When Arnaudville resident Kathryn Guillory enrolled in a health plan under the Affordable Care Act in January, she thought her insurance worries were over. Although she and her husband both work, buying health coverage with two children and a third on the way was costly. But enrolling in “Obamacare” wasn’t difficult, and the federal subsidy was a godsend.
But things went downhill quickly after Guillory’s son was born. One of the many glitches that plagued Healthcare.gov off and on throughout the last open-enrollment period resurfaced. Although some observers worry the website’s issues could hamper enrollment this time around, federal officials have said they are confident any remaining issues will be addressed.
For Guillory, the problems began in July. A day after giving birth, Guillory notified the Lumpkin Agency that she needed to add her son to the policy. Her agent went online to the federal Health Insurance Marketplace and made the change. The website showed Guillory’s application was complete. But two weeks later, when her agent checked with Blue Cross and Blue Shield of Louisiana, the company said the marketplace had not forwarded the information.
Three months and dozens of phone calls later, Guillory finally succeeded in adding her baby to the policy. But Guillory is still struggling to resolve the medical bills that piled up between her son’s birth and Nov. 1 when the baby’s coverage began.
“I worry about it constantly. It’s very stressful. It’s very frustrating,” Guillory said of the bills.
In order to get marketplace coverage retroactively, Guillory must file an appeal with the Centers for Medicare and Medicaid Services, even though it was the marketplace’s technical problems that prevented enrolling her son. There also is a chance her son could be covered through the Louisiana Children’s Health Insurance Program, a no-cost state plan for low- to moderate-income families.
Still, Guillory is luckier than some. Chae Mayes, a benefits specialist at Baton Rouge-based Lumpkin, is handling her coverage and has been since Guillory’s maternity leave ended and she returned to work.
Without Mayes and Lumpkin, Guillory never would have made it this far.
“I can’t handle it. I don’t have time. I work. I have three kids. It’s not like I can just stop what I’m doing, call them and stay on the phone for four hours at a time,” Guillory said.
Here are some of the steps marketplace representatives recommended to add Guillory’s baby to the policy:
- Add her income information to the application. When she did this, the marketplace website showed the application was complete. It was not.
- Apply for Medicaid coverage for the baby and be denied. Guillory already had been through this process in December because her family’s income was too high to qualify. It took roughly two weeks to obtain the Medicaid denial. The marketplace didn’t forward Guillory’s application to Blue Cross.
- Add her husband to the policy. The marketplace didn’t forward Guillory’s application to Blue Cross.
- Remove her husband from the policy. This time, the marketplace informed Guillory that she was no longer eligible for a subsidy.
“No one knew what they were talking about or what should be done and the procedures, because every time you called, you got a different answer,” Mayes said.
Mayes and Guillory estimate they called marketplace officials about three dozen times in an effort to straighten out the mess.
Each time they called Healthcare.gov officials, they had to repeat the entire application process, starting from scratch. This typically took 45 minutes to an hour.
“There was actually one night … I called the guy at 7 o’clock. I didn’t hang up until 12:45 that morning,” Guillory said.
The call lasted so long because Healthcare.gov kept having system errors. The same issue resulted in a four-hour call for Mayes.
“Let me tell you, I got so tired of hearing someone say, ‘The system won’t let me do this.’ The system doesn’t work,” Mayes said.
The problem is that the online marketplace doesn’t work like a normal insurance company, Mayes said. There’s no one to call who can overcome the software problems.
Guillory said the one good thing to have come out of the ordeal is that she and Mayes have become good friends, despite the fact that they’ve never met. Their contact has been by phone, texts and emails.
“I would love to put a face with the voice. I feel like I know her,” Guillory said.