Mama's Got a Plan:

Maternity Care, Health Insurance, and Reproductive Justice


Success! I greet the new year with new health insurance ID cards in hand. Many of them, in fact. How did that happen?

Pre-Affordable Care Act

Until December 1, I was covered by an insurance plan purchased on the individual market. This fall, I received notice that the plan would be discontinued because it did not comply with the ACA. I did not mourn this plan. As mentioned in an earlier post, the only thing going for it was its merely moderately high premiums.

My insurance carrier repeatedly urged me to buy an alternate “Keep Fit” plan. However, I knew  that my federal tax credit would almost certainly make a plan purchased through the Marketplace a better bargain. The Keep Fit plan’s other disadvantage was its notice of “lower deductible and fitness reward if you meet certain health standards.” Translation: your fitness activities and health standards count for nothing if you’re fat. Much has been written about the discriminatory nature and lack of evidence basis of such a restriction, both by the Health at Every Size and Size Acceptance communities as well as those critical of the Workplace Wellness provisions included in the ACA. I hope to return to this topic in a future post; for now, let me simply say that I knew the “Keep Fit” plan was not for me.

Temporary Insurance

To cover the gap from December 1 to January 1, when I expected to obtain Marketplace coverage, I purchased temporary insurance. This is a tactic I’ve used in the past; I mention it here because it can be a useful stop-gap. I did not expect to need any medical care in December, and I made sure to take care of any existing dental problems beforehand. The temporary insurance, which I obtained from the agency that provides our car and property insurance, was simply a hedge against catastrophe. If, for example, I slipped down the stairs and needed brain surgery, the insurance would kick in after a certain amount to ensure that our family did not lose all assets in a medical emergency – a reasonable fear, given that a majority of U.S. personal bankruptcies are precipitated by a medical emergency. The temporary insurance doesn’t pay for any routine care, so it is not suitable for everyone. But it bought me peace of mind for a month.

Enrollment – check! Payment – uh…

As reported before, through the federal Marketplace I successfully enrolled in a new plan from my earlier insurer and was told to expect a bill within a week. But when I opened the bill that arrived several days later, I was surprised to see a premium 50% higher than the one I had been quoted. Some small portion of this was due to federal and state taxes, but the remainder still constituted quite a large difference. I immediately got in touch with by online chat, was referred to the special hotline – only to learn that once I purchased a plan from the Marketplace, I was essentially on my own. I tried to imagine what it would be like if I bought a plane ticket from Orbitz, for example, and then found that the airline had raised the price of my ticket 50%.

Next stop: the insurance company. After I waited a very long time on hold, the customer service representative easily explained the problem. I had missed the reference to “Keep Fit” on my bill. Remember Keep Fit? The plan I did not purchase? Apparently the insurer decided to enroll me without my permission and then billed me for it.

The problem was easily remedied: I was instructed to simply ignore the bill. Imagine, however, that I had dutifully paid it. Now multiply this error by however many former customers the insurer mistakenly enrolled in this plan. I’m sure reimbursement would have been possible after considerable time and effort, but the insurer would have had the use of money not its own for some time – and presumably reaped the benefit in interest.

My many cards

The problem is solved. I eventually received a bill for the plan I actually selected, and I set up monthly payments through my bank account. My premiums are considerably lower now than they were for my pre-December high-deductible plan. With the money I’m saving in premium payments, I plan to pay off debts to various health care providers, all of whom have been remarkably patient. I look forward to scheduling an appointment with my doctor – the first in over a year. For the moment, life is good.

The insurer sent me four different sets of ID cards, including ones for the mistakenly-assigned “Keep Fit” policy. The cards have now been dealt; I look forward to seeing how the game plays out.


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