The Health Insurance Marketplace: One Nurse's Journey

Thanks for this suggestion for us to try to navigate the marketplace.

I have navigated the Marketplace. Due to a few physical ailments, I am not able to work at the present time. In my case, I qualified for my state's Medicaid program. No cost to me, but I had to choose a MCP (Managed Care Plan) to administer the healthcare. After I choose my PCP and MCP, I was sent my insurance card with neither of my choices on there. They had chosen for me, even though I made my choices well before the date specified. The resolution involved calling the state Medicaid ffice and informing the CSR of my choices and then they sent me a new card. The differences I have noticed from having regular Medicaid versus the MCP is just about everything has to have a preauthorization, which will also get you a denial for whatever service you need to have done.I did a simple appeal over the phone to a CSR at the MCP, and the denial was reversed. It's better than having nothing at this point.

I like our system. Someone gets sick or hurt, they will either get taken into the hospital by a friend or ambulance. If its an accident the cost of the ambulance will be covered by ACC, if its a medical emergency the person will have to pay $80. The only other costs may be a taxi/ambulance home from hospital

I was between insurances. I checked out the marketplace. Or at least, I attempted to....I began registration, I was asked a lot of personal information....as in...."which high school did you attend out of the following high schools" etc. That upset me. I'm waaay post high school. "Which bank do you use for your checking/savings account out of the following...?" Huh? Becoming very, very creepy!! After inputting everyone's info, over and over again, the website froze, and I was unable to continue. Six more attempts over 3 weeks. Hours and HOURS. Nothing. Called the marketplace number for assistance...informed it would be bumped up to a specialist and I would get a call back within 5 working days. No call back. Contacted an insurance rep. She attempted to register my family...no luck...it froze in the process. She called them. No assistance. I attempted again. Froze again. Then, an insurance agent let me know how much my deductibles would be and my premiums. Eeeeek. That was the end of that for me.