Just When I Thought I’d Solved My Health Insurance Issues…

A few months ago I wrote a number of posts detailing my personal travels within the individual purchaser health insurance system.   For background reading, they are:

Finally  – A Real ACA Data Point

I Am The Guy Getting Screwed By The Affordable Care Act

NH Insurance Dept Market Study

Daniel Kahneman Can Solve Our Healthcare Problem

“Affordable” Health Care

I Have Solved National Healthcare

The President Lied To Me – ACA Edition

Health Insurance Needs Reform

My Health Insurance Bill Just Increased By 48%

“So, Kid Dynamite,” you’re wondering, “what did you end up doing about your health insurance?”

Well, it turns out that there was a law already in existence in a number of states, New Hampshire included, where if a member renews his plan before a certain date (in NH it was Nov 15th, and then pushed back to Dec 1st), he can keep his plan for another year.   In other words, I renewed my current, NON-ACA-compliant plan early (in December instead of in January) and thus my ACA Day of Reckoning is postponed for another year.   This was not without difficulty – I spent 3 hours on the phone to get this done, with a small monthly premium increase.   But I like to dot my i’s and cross my t’s.  I asked the Anthem agent who was handling the renewal how I’d know that it was done correctly: I didn’t want to wait until the renewal was supposed to take effect, find out it wasn’t done right, and then get the “it’s too late, you’re screwed” treatment.  My Anthem agent told me that if I called back in 3 days, I’d be able to speak to someone who could confirm that the renewal had been processed.

So I spent another 90 minutes on the phone 3 days later getting an agent to confirm for me that, in fact, the renewal had NOT been processed correctly.   It’s a good thing I called.  But wait: the rate I was quoted was no good – it was 10% higher.  I explained to this new agent that I was in a bit of a quandary: I had already been told that I was all set, and now I was being told that in order to be all set I’d have to pay 10% more.   She nodded sympathetically over the phone with hemming and hawing, telling me this was how it was, and promised that my renewal would be done correctly.  I asked to speak with her supervisor – not to complain about her, but to complain about the process – and she promised me a call back.

Three days later I still had no callback, so I dropped an email to the president of Anthem NH, who I had corresponded with previously.  I must have caught her at her desk, because she replied instantly, asking me for more information, and 3 hours later my phone rang: it was the supervisor who had neglected to call me back.   He apologized profusely and assured me that he would put through my renewal. WHAT?  I explained to him that I’d already been assured that the renewal was put through, but whatever – who knows what’s going on behind the scenes there.   This supervisor was also the head of retention for several states for Anthem, and I told him that if he wanted to retain me as customer, he had better find an option that allows my wife and I to keep our doctors with Anthem’s new Pathway (narrow) Network.

Fast forward to today. I get a letter in the mail from Anthem which explains that, emphasis theirs:

“The ACA calls for certain dental coverage benefits for children as one of 10 required “essential health benefits (EHBs).  All members, no matter what their age, gender (male or female), or parental status (kids or no kids), must have all 10 essential health benefits, including pediatric dental coverage.  Starting on January 1, 2014, you are required to have coverage for all EHBs.  In order to ensure you’re following this new requirement, we’ve enrolled you in our Dental Pediatric essential health benefits plan, which will start on January 1, 2014

They then add:

“Monthly premiums for this plan are $5.94 per month per member.  We will send you a bill in the coming weeks that will reflect these benefits.”

Oh no you won’t.  No. No friggin’ way.  See, I already have a plan that does NOT have all 10 essential health benefits.   I have a plan that’s NOT ACA compliant.   If I’m not getting maternity coverage, I’m sure as shit not paying for pediatric dental coverage for children I don’t have.

Anthem also notes that if I already have dental Essential Health Benefits coverage through another company, I can opt out via this form.  Now, see, that just makes me angrier.   It’s one thing to just jam the cost of pediatric dental insurance for those who need it into the cost of my plan – that’s how insurance works: we pay for some things we don’t need – but if you’re going to let people opt out, you should let everyone without kids opt out.   To my lawyer-readers: would it be a bad idea to fill out that opt-out form and write something like “No Kids Inc” as my insurer?  Or to write “Kid Dynamite Self Insurance Agency” and explain to them that I write dental insurance (for my own non-existent kids) on the side?

Kid Dynamite,” you’re about to say, “this is what we have been complaining about regarding the *entire* Affordable Care Act – no one should be forced to buy insurance they don’t want.”

I don’t really want to debate that point in this post, but I disagree with it somewhat: no one should be forced to buy insurance they can’t use… I am not against mandating health insurance coverage because, as I’ve noted previously, we as a society are not willing to deny treatment to those without coverage.   Since we’re going to treat those who don’t have coverage and who cannot pay for care anyway, I don’t have a problem with the desire to mandate coverage.

This pediatric dental essential benefit is different:  there is no possible way that society can be asked to bear the cost of pediatric dental benefits that I am unable to pay, because I cannot possibly incur those benefits, because I do not have children.   This discussion can get off the rails pretty quickly, and it’s really not what I wanted to debate in this post (ie: an immediate logical response is: “KD, why should single men have to pay the same insurance premiums as single women under the Affordable Care Act, when women get benefits like maternity coverage that men cannot possibly use?”    I have no good counter argument.)

If the Government’s goal is to make pediatric dental coverage cheaper for those who need it, then make everyone with every plan pay for it.   Call it what it is:  a tax.   But don’t force it into my health insurance under the guise of “Essential Health Benefits” that I’m already NOT receiving in my plan…

My wife and I don’t have dental insurance for ourselves.   The $144/yr Anthem wants to charge us for the pediatric coverage for the kids we don’t have is the worst kind of insult, and would cover roughly 1/4 of annual dental costs for my wife and me.

Stay tuned for how my discussions with Anthem on this topic go…

EDIT:  after speaking with the regional supervisor, he confirmed that I got that letter because Anthem had processed it before they processed my early renewal.   In other words, had I been rolled into one of Anthem’s new ACA-compliant plans, the letter would have indeed applied to me.  I’m still mind-boggled by the meta-physics of exactly WHO this *separate* pediatric dental policy would cover:  how can one buy a policy on people that don’t exist?  I thought that was insurance fraud.   Anyway – I’ll leave it to one of you other affected Anthem customers out there to pick up this torch and run with it:  call dental insurance companies, ask them how much it costs to buy pediatric dental insurance for children that do not exist, and record the results…



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