Cancer patient’s insurance still on hold

By Katie Kerwin McCrimmon

Cancer patient Donna Smith is stuck in limbo again.

Smith has been trying to buy health insurance through Colorados exchange since opening day on Oct. 1.

She worries now that she might not have her new health insurance on Jan. 1 as she had hoped. Smith, 58, is a two-time cancer survivor now facing a relapse.

Its frightening. Its maddening, said Smith. I cant go without insurance.

Back in October, Smith struggled to create an account because Colorados exchange, Connect for Health Colorado, had some IT glitches when it launched. A few days later, Smith filled out an extremely long Medicaid application, then had to wait 37 days to get a denial from Medicaid. She went ahead and picked a plan in November. Then Colorados floods forced Smith and her husband to move from Castle Rock to Denver. And now, the Connect for Health agents told her that changing her address is not a simple matter and that she may no longer qualify for the Kaiser plan she picked, even though her new home is less than a mile from one of Kaisers Denver medical offices.

Smith is stuck waiting for a written confirmation before she can confirm her Kaiser coverage, mail a check and start to make appointments with doctors for care in January.

The uncertainty and the challenges of the sign-up process have been infuriating.

Im now in a different level of limbo. Its like Dantes Inferno. You just keep going to a different level and thinking, Is this it? Are we stuck here?

Smith testified before Colorados health exchange board last month about her sign-up ordeal. Board member Steve ErkenBrack, who is also president of Rocky Mountain Health Plans, has continued to raise concerns about Smith and patients like her who need seamless health coverage and cant afford not to be covered come Jan. 1.

Smith thought she was all set last month when she got her Medicaid denial and picked her plan. Her husband qualifies for Medicare and she works for a small nonprofit that doesnt provide health insurance, so she needed and individual plan.

She qualified for a small federal tax subsidy and found a mid-level plan for $450 per month, a dramatic reduction from the $875 that she is now paying for a plan through her former employer.

Smith has been sharing her struggle to navigate Colorados health exchange with Solutions. (Click to read the previous stories: After 37-day delay, cancer patient gets insurance and Stuck in Colorados black hole.) Smith also appeared in Michael Moores movie, SiCKO, and updates her situation on her blog.

Now settled in her new apartment, Smith initially tried to change her address through her online account with Connect for Health. The system would not allow her to do so. She called Dec. 4 and waited on hold with 26 people ahead of her for about 25 minutes.

An agent tried to make the address change himself, was unable to do so, checked with a supervisor and found hed have to put in a ticket to have it done.

That worried Smith because there was too much room for error. She wondered, Why couldnt she simply make the change herself?

Then the agent told her more alarming news: that she might have to switch plans but shed have to wait for a confirmation letter to do anything. She expected it to arrive within five days, but it has not appeared and the online account shows no change of address.

Smith doesnt recall the agent mentioning that Colorado has anonymous shopping and she might be able to feed in her new Zip code to see what plans might work for her if she has to switch again. Colorado exchange managers are very proud of the anonymous shopping option that allows people to get quotes by Zip code. Federal exchange managers have since launched a similar feature on www.HealthCare.gov that they are calling window shopping.

When Smith goes to Connect for Healths website, it automatically takes her to her account and she cant search for different plans.

Smith is trying to be patient and wait for her letter. But with wait times for call center customer service agents now exceeding 30 minutes, she doesnt want to call back.

The people are very nice. To a person, theyve been very kind, but Id rather have my head pounded against a wall than listen to that Muzak again, Smith said.

Her husband has suggested calling Kaiser directly, but they may have no clue who she is or that she selected them for care.

Ive been told that once I paid that premium, I could call.

For now, Smith remains stuck.

The saga continues, she said. Its almost like a little bit of a betrayalespecially when youre needing to get care. For some people this can be life-threatening stuff.