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justgamma

(3,660 posts)
Tue Jun 24, 2014, 12:04 AM Jun 2014

Have any of you used the ACA?

Do you know anyone who has? I have issues and I'd like to know if I am the only one. We have/had a choice of 2 insurance companies. Coopportunity or Coventry. I'd like to know which they chose, because I want to know if I'm the only one who got royally screwed by the insurance company.

Thanks all.

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Have any of you used the ACA? (Original Post) justgamma Jun 2014 OP
Royally screwed how? Control-Z Jun 2014 #1
We have Obamacare. snot Jun 2014 #2
First, I am not blaming the ACA. justgamma Jun 2014 #3
We went with Coventry. progressoid Jun 2014 #4
That's who I chose. justgamma Jun 2014 #5
That's terrible. progressoid Jun 2014 #6
The end of May. justgamma Jun 2014 #7
CoOportunity here in the SW working as advertised. All of our Dr.s and Specialists included/covered. IADEMO2004 Jun 2014 #8
I know, that's what I can't figure out. n/t justgamma Jun 2014 #9
I too have been screwed by Coventry rurallib Jun 2014 #10
I looked into it this year 47of74 Jul 2014 #11
Update on my insurance. justgamma Jul 2014 #12

Control-Z

(15,681 posts)
1. Royally screwed how?
Tue Jun 24, 2014, 12:51 AM
Jun 2014

My future ex got a new shoulder last week requiring in hospital stay. Our cost for surgery and hospital comes out to around 5%. The surgery was expensive so maximum out of pocket/deductible was met.

Our old insurance would have cost a whole lot more (if even covered in the first place since it was elective surgery).

Our monthly premium is more than $500 less than we'd been paying. No complaints here.

snot

(10,475 posts)
2. We have Obamacare.
Tue Jun 24, 2014, 01:06 AM
Jun 2014

Prior to it, I was not eligible for insurance at all, except through I job I was trying to retire from; and that insurance was $300 more per month for less coverage.

I remain a single-payer advocate; but for many, including my household, it was at least an improvement.

I'd be curious to know what your non-Obamacare options were.

justgamma

(3,660 posts)
3. First, I am not blaming the ACA.
Tue Jun 24, 2014, 08:58 AM
Jun 2014

This is not about the ACA. That is a great thing. Couldn't get private insurance. This is about the insurance company.

I chose a plan that was affordable and was just what I needed. I was thrilled. After paying premiums for 5 months, I received a letter saying that they don't have any plans for this area and they shouldn't have been on the ACA website. This after I talked to a person about choosing a pharmacy. They paid a claim for my prescription.

They've been on the ACA website since last October and now in June, they decide it was a mistake? The people at the aca said they never heard of such a thing. They were really helpful, but I'm going to end up paying almost 3x as much a month. I've talked to 3 different people there.

I can't be the only person that chose that insurance company. I need to know if they screwed other people. because something is fishy about this.

progressoid

(49,758 posts)
4. We went with Coventry.
Tue Jun 24, 2014, 10:59 AM
Jun 2014

We went with them because one of my wife's docs accepted their plan.

So far, no major problems but we haven't had any big medical issues yet this year so...

After we signed up, they were slow to get us our materials. I think because they were unprepared for the flood of new customers. Also, they assigned a pediatrician as my primary care provider. That was easy to fix though.

justgamma

(3,660 posts)
5. That's who I chose.
Tue Jun 24, 2014, 11:56 AM
Jun 2014

That's why I'm upset. I think they are yanking my chain. They are the ones that told me their plans shouldn't have been on the aca website and I think they are lying. They told me I had to choose a different carrier. I'm not sure what to do, but I'm pissed. It's not like I had any big bills, just my medicine with a copay. I was paying them a lot more than they were spending on me.

progressoid

(49,758 posts)
6. That's terrible.
Tue Jun 24, 2014, 12:10 PM
Jun 2014

I read that Wellmark is backing out of the exchange in 2015 but haven't heard anything about Coventry.

When did you get this notice?

justgamma

(3,660 posts)
7. The end of May.
Tue Jun 24, 2014, 04:24 PM
Jun 2014

I only had 2 choices. Cooportunity and Coventry. Coventry was by far the cheapest. I still don't understand why they let me make 5 months worth of payments before kicking me off. I can't be the only one in this part of Iowa who chose them.

IADEMO2004

(5,538 posts)
8. CoOportunity here in the SW working as advertised. All of our Dr.s and Specialists included/covered.
Tue Jun 24, 2014, 09:13 PM
Jun 2014

Deductible and max annual out-of-pocket were met 3 months ago. $800.00 less a month than the non ACA Exchange plan we could have kept and chose not to keep.

I don't understand how Coventry can issue a policy and then say it shouldn't have been on healthcare.gov. Coventry issues the plan and healthcare.gov collects your information and figures credits. It's a Coventry's Plan.

rurallib

(62,328 posts)
10. I too have been screwed by Coventry
Wed Jun 25, 2014, 12:27 PM
Jun 2014

or more precisely Aetna who took Coventry over at the end of last year. Had I known Aetna had anything to do with it before I signed up I would have gone to Co-opportunity whatever the price.

I have written about this a couple times. In brief I signed up for a plan after checking with my new nurse-practitioner to make sure I would be covered. And so in February I went for my first medical check up in a decade thinking I only had a $10 copay. SURPRISE! I wasn't covered. In March I got a bill for a very expensive office call

I had spent about 40 hours screaming at people from Aetna just to get a policy. They were going to deny me and so I told them I was calling my congressman. 2 days later I had a policy but all my "network" doctors were in Cedar Rapids" about a 50 mile one way trip. My provider is apparently in the Aetna network, just not mine. It is fucking insane.

So I spent about another 10 hours screaming at various Aetna people and I did register a complaint with my congressman. Fortunately I have but 2.5 months until I get Medicare.

---------------
If you ever listen to Steph Miller, she has Jackie Sheckner on every Thursday at 10AM. Jackie helped write the ACA and is an expert.
According to what I have heard what what Aetna is doing is technically legal but sure unethical. People all over the country are having the same problems with all insurance companies.

So I will have a chance to see some congressional staff this weekend. I will pursue this further and I really want to do what I can to tarnish Aetna's reputation. But as you can probably remember the chairman of Aetna pretty much came out and said his company would do what it could to break the ACA, even while taking its money.

And no, this is not a problem with the ACA, it is a problem with the insurance companies who refuse toact in good faith.

 

47of74

(18,470 posts)
11. I looked into it this year
Wed Jul 2, 2014, 09:28 PM
Jul 2014

I remained with the company's plan but I did make sure to point out to them for just a little bit more than what we both pay together per month I could have gotten a platinum level plan instead of the joke they offered us this year.

justgamma

(3,660 posts)
12. Update on my insurance.
Mon Jul 28, 2014, 02:40 PM
Jul 2014

Got a bill from new insurance company for 6 months worth of premiums. Gahh! Called healthcare. gov. explained again that I had been paying to another insurance company who covered my medicine. So I was covered, but they kicked me off. Got that straightened out. Btw, those people on the.gov site are all friendly and very helpful.

Went to a meet and greet with Jack Hatch and talked to a state rep. He suggested I call Harkin's office. They had never heard of such a thing and urged me to send a complaint to the insurance commissioner. I did that and should hear back in 30 days. We'll see what happens.

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