Qualifying for Medi-Cal Due to Obamacare

          

          In other news, since I officially don't have any more unemployment benefits and don't know where and when my next income is going to come from, since you remember I've only been hired as a part time employee with no guaranteed working hours, I've re-qualified for Medi-Cal (Medicaid) insurance. (Did that sentence run on?) It was supposed to be effective June 1st, 2014 but due to government backlogs, I didn’t get it till mid July. In the meantime, I stopped paying Healthnet the monthly $135 I’ve been sending them since January. I thought that  I still have to continue paying Keenan Healthcare $45 a month for dental insurance thru COBRA from my previous employer but it turns out Denti-Cal was reinstated by California effective May 2014.

          Let me backtrack a little bit. In May, I had to call Covered California (the California Healthcare Exchange) to make the changes and was glad the wait time on hold wasn't as long as it was late last year. Charlie checked my eligibility and in a few minutes was transferred to the L.A. County Medi-Cal representative Lily who had me scan my last EDD unemployment check notice and upload it to the Covered California website. There are still some bugs in the system, but not as bad as it was before because the representatives have found workarounds to bypass the bugs. It also seems like the reps have more latitude to approve the changes based on the proof you upload. I thought that was it and that free Medi-Cal insurance would kick in on June 1^st. I made a doctor’s appointment and the medical assistant confirmed my eligibility. However on May 27^th, I got another call saying my Medi-Cal was deactivated. I called the L.A. County Medi-Cal office and was told that I had to wait for it to be reactivated again but without an approximate time. A few days later I got a letter in the mail informing me that a caseworker has been assigned to me at the local Department of Public Social Services (DPSS) office. I was also expecting another packet in the mail to pick a managed care plan.

          So I waited, and waited, then waited some more, and I called the DPSS every other week. Meanwhile I was getting tons of mail from Covered California which said I qualified for this and that federal subsidy which was basically what I was paying Healthnet for 5 months. It seemed that Covered California’s computer system finally caught up with the applications and the eligibility information I uploaded way back in October 2013.

          On the second week of July, I called the DPSS office again and my caseworker said that my Medi-Cal would be reactivated the next day, but to wait another day for me to make a doctor’s appointment. When the time came, I called the doctor’s office and they verified that my insurance coverage was again active. Hence, I made an appointment for the following week.

          So I finally made use of the free medical insurance last week  and went to see a doctor for a checkup almost a year since my last doctor's visit. Not just any doctor mind you, but one who accepted Medi-Cal and someone I used to work with as a mental health worker 20 years ago before he went to medical school and haven’t seen since. I went to the clinic 10 minutes early, filled out the necessary paperwork regarding my medical history, then waited in the examination room. When the doctor finally entered, he greeted me, then had to do a double take. He said "hey, I know you!". I was going to ask if he remembered me but it was too late for that. He asked me if I was in touch with any of our former co-workers, which I was not. So he mentioned a couple of nurses whom we used to work with and that they were his patients too. Hopefully, there was no HIPAA violation there since we were all friends way back when. So I had my checkup done, blood drawn for lab tests right there in the office, had my maintenance medications refilled, and experienced the advantages and joys of free Medi-Cal insurance: no doctor’s visits co-pay, no lab co-pay, and no pharmacy co-pay. All thanks to my much much lower income and Obamacare. I already addressed this in my blogpost way before Obamacare kicked in : http://aboutlifeandrunning.blogspot.com/2013/04/an-obamacare-loophole-for-early-retirees.html

Seeking a Financial Sweet Spot

          Now I have this dilemma of finding a full time job with benefits or working part time (and semi-retired) to keep my income within the limits required to stay eligible for free Medi-Cal. I'm torn between staying semi-retired and earning less (with free coverage for medical,dental, vision, and most prescription meds) or getting full time employment and earning more while paying for regular medical insurance with all the co-pays. I was offered a full time job which starts in mid-August which more than doubles what I earn  now, but in exchange, I have to work longer hours. The decision has to be made soon on whether to stay poor and get free insurance as long as Obamacare is in effect, or earn more money and start paying for employer sponsored insurance with all its co-pays. And perhaps, not too far down the line, since my mortgage is already paid off, finally take vacations I never took in the past 34 years of working so much.

           A final note on free Medi-Cal: when you choose a managed care plan, they even supply a postage paid envelope. That's your tax dollars at work folks. No wonder a lot of people pretend to be permanently disabled like some of the psych patients I've worked with.

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Covered California (Obamacare) Update - The Saga Continues

BREAKING NEWS: Hours after I posted what I wrote below, I received snail mail from Covered California notifying me that I'm temporarily qualified for the federal subsidy for only 3 months because they needed proof of income, citizenship, and social security. I scanned and uploaded those to the website immediately but as probably should be expected my first two attempts gave me an error message. Fortunately, I remembered a workaround from a couple of months ago when somebody from Medi-Cal assisted me with my enrollment and uploaded the documents to a different section for eligibility changes. We shall wait and see what's going to happen next.

         
          After I had my insurance choice changed from Anthem Blue Cross Silver to Healthnet Platinum, I waited a week for an acceptance letter from Healthnet. When that didn't arrive, I called Healthnet to find out if my name was in their system. To my consternation, it was not and January 1st was fast approaching and I didn't want to be without medical insurance at the start of 2014. I scoured the internet for similar problems and one of the websites mentioned a Covered California phone number that one of the commenters posted that wasn't publicized by Covered California.

          I called the number and I was surprised that it wasn't busy nor did it have a waiting time. Initially, they couldn't check on my status because the system was down for maintenance. I tried again an hour later and they were able to verify my choice of insurance. The person I talked with said he was going to forward my concerns to tech support. When I called Healthnet the next day, my name was already in their system. I was given my subscriber ID number by the customer service representative and another phone number to call where I could pay and choose a doctor. It was an automated system (I thought I was going to take to another person) and the option to choose a doctor was not available, but I was able to pay for the January premium by credit card. My name didn't come up but the ID number corresponded with my platinum coverage choice and amount that Covered California quoted.

          The next day, an acceptance letter arrived from Healthnet, which was out of turn chronologically. I then tried to register with the Healthnet website for several days but it wouldn't take my ID number until January 1st. When I was finally able to log in, I found out that I had been preassigned a doctor based in Huntington Park. I called the Healthnet again on New Year's Day and wasn't expecting a live person to answer when I didn't press any buttons, but someone named Candy answered and she was able to change my doctor. I even joked and asked her if she picked the short straw so she had to work on New Year's day. I printed out the overview of my coverage as a temporary ID in case I needed proof of insurance since I was joining my relatives the next day for a day trip to Pechanga Casino.

          So it was great relief to find out I was finally covered even though I had to pay for it and it's a lot cheaper than what I paid for private insurance in November  and December. It had been an almost painstaking three months to get covered which was not helped by being unemployed. Then another surprise came up. I got a Medi-Cal card in the mail and called their L.A. County office  who told me I'm also temporarily covered and can use it any time until more information comes in the mail, so I can choose a Managed Care Plan, kinda like an HMO. I'm temporarily covered by Medi-Cal until they can verify my projected 2014 income. Again, out of turn, my Healthnet ID card arrived a few days later.

People who haven't bought insurance by March 31st are supposed to be fined by the Federal Government. My question is how will the government know if they haven't bought it? I also think it's going to be a mess once the insurance companies start trying to collect the subsidized amounts (based on income) from the government. How well the Obamacare system works out remains to be seen.

          This is what would cost me to have health insurance: if I took COBRA from the job I was laid off from = $503, if I continued with Anthem Blue Cross Silver (which I subscribed in November and December on the open market)= $193, with Healthnet Platinum = $134. Medi-Cal, if it comes to it, is free.

Here are my other posts regarding Obamacare:
http://aboutlifeandrunning.blogspot.com/2013/04/an-obamacare-loophole-for-early-retirees.html
http://aboutlifeandrunning.blogspot.com/2013/12/complications-in-making-changes-in.html
http://aboutlifeandrunning.blogspot.com/2013/11/my-experience-with-obamacare-sign-up-in.html
http://aboutlifeandrunning.blogspot.com/2013/12/glitches-ive-encountered-with-covered.html

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Complications in Making Changes in Covered California (Obamacare)

          

          Register, Enroll, Pay, get medical insurance coverage. If only it was that simple. I should be done with this by now and I never expected to blog so much about Obamacare as I have already. I've even run out of blog ideas this week until this came along. To add a quote by Michael Corleone from the film The Godfather - Part 2, " Just when I thought I was out... they pull me back in". Sometimes things just don't work in a logical manner. As Spock would say "It's not logical Jim".

          Case in point: I originally registered with Coveredca.com for Obamacare on the day before I got laid off and picked Anthem Blue Cross Silver Plan because that was what I thought I could afford based on the federal subsidy discounts. Then of course the day after, I got laid off, so I made changes on my projected income in the Covered California website. No income would have meant I qualified for Medi-Cal and a few weeks later, I received a letter from Covered California saying so.

          I patiently waited for Medi-Cal to send me more information. When none arrived several weeks later, I finally called the Los Angeles County Medi-Cal phone number that Covered California gave to me in their letter. I was able to speak to a nice lady named Heidi S. who asked me for my updated income and she was able to update that information. However, it was based on a whole year of me receiving unemployment benefits which disqualified me for Medi-Cal. Well, those benefits are only supposed to last for 6 months but the system didn't allow for this, so Heidi said that when my benefits expire in April, I can call them again so they can qualify me for Medi-Cal. She was also able to let me log in to the Covered California website again (remember I was locked out of the system) by giving me an access code and merging a new username and password with my old one. Strange system isn't it? Heidi asked me to upload my new income information but we encountered another glitch - the system would not accept the upload and said to contact system administrator. Heidi told me that they have been able to work around this problem and she had me upload my EDD unemployment benefits data to the California proof of residency link instead. That worked and she was able to qualify me for Obamacare based on reduced income. This reduced income would have enabled me to enroll in a cheaper coverage because of a higher federal subsidy. But then the system would not let me make changes on the original Anthem Blue Cross I was enrolled in. Heidi said she was going to ask her supervisor about this and call me back.

          In the meantime, I got on the treadmill and did a 45 minute hill walk/jog while waiting. I got Heidi's call back after I finished my workout and she said they couldn't do the changes from their end and that I would have to call Covered California. Being pig headed, I tried to make changes in the website myself by inputting everything from the beginning and with the new income that Heidi had helped me with. When it came to the enrollment part and after I tried choosing a new insurance plan, the system still didn't reflect any changes and kept it with Anthem Blue Cross. Believe me, I tried 3 times.

          After lunch, I called the primary Covered California number which gave a very prolonged message in English and Spanish telling me to call another toll free number. I did and the system told me that the waiting time would be more than 30 minutes. I hanged up and called Anthem to find out if they can do it on their end. I was told that Covered California still haven't sent my information to them and until then, they couldn't do anything. I tried Healthnet too and asked them if they can help me enroll directly. They said they could not. It was back to the Covered California phone number then.

          I watched a movie, read the news, surfed the web and waited. Thank goodness I was able to figure out how to listen to the elevator music on my computer speakers instead of holding the phone on my ear. After almost an hour, an agent finally answered the phone. Well I'll be darned but if it wasn't Tony whom I had spoken to about three weeks before about resetting my password and updating my income. I recognized him by his name and accent. He wasn't able to help me several weeks ago, but this time he said he would be able to change my insurance choice. He said that the system doesn't allow for the consumer to make the changes because otherwise people would keep on doing it if they were not satisfied. He made the changes in his computer then I tried to log in to see them. The system would not let me do it. Tony gave me another number that I can call to reset my password and also gave me a California State Client I.D. number which he said would help me in the future. After we hanged up, I emptied the cache of my browser and tried to log in again. Surprise, surprise, I was able to! It looks like Covered CA will not let me log in when agent is logged in and is using or updating my data.  It showed the changes that Tony made and I was now supposedly enrolled in Healthnet Platinum Plan instead of Anthem Blue Cross Silver Plan. Even though I didn't get the free Medi-Cal insurance I had hoped for, because of the higher federal subsidy, I was able to get better coverage for lesser money with Healthnet. Thank you so much Tony! Now I have to wait for Healthnet to bill me and send me my enrollment information. Then in April, if I'm still unemployed, I can try for Medi-Cal again.
          With all the complications and glitches I've experienced so far, I should be in critical condition by now.

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Glitches I've Encountered With Covered California (Obamacare)

          

          Even though the Covered California website (coveredca.com) didn't have as many glitches as the federal Healthcare.gov website, it still wasn't smooth sailing as should be expected. In my first attempt at applying in October, the section where I was supposed to enter my citizenship information stopped me in my tracks because it wouldn't take the A90 number of my citizenship certificate. The website showed an error code and told me to contact the System Administrator. Well, I don't work for them so I didn't have a way of doing that. A week later, it miraculously accepted my citizenship info and I was able to proceed. So my registration was completed and the website presented me with options on what companies and insurance coverage I preferred based on my projected income in 2014 if I was still employed. Unfortunately, the next day, I was laid off so that changed the income equation.  If I remained unemployed in 2014, that means I would not have an income, so I had to make revisions with Covered California. When I tried to input my projected income of zero dollars, the website would not accept the value, however, when I put in 1 cent per hour, it was accepted. To prove that my income had changed, I was asked by the website to upload whatever evidence I had. I was able to upload my WARN Act Letter and my Termination Notice. Based on a projected annual income of $1,664 a year, I qualified for free insurance coverage through Medi-cal which is California' version of Medicaid. I don't know how much Medi-cal covers but at least it's free and better than not having any health insurance coverage.

          A couple of weeks later, I logged on the website to check on my status and it showed me that I was approved for Medi-cal based on my revised projected income and the evidence I provided. However, I didn't know what the next step was. By that time I had started receiving unemployment benefits so I had to update my information and report my new income. I would still be receiving substantially less than the $15,800 threshold for subsidized private insurance where I have to pay a certain amount, so I would still qualify for Medi-cal. As required by the rules to be truthful with my information, I tried to make the changes to my income. Again I hit a roadblock similar to the one with the citizenship information. Thinking maybe the website was too busy to process the new information, I tried to log in again in the evening. This is where a new problem cropped up. The website said I entered the wrong password so I tried to be more careful the second time. I got the same message so I clicked on the "Forgot Password" link which brought up some challenge questions to prove my identity. I know for sure that I answered them correctly but the website locked me out.

          The next day, I contacted customer service via Instant Messaging and was told to call the customer service number for help in resetting my password. I did that and after about a 35 minute wait, I talked to someone who told me to wait 24 hours before trying to log in again. He said that should help in trying to reset my password. While he was on the phone with me, I asked him if he could change my income information. He found me via my case number and did what I tried the day before. He failed as well because his computer gave him the same error message that I got. His advice was to just let it go since the new information wouldn't change my qualifying for Medi-cal anyway.

          I waited for more than 48 hours before trying to log in again but was still locked out of the system, and wouldn't even allow me to change my password. It didn't even ask the challenge questions again but rather just told me to call the toll free number. I sent an email to customer service with my dilemma and they were supposed to respond within 2 days. Two weeks later, I still haven't gotten one. Being bullheaded, I called customer service again and got someone on the line within half an hour. I asked him about resetting my password and he said that they are not allowed to do that anymore. What should I do if I needed to update my info, I asked? He said I would have to do it over the phone. Like the previous representative, he suggested that I leave well enough alone with the income situation, because I would be assigned a Medi-cal caseworker anyway at a later date who would verify my income.

          On December 5, 2013, I finally received a letter via snail mail stating that I didn't qualify for lower cost subsidies for private insurance, but rather I qualified for Medi-cal. At least now I know that my information was in the system. I was to wait for more paperwork, but this time it would be coming from Medi-cal and not from Covered California.

          Another glitch I encountered with the website is the Instant Messaging system. Sometimes after waiting in the queue for a long time while it counts down until you become number 1, the system kicks you off and says that no representative is available. This happened to me twice. So I think it's better to wait on the phone or do both at the same time if you want to talk to anybody.

          Time it was when I was so naive before I moved to the U.S. when I thought that if ever I become sick in America, I could just go to the nearest hospital's charity ward. After living here since 1981, I still haven't seen a charity ward in all the hospitals I've worked in.

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My Experience With Obamacare Sign Up in California

          Since I became unemployed, medical insurance coverage has become a major concern. I can apply for COBRA from my previous job but it's very expensive. Private insurance although slightly less costly, is still high and the co-pays and deductibles are high as well, meaning more out of pocket expense. I may be able to cover COBRA or private insurance up to the end of this year, but what about if I become long term unemployed? This where the advantage of Obamacare or the Affordable Care Act kicks in. So the day after I got laid off, I immediately applied at California's health insurance exchange - Coveredca.com. We've all already heard about the problems the federal site (healthcare.gov) was having so I'm not even going to say anything about that. I've previously researched this issue several months ago which I wrote about here: An Obamacare Loophole for Early Retirees?

          So I explored the coveredca.com website and clicked on the Individuals and Families link, then Start Here, which took me to another site -  https://v.calheers.ca.gov/apspahbx/ahbxanonym.portal. This where you can create an account and put in all your information. You can also Preview Plans so you can estimate how much you can expect to pay for your premiums depending on your income. I entered all the information as prompted by the website and when I arrived at the part where it asked to verify my citizenship, I hit a wall. Each time I clicked Continue , an error message appeared. I tried several times and it showed a different error message number each time. I gave up and contacted a customer service agent via Online Chat (you have that option or call them at the toll free number). I told them my problem and was informed that they were having some glitches and they don't know when it was going to be fixed, and for me to try again later. I tried again but encountered the same problem and this is when I noticed that from about 10 p.m. to 6 a.m., the website was down for maintenance. So I tried the next day and the day after with the same results. Finally after the third day of trying, the website suddenly accepted my citizenship data. By the way, just to let you know, I'm a naturalized citizen. So with the website finally cooperating, I was able to finish my application. Next was to find out what kind of insurance coverage I qualified for based on my income. I'm going to spare you the explanation of Bronze, Silver, Gold, and Platinum plans. They are all based on how much federal subsidies you qualify for and how much you are willing to pay out of pocket. Anyway the best one I could find to fit my limited budget was the Silver 73 plan with co-pays of $40 for a doctor's visit and lab tests, $50 for x-ray, $250 for CT, PET, or MRI's, $19 for generic drugs, $250 after deductible for ER visits, etc. Well you get the idea. The most affordable I saw was with Healthnet at $137 per month.

          Next was to check if the primary care physician I've been seeing for years was part of that insurance plan. So you click on a link called Find your doctor and type in your doctor's name and zip code. Well my doctor was in the system but did not accept Healthnet. He accepted Anthem Blue Cross, but  my monthly cost would go up to $196 for the same coverage as Healthnet. I wanted to continue seeing my doctor so I signed up for Anthem Blue Cross. I could have picked another doctor I knew who accepted Healthnet but that would have meant establishing a new relationship and history with that doctor, whereas my current doctor already knows my history.

          This brings me to the matter of my unemployment. Since I'm jobless, I no longer have an income and from my research, I knew I could possibly qualify for Medicaid (Medi-Cal in California). I contacted customer service again via online chat and was informed that since I had a major life event change, I could either call in that information or click Report a Change after I log in on the website. Since that happened on a Friday, I waited until the weekend was over before trying it. On Monday (November 4), I reported the change in my income. The website asked me for my income but it would not accept $0.00 as a value, so I ended up putting in $0.01 as my hourly income. The website accepted that value and it proceeded to ask me for identification to prove that I live in California and qualifying papers to prove my new income. I was able to scan my California driver's license, WARN Act Notice, and Notice of Termination and uploaded it to the site. The only thing I have to do now is wait for the California Health Exchange to review and verify those papers and notify me if I qualify for Medicaid.

          So other than that initial 3 day glitch in the system and at times having to log off and back in to get back to where I wanted to be in the website, it worked pretty well. No doubt much better than the federal website. I can now only hope and pray that I qualify for Medicaid because that's going to help a lot in reducing my monthly bills in case I don't find work for the long term.

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