If you’ve followed my saga, I signed up directly with North Carolina Blue Cross/Shield on December 5th, 2013 agreeing to a $511/month ACA compliant policy with a $5,500 deductible and out of pocket maximum. Had I not moved from Illinois, my HIPAA continuation plan would have been in excess of $900 – but an ACA compliant policy would have been similarly priced to the NC policy.
The signup process immediately took my $511 and confirmed I was covered. My ID card and welcome kit would arrive within 2 weeks. On the 23rd with no card, I called customer support and after 3 hours was told that the cards were delayed, but I should get it within a week.
Now the update – BCBS of NC sent me an email encouraging me to login to my account and experience all the wonders of being covered. Right away there was a system wide message announcing that people with coverage starting 1/1/14 (aka me) have not been sent their cards yet – and if they don’t arrive by 1/10/2014, I should call customer support right away!
The main thing I wanted was to read the plan description document to see what I actually bought. I think it is HSA compliant, but not positive. I clicked the link to view the document and received an error that the computer that has that document is offline, and urged me to call Customer Service to report the problem. This was around midnight and Customer Service operates from 8 AM to 9 PM Monday through Friday.
I then noticed BCBS has physical offices you can go to if you want to see a human in person. When I selected South Charlotte, I was informed the office near me was “coming soon”.
It appears I have an ID and printed a temporary card, and do have access to the doctor and hospital directory. There is a neat feature which estimates the “right” price for common procedures. Since the first $5,500 are coming right from me, knowing how much something costs (like an overdue colonoscopy) would be useful information. No matter what procedure or facility I chose, I was told that information is not available.
The end of private health insurance for individuals is imminent. No matter what Blue Cross does, they’re dead.
Blue Cross isn’t really so private. Its organizations are “non profit” because may politicians believe no one should be able to make a profit in healthcare.
In fact, in Minnesota, it is illegal to make a profit selling or providing health insurance. How does that work? The big boys set up non profits in the state and then sell them services to transfer the revenue to the parent and ensure no profits in Minnesota – ensuring that out-of-staters make the money on the business.
And by “big boys”, the reality is BCBS is the doctors and hospitals.
Just because a hospital is “non profit” doesn’t mean the administrators aren’t earning a million dollars, Goldman Sachs isn’t making fees on indebting the hospital and pharmaceutical companies aren’t extracting large amounts of money.
My neurologist relative and I got into a discussion about administration of TPA which is a miracle drug that quickly reverses the blockage of a stroke that is killing the brain. There had just been a news story about billions in waste because once the first dose is administered, Medicare pays for the entire treatment of $11k even if it is determined the person wasn’t having a stroke.
One key government “quality” metric is whether TPA has been administer within 3 hours of the onset of symptoms. Especially in rural areas, it might make sense to carry TPA in the ambulances to be injected by the EMT even if it turns out the diagnosis is wrong.
Her opinion is the risks from administering TPA are minimal and the consequences of not doing can be catastrophic, so don’t worry about the cost.
What if the person is 85 years old in a nursing home, deaf, with Alzheimer’s and 2 prior heart bypass operations? Is there anything medicine can do where we should just say “let God decide”?
49,000 children in NC being dumped into Medicaid had their ID cards mailed to the wrong address.
http://charlotte.cbslocal.com/2014/01/04/49000-nc-medicaid-cards-mailed-to-wrong-addresses/
My guess is the card and the letter with the mailing address got “out of sync” during the envelope stuffing process so people got cards for the person before or after them in their zip code.
At least I’m not alone.
I’ll bet it results in someone getting promoted… record number of government employees got promoted after 9-11.
The 49,000 children were enrolled in a state funded program for parents who made too much for Medicaid but not enough to afford insurance. By dumping them into Medicaid, most of the funding now comes from the Feds – and as a bonus, providers that accepted the state plan are now required to accept all Medicaid patients
Is this not being done for the benefit of the children? Wonder how many parents realize their children are racking up a huge debt that is only being deferred? The government will collect on the debts after the patient dies, so long as the IRS remains functional.
I have a very abstract idea (albeit a record keeping nightmare) that we should keep a running count of direct government expenditures – like the 12 or more years of free public education, subsidy of public university education, unemployment benefits, food stamps, medicare (to the extent it exceeds what you paid in during your life),etc… And that “debt” would come off the top of your estate and repaid to the jurisdiction that incurred the cost.
The hole in the Libertarian concept of “it’s my body and it’s nobody’s business” is that “we” were legally obligated to provide you with a public education and other “safety net” protections. Unless we’re willing to let people die at the ER door because they have no money, we’re part of a social “contract”. With benefits come strings.
You’re right.
Another healthcare example is someone after a major car accident unconscious and bleeding on the side of the road. When he wakes up in the ER, he could claim he doesn’t owe the hospital or ambulance any money because he didn’t call them or agree to the fees.
Envelope in mailbox from BCBS of NC – yay!
No ID, no plan description – but I have an invoice for next month! – at least that system works!
Got my NC plate today, so I’m fully a tar heel again.
Well, from the ObamaCare perspective you are now counted as ‘signed-up” and that is the most important stat. Anyway, hospitals are brewing cauldrons of resistant infections so stay out of them if at all possible. A big part of the problem is people go in for ‘normal’ treatment and end up with an almost untreatable infection, and 40% to 50% end up dead.
Hey, I thought once a tar heel, always a tar heel. Anyways, congrats on getting legal to drive around in the state of NC.
If one were to believe that McAfee, Symantec and the governement are developing computer viruses…. where would one stand on hospital viruses?
Perhaps someone will develop a virus that quickly kills but only works on people with certain DNA sequences!
Alex Jones, please pick up the nearest white courtesy phone…
They already figured how to do that, i.e., kill only people with certain DNA sequences.
HIV?
Kidding aside, there are targeted delivery mechanisms that can deliver medicines to only certain cells based on the molecules of that cell.
Turns out you had it easy, Art. (You probably didn’t walk up hill on the way to and from school as well. 😉 ) Enjoy the California signup saga:
http://www.zerohedge.com/contributed/2014-04-21/uncovered-california
The great thing about the Internet is everyone has a voice. It’s also the weakness.
By the first paragraph, he’s already off track. The issue of State Run ™ exchanges has almost nothing to do with the web site, but everything to do with who regulates health insurance. For states like North Carolina, the only choices are the federally regulated Multistate plans – which basically means only Blue Cross/Shield. Coventry is the only other choice and they’re unprepared to handle the responsibility (based on my interactions with them).
California, on the other hand, has Kaiser Permanente and a number of other California only insurers (and health care provider networks). The California Insurance Commissioner has significant latitude in the California rates and rules, as long as they stay within the ACA definitions.
He also immediately threw in the red flag “self-employed”. A person who owns a business, but has no employees is considered an individual policy holder for purposes of rates – otherwise people would claim to have a business just to swim in the small business risk pool. If he has employees, he should be talking with an insurance agent or companies that provide managed benefit services for small businesses. Last I heard, healthcare.gov does not have the small business functionality working. I doubt it will ever be the most reasonable way to buy the insurance. Market forces will drive those employers to shared risk private insurance pools.
” A person who owns a business, but has no employees is considered an individual policy holder for purposes of rates”
That is correct. It is common for a business owner to employ himself and his spouse. Two employees separates you from the individual pool which had been people they were unemployed (i.e., often “unemployable” due to extreme health issues) and in a much higher cost pool than the employed.
Realizing how big that hole is, I think they ended up merging the small employer and individual pools – which probably is why small employers were given a delay while they sort this out.
So, because I hate everything about this process – I finally got around today to the funding my HSA account. Since this is not the employer funded, this is just me transferring money from my bank account to a special HSA account held by Bank of New York / Mellon. Blue Cross Blue Shield of North Carolina prefers that you use this account, as it’s directly linked in terms of claims processing. I don’t have an issue with that. The account will be earning .05% interest!
Because I’m older than 55, I can contribute up to $4300 for 2014. That money comes off of my 2014 income for tax purposes – but since I probably won’t be employed in 2014, that may not mean much – in fact, in a perverse way because all the rules because North Carolina withdrew from Medicaid expansion – it may actually harm me to take the tax deduction.
In any case, I’m now caught in a computer/phone hell with my new bank. I got to the end of the online sign-up process, and was told that an unspecified error had occurred – and that I should call the toll-free number during business hours.
I could send them a check through postal mail, but I would prefer to do it through an online withdrawal from my checking account by ACH. However, my account is in a “pending” state, and until the account is officially “open”, I can’t make a deposit into it. To the customer service people, my account appears to be open – and they told me to try again tomorrow.
My suspicion is since I tried to open the account at 4 o’clock in the morning, some computer system somewhere was offline and that’s why my sign up failed to complete successfully.
I have however documented an attempt to open the account, which would make any expenses from today on eligible for reimbursement by the HSA even though the account isn’t actually usable yet.
The HSA account can be used for things that are not covered by my wonderful Blue Cross Blue Shield Bronze policy – for instance hearing aids and dental work. I’ve been told I will be issued a debit card which I can then use to pay for things not covered by insurance as long as they are in the IRS approved list.
For things that are part of Blue Cross Blue Shield, the provider will submit the claim to Blue Cross Blue Shield, who will then withdraw the money from my HSA account to cover my portion of The cost. Since I have a $5,500 annual deductible, during the first year the amount on deposit will not cover the entire deductible if I do and have significant expenses. I will be sure to remind the provider that I am paying their bills, not Blue Cross.
HSAs are still a good deal. As you know, if you only use $1000 of that $4300, and then add another $4300 next year, you will have $7600 for your expenses next year. Furthermore, when you pass, you can leave that money to your heirs.
Your last item is a complete non-issue.
For some people it is. If you pay that money instead to a “gold plated” obamacare plan, you will never see it again.