In 1969, Robert Lamm of the rock group Chicago sang:
“Does anybody really know what time it is?
“Does anybody really care?”
In 2014, these are the questions which I am asking myself after my experience signing up with NY State of Health.
There are some people out there who care, who are trying to do a good job and help you out.
But as far as the time is concerned, that is another story.
Are prescription benefits covered from Day One or do I have to meet a deductible first? Are there any plans that cover dental and vision? Does anybody really know what time it is?
Healthcare Navigator 1 — of three — did not.
In the middle of a crowded hallway in the science building of a college campus, she is sitting behind a tiny folding table set up next to a soda machine. During the next three hours, students will randomly interrupt our meeting in order to ask for change of a dollar. Her laptop will crash multiple times, then it will run low on battery power.
There is no outlet where we are sitting. I suggest unplugging the soda machine. We eventually move to a nearby lecture hall. She plugs in her laptop. Her computer is working again, but she has no answers to my questions.
She is a polite, soft-spoken, middle-aged lady, the type of person it is difficult to get angry with … except that now it has been more than two hours. The hallway is empty and my application is still incomplete. There will be no discussion about Gold vs. Silver, Platinum or Bronze. No discussion about what each specific plan has to offer — only more failed attempts at communication.
And as it is becoming clear to me that my questions will not be answered, that my application will not be finished on this day and as I am still struggling to understand how the tax credits work, she tells me I am going to qualify for Medicaid.
She has only asked me for paystubs from Jan. 1 to the present, paystubs that reflect another bleak winter in the seasonal occupation of being a professional musician. For a moment, I am delighted at the thought of having free, state-paid health insurance, but I know it is a mistake.
I explain to her that my work is seasonal and I will make more money later in the year. It does not matter. It has been three hours and it is time to go. The campus is quiet now and her kids are calling on the cellphone. She is running late for a dinner appointment. That application would never get finished.
The following week, after a futile effort of obtaining and faxing paperwork to Navigator 1, I decide to start from scratch.
I will reach out and meet with Navigator 2. I will find myself sitting next to the same soda machine, with different students asking us for change, but the result will be better the second time around, and for a moment I will feel sane.
But the end of the meeting with Navigator 2 is rushed, and I do not have adequate time to properly select a specific plan. It does not matter, I am told, because I can change my coverage at any time.
No one seems to be able to agree on what time it is, whether it is a navigator, an insurance company, or NY State of Health.
Not even a supervisor. When I called 1-855-355-5777 April 1, less than 24 hours after open enrollment had ended, I was looking for guidance and insight from a healthcare reform professional who could point me toward the right plan.
I did not expect to be told that I cannot change plans because open enrollment was over, nor that a supervisor would tell me that I needed to file a report that would indicate I had had a “life-changing event” that would qualify me for “special circumstances.” Huh?
The following day, Navigator 2’s voice mailbox is once again full and I cannot leave a message, so I call the insurance company directly: “There is nothing we can do, but why don’t you reach out to Navigator 3?”
Navigator 3 is sympathetic to my plight but tells me there is nothing she can do, that I will have to wait for a “determination” to be made.
Everyone agrees that none of this makes sense, yet no one can do anything! And so I am resigned to await the outcome of the report which I have made at the behest of a NY State of Health supervisor.
Navigator 3 does something, though, that not many people do. She calls back. She cares. She has the answer. After spending the next hour digging through an inbox inundated with e-mails from no-reply@nyexchange.org, I will find the elusive “invitation code” and wrestle nine times with the captcha lettering.
Finally I am in! Click on “Plan.” There it is. The magic button. The button that no one seems to know about. “Change Plan.”
At the end of the day, I will end up paying roughly the same for health care as I have done for the past 15 years. Some will pay less, some more.
The state Health Department announced that more than 865,000 residents across the state are now enrolled in health insurance through the U.S. Affordable Care Act, and that 38,000 people successfully enrolled March 31 alone.
The system is far from perfect, but it will improve, as will my mood.
And so I ask myself, “Does anybody really know what time it is?”
Yes. Time to find a new doctor.
Jeff Lubin
Little Neck
