did yourself a favor and saved yourself a lot of misery.

Doctors are like any other service provider. There is always another one. Next!

[Esten]

A lot of insurance company bs you had to deal with... thanks for sharing your experience.

[Dickhead]

I just tried to suck CIGNA's mistake back into my checking account but I could not. < : (

And don't get on my ass for it because even though this has all been "straightened out," I paid for coverage in July and August and I couldn't use it. It's not like these fucks can go back and refund me for being sick and not being able to go to a doctor, despite having paid for the coverage. I would have been in the ER once in July and once again in August if all this bullshit hadn't happened.

Among the more heinous results of this whole ordeal was learning that my "personal physician" had delayed arranging a fairly urgent test due to waiting to see whether they would get paid for my previous visit. Needless to say, she is fired.

[Dickhead]

Congratulations.

In my own limited experience in having purchased a health insurance policy only twice in my life (3 times if you include my policy with Hospital Aleman here in Argentina), the process was simple: The agent came to my house, conversation ensued, I signed an application, gave him my check, and the rest was automatic.

And now for the $64,000 question: In general, was health insurance this difficult to buy BEFORE ObamaCare?

And DH, more specifically to you: Do you attribute the aggravation you experienced to the processing of your ObamaCare subsidy, or do you absolve ObamaCare itself of any complicity in this regard?

Thanks,

Jax.

I still haven't seen the full results of the investigation but right now it appears that CIGNA was just doing what the documents the state health insurance exchange sent them. I don't know what my experience would have been in a state that used the federal exchange. I'll let you know what the investigation reveals but right now it appears that the initial problem was a computer system overload back in the open season, and then the billing shit arose from a simple human error by an employee of the health exchange, who misunderstood something I had told her on the phone. So, the difficulties certainly emerged from the processing of the application in total, not just the subsidy. If I had bought the insurance through the exchange without the subsidy, I would have had the same problem except CIGNA would have been hounding me for about 2. 5 times as much.

I can't answer to the difficulty of buying insurance before Obamacare because I couldn't afford it. I will say that I bought private health insurance in Argentina and it was a big hassle to get them to stop billing me after I no longer needed the policy.

But this was difficult. Real fucking difficult.

[Jackson]

Finally this shit is straightened out. I originally applied on Oct. 23, 2013 and now, on September 3, 2014, I have achieved coverage. CIGNA has called off its dogs and in fact, because they are so fucking incompetent, they took away seven months of bills when only six months were bogus. Thus, as another poster predicted to me via PM, I am a month ahead. I will let you know if they catch the mistake. The state insurance commission's investigator was very helpful. CIGNA may get some sanctions but I won't know that for another couple of weeks.

Congratulations.

In my own limited experience in having purchased a health insurance policy only twice in my life (3 times if you include my policy with Hospital Aleman here in Argentina), the process was simple: The agent came to my house, conversation ensued, I signed an application, gave him my check, and the rest was automatic.

And now for the $64,000 question: In general, was health insurance this difficult to buy BEFORE ObamaCare?

And DH, more specifically to you: Do you attribute the aggravation you experienced to the processing of your ObamaCare subsidy, or do you absolve ObamaCare itself of any complicity in this regard?

Thanks,

Jax.

[Dickhead]

Finally this shit is straightened out. I originally applied on Oct. 23, 2013 and now, on September 3, 2014, I have achieved coverage. CIGNA has called off its dogs and in fact, because they are so fucking incompetent, they took away seven months of bills when only six months were bogus. Thus, as another poster predicted to me via PM, I am a month ahead. I will let you know if they catch the mistake. The state insurance commission's investigator was very helpful. CIGNA may get some sanctions but I won't know that for another couple of weeks.

[Dccpa]

Dickhead, I concur on CIGNA. They are by far the worst insurance company I have ever dealt with. My claims were for year 1 nursing home coverage for my Mother. I was told by a relative that CIGNA didn't pay for this Father's nursing home care under the same policy. I jumped through all the hoops, including filing 13 separate claims for a 12 month period. First CIGNA took the 13 claims I sent in one envelope and split them up to process. Eventually, CIGNA paid (with multiple checks). Next, demanded the money back. I told the lady, first of all, you are not getting the money back, now what can I do for you. .

Turns out CIGNA wanted the money back because Medicare had not rejected the claims. Keep in mind that a CIGNA employee determined that a Medicare claim did not need to be filed because it was not a covered situation. I had the nursing home file Medicare claims, Medicare rejected the claims and CIGNA went away happy or at least went away.

[Dickhead]

All the previous has been reneged upon, so:

Prior to Obamacare, I had no health coverage.

Since Obamacare, I still have no health coverage, but I am out $450.46 and have a collection agency on my ass. Soon, I will have the doctors whose claims were rejected on my ass as well, another $348.

The only real good news is that I think the regulators have a hard-on for CIGNA. I say this because within two hours of filing the complaint, I got a response from a senior complaint analyst and she had already sent CIGNA a lengthy demand letter, requesting timelines of coverage, spreadsheet analysis of my payments, any recordings of our conversations (could be bad because I went into ballistic mode last week), copies of all interface between the health insurance exchange and CIGNA (it was the health insurance exchange that originally fucked everything up but they've got their shit together now and it's CIGNA that is obfuscating), etc. 14 demand points in all. And whoever this is at CIGNA that the complaint analyst contacted has to send me personally an explanation of all this shit by Sep 9. My guess is they snail mail it to gain more time (has to be postmarked by Sep 9 but if delivered electronically has to arrive on Sep 9) because the deadline for me to submit the money they say I owe for July is Sep 15. Right now CIGNA says if I pay for "July" by Sep 15 they will reinstate as of July 1. But, I already paid for July and have the cancelled check to prove it, and I sent that to the insurance commission, so ideally I'd like to see the response before I pay. If I were healthier I would do that, but instead I see no choice but to pay, get the insurance card, get treated, and continue to fight CIGNA.

I contacted my state legislator about all of this and she did get back to me promptly. She got with the health insurance exchange but it appears the exchange has it right now, and CIGNA would, of course, not talk to her staff for privacy reasons. Today I delivered a notarized privacy waiver to her office (I bet CIGNA still won't talk to them) and my legislator had left me a letter offering me the use of a staff person to do some research if I needed it. I thought that was a good response but I got research out the ying yang. What I need is coverage and treatment, and for my doctors to get paid, and for this collection agency to get off my ass. I told them to bring it on and outlined all the documentation I would use in case of litigation. They ruin your credit anyway, so that's not really all that much comfort.

Further updates to follow. A collateral issue that relates to this whole health exchange dynamic is that now I have a deep and abiding hatred for CIGNA but I am stuck with either them or no one until the first of the year. The only way around this is to move out of the coverage area. Depending on what response I get by Sep. 9, I am certainly considering doing that or at least faking doing so. I am researching how to fake this right now but it should not be too hard. I shouldn't have to resort to that subterfuge because I did everything by the book. But, this has not been a fair fight by any means; it's pretty much all out war now so fuck the book.

[Dickhead]

My coverage has now been allegedly reinstated and I was able to get prescriptions filled under my plan. However, CIGNA still maintains that I owe them premiums under a non-existent policy that is a figment of their imagination, from Jan-Mar. This could be said to be an improvement over their previous position that I owed for Jan-June, but since they cannot produce any documentation of any contact between us prior to May 25, it is still kinda frustrating.

[TejanoLibre]

This is about Argie Health Care.

Which company is the best?

Swiss Medical?

Hospital Aleman?

Osde?

Fuck I don't know!

Do I have to wait 90 days to get covered?

Will they or can they exclude me for previous conditions?

It just cost me 40 k to have my hand sewn on backwards!

No insurance!

Fuck Your American Insurance Companies on this site!

I need the best insurance that pays for everything, zero or minimal cost.

I do NOT want to pay first and then get reimbursed!

That's the same as not having coverage.

I want to add a single white female to my coverage because I am a nice guy.

Non-smoker, non-drinker. Zero drug use.

Should be cheap!

Right?

Thanks,

TL.

You can tell Obama to Fuck himself! Especially if you like that fucking # !

[Dickhead]

So I still don't have coverage. It's now been ten months that I have been attempting to comply with the individual mandate. I filed a complaint today with the state insurance commission, and also an appeal with the state insurance exchange to have the premium based on my age when I originally submitted the application that they lost. I have copies of the premium checks CIGNA cashed for July and August, the latter of which had a restrictive endorsement on it (valid in MY state, but who knows about theirs) stating it was "payment in full" for August. Nonetheless they denied my claim for my doctor's visit in July. At one point they had sent me a letter saying pay up or else but that was dated August 9. I have another doctor's appointment tomorrow and I have the direct number of a supervisor at the health exchange who says he will tell my doctor that my coverage is valid, but who knows what the docs will say to that. They don't know me from a plate of piss.

By state law, the insurance commission has to respond to me within 14 days so I will keep you all posted. I also included as part of my complaint that CIGNA refuses to provide me any plan documents and won't change my address even though I have made two phone and two written requests, including one by certified mail.

So you have the concept of the private sector being hungrier and more efficient than the public sector. I can assure you that in this instance, both are equally slothful and inefficient. However, the level of sheer incompetence is higher at CIGNA than at the state health exchange.

Because I have empathy for my fellow citizens, I also contacted the city / county council to inform them that a lot of the people living in my zip code are probably getting ripped off as per my earlier post, and I have the citizens' advocate at the state health insurance exchange looking into this as well. Depending on what kind of response I get from the regulatory agency, I might contact my elected representatives about all this crap. I have the time to do that now that I'm semi-retired. I would do more for my fellow citizens if I did not have just a charred piece of bacon where my soul used to be.