[Fourth Edition] Health care adventures
Fair warning, we’re going a little far afield this week and peeking a bit behind the curtain.
This week’s newsletter is a day delayed because my early week has been eaten with dealing with the American health insurance racket.
It’s far better than in the olden days, but one of the primary concerns with going out on your own - especially with a family to support - is how to secure health insurance to cover all the doctor’s visits and untold emergencies that might befell your family.
When you have a regular employer, those typically come with insurance as part of the deal. When you have no employer - or the employer is yourself - it’s on you to go find health insurance. Or, you can pick up the very expensive continuing coverage (COBRA) that your employer might have made available if your employment was “involuntarily terminated”.
The last time I went through this it was the early days of the Affordable Care Act, and I used an agent to help me through the process. I have fond feelings from those days as that legislation and the resulting marketplace really came through for us.
This time, I decided to go through the process myself.
And it’s been an unmitigated disaster from tip to tail.
Firstly, the portal seemingly didn’t let me pick a plan until my last insurance expired - so I went and enrolled on February 1.
But then, plans don’t start until the first of the following month. So, March 1.
That wouldn’t do because the kids had appointments and whatnot, so I asked for a waiver to push the start date back to February 1 - and went ahead and paid the premium.
It wasn’t until the appointment near the end of the month was coming up that I grew worried that everything from the insurance provider was still saying March 1 as a start date.
Three hours of three-way conference calls - with the marketplace, the provider and me - and I realized we were stuck. Because the marketplace had already sent the documentation, but the provider seemingly didn’t get it or lost it … and the marketplace couldn’t resend it.
So, we changed the kids’ appointments to March and tred carefully for a week or two.
Now, we’re in March, and we can finally use our shiny new self-owned health insurance!
My son goes for his annual checkup - preventive care all the way - and we get hit with a bill.
That’s weird.
I call to appeal the claim denial - the denial saying our pediatrician of many years was out of network when I had picked the plan that felt like it most closely resembled my employer plan from the provider to the structure and everything else.
Turns out: They are somehow out of network for this plan.
Turns out: All of our regular doctors are out of network for this plan I picked for myself.
I literally picked an insurance plan that doesn’t cover anything my family needs.
facepalm
And, in a fresh round of phone hell, I discovered that I am no longer within the 60-day period after a qualifying event - my layoff in this case - where you can change your marketplace plan.
Luckily, I was within the 90 days where I could elect that pricey COBRA coverage and wait out the year before I can take another crack at it for next year.
But I’m essentially out the one month of this plan I just canceled today.
A costly $1,100 mistake when I’m just starting this business.
A few tips/notes should you go through this yourself:
1. Get help: There are healthcare marketplace experts out there. They’re generally free or inexpensive to work with. Talk to other freelancers or very small business owners in your network to get recommendations.
2. Always check if your provider is covered by the plan: Don’t do like I did. Don’t assume because it’s the same provider and plan type as what you had before that it will still be in-network.
3. Work quickly: You have a limited amount of time past a qualifying event where you can make choices. Get on this work as fast as you can after a job loss or similar.
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On the blog later this week:
I had a past colleague of mine - in the executive suite - who had an odd fascination with hackathons.
I suspect I have rather contrarian views on such things, and we’ll talk this week about how I view them and why I generally distrust them.
And how to do them if you must.
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To close, Happy Tuesday!
We don’t often get to chat on Tuesdays, the week’s true middle child.
Mondays we all stereotypically dread.
Wednesday is hump day.
Thursday is practically Friday - the weekend growing so close we can almost taste.
Friday is the best day to deploy software (everyone knows this … and if not, wait until next week’s blog).
But Tuesday? What’s Tuesday ever done to somebody?
Tuesday’s the breathing day. The pause in the week. The day to get shit done.
So, go get after it if you haven’t already.
Or not.
It’s your life, and I trust you to live it and do your best with what you have.
As should you.
Stay crispy, folks!