SandeeD 363 Posted December 2, 2013 I had to appeal their denial for a subsidy because I DO qualify for it! (I make under $40,000 a year). I submitted my appeal over two weeks ago, heard nothing. I called and no one knows anything...appeals department is in a different location, we have no phone number for them, blah, blah, blah...the runaround! I have insurance right now but it doesn't cover bariatric surgery until I'm on the plan for year (which won't be until April 2014), AND, they're canceling that policy as of April 2014 because it doesn't abide by the new health insurance laws. To top it off, if I decide to purchase insurance outside of the Marketplace I then forfeit my subsidy (IF I get it). I called to get the status and they are now telling me it will take 90 days to get their decision. I AM BEYOND FRUSTRATED RIGHT NOW!!!!!!! I want them to just tell me something so I can move on either way!!!!!! Share this post Link to post Share on other sites
1Day1Life4Now 882 Posted December 3, 2013 If you research the national health plan in Canada or the UK, the folks will tell you this is how it works. Its a waiting game and they aren't going to be in any hurry to spend money on us. I can't understand why you would have to be on the new plan for a year since they told us they were doing away with the pre-existing clause. I am hoping my surgery takes place before the government messes up my insurance. Good luck to you. Share this post Link to post Share on other sites
SandeeD 363 Posted December 3, 2013 Apparently the plans prior to 2014 are what they are, they are not making changes to them. Basically, they getting rid of the "old" plans prior to the health change laws and replacing them with "new" expensive plans that have to cover more stuff. Share this post Link to post Share on other sites
SandeeD 363 Posted December 3, 2013 I'm going to wait it out as long as I can (keeping my current plan that ends on 4/1/13). If I don't get an answer on the subsidy by March, I'm going to have to purchase something on my own. Share this post Link to post Share on other sites
Beach Lover 1,084 Posted December 3, 2013 I'm afraid many people are going to be going through the same thing that you are unfortunately experiencing. I truly hope this gets straightened out so you can move forward! Best wishes!! Share this post Link to post Share on other sites
SandeeD 363 Posted December 4, 2013 Thanks a lot. I've made the decision that if I don't hear something within the next two weeks, I'm just going to purchase new insurance and take the hit. I can't wait longer to have this surgery, my well being depends on it. Share this post Link to post Share on other sites
Tropical.Lover 24 Posted December 23, 2013 Thanks a lot. I've made the decision that if I don't hear something within the next two weeks, I'm just going to purchase new insurance and take the hit. I can't wait longer to have this surgery, my well being depends on it. Go girl !!! Wish you the best ) Share this post Link to post Share on other sites
SandeeD 363 Posted December 23, 2013 Thanks Tropical! Since that post I have upgraded to one of the new Horizon BCBS of NJ plans that will in fact cover the surgery. If I didn't do that, I would have had to wait until April 1 which is when my current plan would renew and it would be the one year I needed to be eligible to have any pre-existing conditions covered. Originally HBCBSNJ was not going to renew that plan, but I recently got a letter stating that since President Obama had promised us that we could keep our current health coverage, they decided to allow the policies to be renewed. I didn't want to take any chances, so I went ahead and got one of the new policies. It's way more money, but when I file me taxes in February, I'll be able to apply for a subsidy (which will lower the cost). One more week of pre-op stuff in January, then I can submit! Share this post Link to post Share on other sites