Applying for State-Assisted Health Insurance, Part 1
In early December, my employer kicked me off of their group health insurance plan. While it was a terrible plan with high co-pays and many uncovered services, it was better than no health plan at all.
I live in Massachusetts, which I believe is the only state where it is illegal to not have health insurance. When I lost my health insurance, it was not an option to go without. As my salary is low and insurance premiums are high, I had to figure out what to do.
Today is the day a representative from my company’s new health insurance provider is coming onsite to enroll us. I knew that I was technically no longer eligible to be on the company’s group plan because I have not been meeting my sales quota. However, the company is far from on the ball and I’ve been able to stay under their radar. Because of this, I had high hopes that the company’s disorganization would keep me continually insured. I was wrong.
When I went to meet with the insurance company representative, she was set up in our lobby. Our lobby is small and people continuously pass through it. There is no privacy and everyone can hear what you are saying if they pay attention. This was where people were supposed to talk about intimate details regarding their health? Really? I’m not sure that was legal; people are probably entitled to a semblance of privacy when discussing personal topics like this.
When I sat down (in the lobby) for my meeting with the insurance rep, she told me that I was not on her list and she would need to call HR and verify that she could put me in the system. She called, then we waited for an answer. And waited. And waited. And made annoying small talk. Finally, she received a text that said, “Stacey Goldstein is not eligible for insurance.” The rep read me the text. This is how I was kicked off my company’s health insurance policy. In the lobby, by text, via someone who did not even work for my employer. Shouldn’t my company’s HR department have informed me of this themselves and in a private setting?
Yes, the company had every right to take me off their policy. I was not meeting the guidelines they set forth; it was a black and white issue. However, the roundabout, public way I was informed of this fact infuriated me.
While still fuming over the treatment my company gave me, I looked at my options for health insurance. I knew that health insurance costs a lot, but I was still surprised by the premiums.
I decided to look up exactly what the Massachusetts state law says about requiring affordable health insurance. I found:
The Massachusetts Mandated Health Insurance Law
“St. 2006, c.58. An Act Providing Access to Affordable, Quality, Accountable Health Care. Added MGL c.111M and amended many other sections. Key provisions of the law include subsidized health insurance for residents earning less than 300% of the Federal Poverty Level, and low-cost insurance for all other residents who are not eligible for insurance through their employers.”
I am no longer eligible for insurance through my employer and I earn less than 300% of the Federal Poverty Level. This information fits me.
I looked further into what health care may be available to me through the state. I decided to apply for a subsidized health insurance program, Commonwealth Care. The income guidelines confirm that I may be eligible. This made me sad, but these programs are there for a reason. I make so little money that paying completely out-of-pocket for health insurance may be my breaking point.
I started to download forms and figure out the application process.
I’m done with my application and it is ready to send in. However, nowhere on the forms or on the state’s website does it state how long it takes to get an answer on approval. To try to find out, I called and asked.
The first person I spoke with told me that getting approved for January shouldn’t be a problem, as long as my application was received by the 25th of the month. The operator said that every application received has to be processed by the 25th. To make sure my application gets there in time, the operator recommended that I drop off my application in person. He gave me the address of where I need to go.
I asked what hours the drop-off center has and the operator said he did not know, I will have to call them. So, I do. The operator at the drop-off center tells me that if I am a first-time applicant, I can’t drop off my application in person. Hmm. I am confused by this conflicting information. I decided to mail in my application, rather than drive half an hour to an office that may turn me away.
It is past the 25th, so I called the state to check on my application. An operator who obviously hates his job and his life answered my call. He had the vocal intonation of someone who has no interest in helping anyone. I am guessing that at some point, maybe he did want to help callers, but now has been beaten down by his job and has become bitter. This man told me that it takes 25 business days to process an application and I am not even in the system yet. I explained that someone else I spoke with told me that all applications have to be processed by the 25th of every month. He repeated that it takes 25 business days. I asked what happens if I get approved in very early January, as I am wondering if I will then be covered for the remainder of the month. He repeated that it takes 25 business days and if approved, I will become covered on the 1st of the following month. This guy was really stuck on this 25 business day thing. Information which, again, conflicts with what I was previously told.
As it feels hopeless that I will receive an answer in time, I decided to purchase a health plan for January. After selecting a plan, I found out that it is too late in December to buy coverage for January. I tried to call one of the health plan companies directly to see if maybe I can get coverage if I talked to an actual person. Guess what, you can’t speak to a person at the health insurance company unless you are already a member. It appears that I will be uninsured for January. This is not good.
Goldstein, S. (2013). Applying for State-Assisted Health Insurance, Part 1. Psych Central. Retrieved on October 7, 2015, from http://psychcentral.com/lib/applying-for-state-assisted-health-insurance-part-1/