OUR ENVIRONMENT NEEDS MORE LOCAL REPORTING

The Concord Monitor is launching its Environmental Reporting Lab, a long-term effort to better inform the community about the New Hampshire environment. To launch phase 1 of this effort, we need your help. The money raised will go toward hiring a full-time environmental reporter.

Please consider donating to this effort.

 

Tales from the front: enrolling in Obamacare in New Hampshire

Last modified: 3/3/2014 12:26:36 AM
Despite Obamacare’s rocky rollout, almost 17,000 people in New Hampshire had signed up for health insurance through the federal exchange by Feb. 1.

Many received subsidies to help pay for coverage, and they say the financial help – and their peace of mind – more than make up for the headaches of enrolling.

But the headaches were plenty – with the website, with the technical difficulties and with Anthem Blue Cross Blue Shield, the only insurance company selling plans on New Hampshire’s exchange this year.

And for many people, they’re not over yet.

Uncertainty looms

Headaches – technically, a neuropathic itch – are exactly why Lyn Betz of Bradford was eager to sign up for health insurance through the exchange. The itch is a side effect of the tumor removed from the base of her brain four years ago.

Betz is an interning minister at the Unitarian Universalist Church of Concord and doesn’t have employer-sponsored insurance.

With insurance companies hesitant if not hostile toward writing policies for her, she’d have to wait 10 years from her first clean MRI to get a plan on the open market.

“That’ll be 2020. That’s just too long to go without insurance. I’m 52. There’s a decent likelihood I will need health care before then,” she said.

When she quit her full-time job in 2011 to go back to school, she got insurance through the state’s high-risk pool. She expected to transfer to the exchange when it opened this year.

She sat down at her computer right after the website went live last October.

“I quickly surrendered,” she said. “I watched the news for signs that the website was working before I tried again.”

When she did, in November, her application went smoothly. A snag over entering her sons’ names was resolved with a quick phone call. Her new plan is about $540 a month, instead of the $700 she was paying last year.

It looked like blue skies ahead, she said, until Jan. 1 came and she didn’t have her new insurance cards.

She had medication she needed to pick up, and no proof of coverage to offer the pharmacist.

The medication can’t eradicate her neuropathic itch, but it does help, she said. While she waited first for her insurance cards and is now waiting for Anthem to approve her prescription – it’s not on the covered formulary – she pays $100 a week out of pocket.

“I do kind of resent the fact that in order to get a medication approved, you have to go backwards and prove that you’re unhealthy on other meds. I’ve already tried everything under the sun, and I expect they will approve it. But it irks me to think I will have to pay for all the weeks that my appeal was sitting in the backlog,” she said.

She expected some hassles, the kind that happen whenever you switch insurers. She just didn’t expect the hassles to be quite this hard.

“I dissolved in tears the day before yesterday, on the phone with Anthem,” she said last week. “When it’s your health, when you’re uncomfortable, and you’ve got somebody on the phone who can’t answer your questions, that was a definite low moment of feeling like I was up against a corporation that was much more concerned with their bottom line than with my well-being.”

She doesn’t know yet if her doctor will take the Anthem plan, which uses a limited network that doesn’t include Concord Hospital or its physician practices.

She doesn’t know if she’ll get reimbursed for the weeks of paying out of pocket for her prescription, and she doesn’t know if she’ll have to go through this all over again when she – hopefully – gets employer-sponsored coverage at a Maine church this fall.

She hesitated before answering when asked if the $200 a month savings was worth the fight.

“It’s all very exciting, that’s what I keep telling myself. I’m doing a job I completely love, and I wouldn’t have gone back to school if I didn’t know this coverage was coming. But it still feels, to me, like tweaking a bad system. I don’t think the Affordable Care Act goes far enough, because I’m a firm believer that healthy people are a social benefit that’s worth paying for with our tax dollars.”

‘Time to breathe’

Keri Wolfe, 27, didn’t start looking at HealthCare.gov right away when it went live in October. She was hoping the state would expand Medicaid to healthy low-income adults, as allowed under the Affordable Care Act, and that she might qualify for health care that way.

Despite working and volunteering between 55 and 60 hours a week teaching history and writing courses at NHTI and Granite State College and providing child care, she was making just above the federal poverty limit last year, she said.

When a special legislative session failed to reach a consensus on an expansion plan in late November, she sat down to enroll in an Anthem plan on the exchange.

By then, the technological kinks had been worked out and the one glitch she ran into was solved with a 10-minute phone call to a government hotline, she said.

Her premiums went from $680 a month – more than her rent and heating bill combined – to $66.

“It’s been a godsend. My car needed a significant amount of work at the beginning of February. I was barely breaking even in the fall. With the car troubles, I would have been really bad,” she said.

But, she said, “it’s been a little bit of a different story dealing with Anthem. They clearly had some backlog. It sounded like they were not quite prepared to handle the rollout.”

The company lost her check paying her first premium, so her coverage was delayed. Like Betz, she didn’t have the insurance cards she needed to get her prescriptions covered in January, but with a pre-existing endocrine disorder, she couldn’t wait. So she has her receipt and she’s waiting for reimbursement, without any sense of how long it could be.

And like Betz, she’s happy to be doing work she loves, even though it’s work that doesn’t come with health insurance.

“This is where I was hoping to be,” she said. “Having my current coverage, it will afford me the opportunity to start saving and even to start considering changing my life that drastically” by settling down or starting a family.

“In my current state, how I’ve been living with the added health care costs, that hasn’t been something I could even consider. I haven’t had enough of a financial back-up. This will allow me to plan, to take some time to breathe and re-evaluate.”

‘Nightmarish’

Kurt Steelman is still waiting to exhale, waiting for word that his family of four will have health insurance this month.

“It’s been a nightmarish time trying to make this all work,” he said.

After logging on Oct. 1 and spending an hour going around in circles while the pages tried to load and kicked him out, he waited until after the new year to try logging on again.

That time, the system deleted the entire profile his wife created for their family, which is in Keene. After she re-created it and the government system sent a letter approving them for a subsidized plan, Anthem contradicted the letter, saying the family doesn’t have approval yet.

“So we’re probably going to live the month of March without insurance,” he said.

With two sons ages 12 and 7, not having insurance during snowboarding season is “not a very welcome thought.”

He’s going to keep working to get through the bureaucracy, though. He and his wife both run their own businesses, one a concert production company and the other an event rental company.

The plan he thought he bought from Anthem was $774 a month. Last year, they were paying about $1,200 a month for insurance – “just slightly less than my mortgage.”

“It gets to the point that you’re working just to pay the insurance policy,” he said.

“I won’t give up. It’s a typical government agency,” he said. “If it comes through, I’ll be impressed, but at the moment, I’m not very impressed.”



(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

This article has been corrected as follows: Lyn Betz had a non-cancerous tumor at the base of her brain. It was incorrectly described in an earlier edition.




Jobs



Support Local Journalism

Subscribe to the Concord Monitor, recently named the best paper of its size in New England.


Concord Monitor Office

1 Monitor Drive
Concord,NH 03301
603-224-5301

 

© 2021 Concord Monitor
Terms & Conditions - Privacy Policy