Affordable Care Act Appeal Process is Terrifying

I haven’t seen any other posts on this topic, so let this serve as a warning/informational piece. I was turned down for ACA support for 2018, I was too sick in 2017 to complete some needed paperwork in time. I filed an appeal as soon as possible, early January. Since then I’ve been asked for more and more and more documentation, and been steered into some strange dead ends as well. Finally they said a bit more than a month ago everything was complete and a determination was about to be made. Nothing. I called and called,

last week a representative stated it was the craziest appeal she had ever seen, she used the word “insane” and promised a supervisor would contact me within 48 hours. Nothing. I called today and all she can say is sometime it will be determined. No explanation, nothing other than they need time to be sure to make the best determination. I pointed out six months was too long. She tried to tell me they’ve had the appeal only since January 22 so it was only four months. Four months from Jan 22 actually would be May 22 – but that seemed like an argument too bizarre to continue.

Of course, once the appeal goes through,If it’s in my favor, I wait for the insurance company BCBS to reimburse me. And I’m certain that isn’t a quick process.
I asked her to note in my file that if I don’t hear back this week I’ll contact my elected representative for help and to let them know how bad the process really is.

The part that brings me anguish is what in the world does a person without resources do? The vast majority of Americans have a few thousand in savings at most. A case just like mine could have required over $12,000 in expenditures that may or may not ever be reimbursed – or much more. Yes, this is the sort of system that kills people. That is very real to me right now. Maybe sharing the story will help, maybe going to Dingell’s office will make this more obvious.

I am profoundly lucky, and absolutely privileged. I never imagined that would in fact save my life. If you think sharing this would help in any way, please do.

Health care in this country is indeed insane, and here is just one more example. My own illness and brush with death was pretty terrifying this last year. But so is the health care “system” that I’ve reluctantly become a participant in.

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