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(19,768 posts)
13. My sis has been dealing with the incompetent navigators for weeks.
Mon Mar 10, 2014, 06:26 PM
Mar 2014

She left her husband but found out that if you are married and try to get insurance for only yourself and/or children, but aren't living at home with hubby, and including him, then you don't get a subsidy. She moved back in with the jerk (long story, he is abusive, mostly verbally), and called the obamacare hotline back in January! She has been told that her application has been "expedited" over and over again, only to call back after checking with the new insurance company (some co-op that was evidently created by the ACA law - that barely has any pain management doctors in the entire state of SC, judging from their online search tool - very sketchy "insurance" company to begin with), and being told that they have no record of her, then speaking with a different navigator who says there's no record of her application being "expedited" but that it was in process - for weeks now, over two months. She gets a different story every time she calls, and has spoken to supervisors who say things like, "oh, the request to expedite was entered incorrectly" and on and on, one excuse after another. She's been told repeatedly by people up and down the chain of command that her insurance will be retroactive until March 1 because of the trouble. I know it's bs. She still believes them. Yet, as of late last week, the insurer (Consurmers Choice something or other), has no record of the application. She's been dealing with debilitating back and leg pain, nerve related according to all local doctors we've seen, for about three years now. She is on expensive meds for this. She finally, after jumping through some hoops, has secured an appointment at Mayo Clinic in Jacskonville, FL for April 1 in hopes of getting to be bottom of the cause of the pain and having the experts craft an effective treatment plan. But Mayo can't tell her if this new insurance will be accepted until she can provide them with the insurance info - account number, group number, etc. The deadline for enrollment and her Mayo appointment are just weeks away, and she's still getting daily bs from these navigators. I've told her she should just cancel the current application and do a new one online, but she still believes them when they tell her they will make her coverage retroactive to March 1. This is important to her because she sees several doctors and she doesn't have the funds to pay them out of pocket for the visits to them this month. That doesn't matter that much to me, however, because almost none of them show up when you search the new insurance co.'s network anyway. I'm sorry, but this is the most incompetent, cluster-f*** bs I've ever seen anyone have to go through.

Recommendations

0 members have recommended this reply (displayed in chronological order):

Any healthcare navigators here? [View all] Glitterati Mar 2014 OP
Yep, pretty much Warpy Mar 2014 #1
So she's just screwed? Glitterati Mar 2014 #2
Call any (responsive) representative you have...state and federal... CTyankee Mar 2014 #3
I have tried that as well Glitterati Mar 2014 #5
She's got a lot of company, too Warpy Mar 2014 #4
She DOES qualify to be on my subsidized plan Glitterati Mar 2014 #6
This is clearly insane, then Warpy Mar 2014 #8
Her job situation WILL improve, she does seasonal work Glitterati Mar 2014 #10
We ran into a similar problem scorpiogirl Mar 2014 #7
OMG, what a total clusterf**k! Glitterati Mar 2014 #9
Yes! The bureaucracy is the worst. scorpiogirl Mar 2014 #12
I just realized I have been working on this since November 1 Glitterati Mar 2014 #16
I wonder if a class action suit against the state would work in a state like Georgia where they are jwirr Mar 2014 #30
We need an attorney willing to bring this case Glitterati Mar 2014 #36
Sounds a lot like my problem and why I will not get Insurance. I'll take the fine. Cofitachequi Mar 2014 #11
Your income is too low for you to be fined. missingthebigdog Mar 2014 #14
yet, more than one third of my income cannot go to healthcare. Cofitachequi Mar 2014 #41
As written, the ACA would be providing your care virtually free. missingthebigdog Mar 2014 #43
Reaaly? On my behalf you're going to HOPE for CHANGE. Thanks. Cofitachequi Mar 2014 #44
Excuse me for trying to be nice. missingthebigdog Mar 2014 #45
My sis has been dealing with the incompetent navigators for weeks. Skip Intro Mar 2014 #13
Oh, don't I know it!!!! Glitterati Mar 2014 #15
sucks when the right wing is right. Cofitachequi Mar 2014 #42
OK, the latest from healthcare.gov Glitterati Mar 2014 #17
her income will be considered for your "shared" out-of-pocket Schema Thing Mar 2014 #18
Even if she's on a separate policy? Glitterati Mar 2014 #19
well, no, it shouldn't be considered in that case Schema Thing Mar 2014 #21
I went for a great plan - Humana Silver Glitterati Mar 2014 #23
Generally the way insurance works - Ms. Toad Mar 2014 #20
OK, that makes sense Glitterati Mar 2014 #22
The separate policy doesn't make sense to me either. Ms. Toad Mar 2014 #24
The hoop jumping is insane! Glitterati Mar 2014 #28
WHY do they have "enrollment periods" at all? It's ridiculous. LiberalEsto Mar 2014 #25
It does make sense. subterranean Mar 2014 #26
Because that is how folks game the system. While most of us pay in Hoyt Mar 2014 #27
The sad thing is Glitterati Mar 2014 #29
The problem is with the people leading your state and making decisions. bluestate10 Mar 2014 #46
Well, the FIRST thing that has to happen is for DEMs to get on the ballots Glitterati Mar 2014 #48
My 30-year-old daughter hasn't had health insurance for years LiberalEsto Mar 2014 #31
Your daughter will qualify for Medicaid Glitterati Mar 2014 #32
Thanks! That's very good news. nt LiberalEsto Mar 2014 #33
That's different, and I get it. But, there are people who think it's OK to go without and then Hoyt Mar 2014 #37
It's stupid and arbitrary Glitterati Mar 2014 #40
Enrollment periods come around every six months, so the next one should be in May. bluestate10 Mar 2014 #47
Medicaid caseworker here Puzzledtraveller Mar 2014 #34
Any idea what the delay is? Glitterati Mar 2014 #35
What state are you in? Puzzledtraveller Mar 2014 #38
Georgia n/t Glitterati Mar 2014 #39
Latest Discussions»General Discussion»Any healthcare navigators...»Reply #13