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If the US health insurance fails: Without a lifebuoy in the Omikron tsunami

2022-01-11T17:16:29.447Z


The US health care system remains a farce, despite Obamacare. I noticed that now when my health insurance kicked me out unannounced - in time for the new corona wave in New York.


Enlarge image

Queue for corona tests in Manhattan (December 2021): New focus of the pandemic

Photo: Braulio Jatar / ZUMA Wire / IMAGO

Wanda, the office assistant, is friendly but determined.

"Sir," she says on the phone, which immediately makes me feel ten years older than I am anyway, "we have to cancel your appointment tomorrow."

Cancel?

For what reason?

"You are not insured."

Nonsense, of course I'm insured.

"No, sir." Again that address.

"They are not.

Sorry. "

The new year starts well.

With a routine check-up at the family doctor, which suddenly becomes anything but routine.

Confused, I try to convince Wanda otherwise.

I have, I assure you, only recently extended my US health insurance, which has remained unchanged for years, for 2022.

The insurance company has long since debited my January premium and sent me a new membership card with my name and my known insurance number.

Wanda is unmoved.

"The insurance company records you as 'expired'."

Welcome to U.S. healthcare.

This has always been a farce, but even more so now, when you are more often than ever undergoing basic examinations here from a certain age.

No insurance, no check-up, no special midlife treatment.

Not to mention falling off the ladder or slipping on black ice.

Almost all friends have Covid

That would be annoying enough. But now the omicron wave is also sweeping through New York City - my adopted home and the new, old focal point of the pandemic. Around 33,000 people are newly infected here every day. Including almost all of my friends and acquaintances. Like me, all of them have been vaccinated and boosted, and all of them have had mild symptoms so far. Still, I really don't want to catch that - especially not with an "expired" insurance policy. It's like jumping into a tsunami without a lifebuoy.

US hospitals must admit every emergency, a rule that is particularly popular in New York, with all the shootings. But the bill is just as reliable. (My last blood test, without any shooting, came to $ 1,700.13, paid for by the cash register.) And right now, in the hopelessly overcrowded clinics, you'd be forgotten in a bed in the hallway anyway. Even cancer patients currently have to wait, "silent triage" is an issue here too, and the uninsured are the very last in line.

In order to avoid such horror scenarios, I had made an extra effort and renewed my health insurance in December 2022, as it should be.

From Germany, where I was on vacation at the time, I logged into the website of my US insurance company, extended my cover unchanged for the coming year and, to be on the safe side, paid my first monthly premium in 2022, I also received a receipt.

I explain that to Wanda too, to no avail.

She refers me to the insurance company for all further questions and cancels my appointment.

"Happy New Year."

Nobody answers at the insurance company.

Advised waiting time: 47 minutes.

The elevator music makes it seem longer.

Finally someone picks up the phone: My "lawyer", as the health insurance company calls its customer advisor, is called Michael.

A rooster crows in the background.

At first I think he's crows somewhere near me, but there are no taps in this corner of Brooklyn.

Yes, Michael confirms, he's in the home office.

On a farm?

But back to your problem, “Mr.

Pitzkie «.

No problem, says Michael after I've complained about my suffering, and puts me on hold while he researches.

Michael types, the rooster crows

Another 45 minutes of elevator music.

Every now and then an automatic whisper is faded in: I should register for a routine check-up with my family doctor.

"Better safe than sorry."

Michael comes back.

He found out that the insurance company he works for "accidentally" posted my January premium ($ 1,382.80) to my old 2021 account.

Where the money does nothing but a personal donation to this mega-corporation with annual sales of more than $ 800 million.

Michael regrets that my account for 2022 will remain "invalid" for the time being.

Can't the lost premium simply be rebooked?

Michael types, the rooster crows, I wait.

"It takes 24 to 72 hours."

At least I know now.

If I hadn't happened to have a doctor's appointment the next day (which I no longer have), I would have continued to sail uninsured and blind into the Omicron wave.

By the way, my insurance is called Emblem Health.

Their longtime CEO Karen Ignagni earns more than three million dollars a year.

Before that, she was a lobbyist, not just any old, but "the most influential lobbyist in the health industry."

As such, she also fought against the pharmaceutical industry's most unfortunate element of Obamacare, the 2010 US healthcare reform.

A year ago, as one of his first official acts, President Joe Biden reinforced reform by a decree.

Nevertheless, some insured persons hardly notice any difference between before and after.

In any case, no financial difference: My premium is higher than ever, but the benefits are shrinking more and more.

Pure capitalism.

As long as the award arrives at the right place.

My blood pressure is rising

I'm supposed to call back in three days, says Michael, the lawyer.

He sounds hopeful and dictates a new membership number and an eight-digit file number so that I don't have to explain everything all over again.

The rooster crows to say goodbye.

Three days later.

Called Wanda: My insurance has still "expired".

Call the insurance company: This time happy country music is playing before someone named Gilbert answers.

Don't worry, says Gilbert, my bonus is "on the way" from one account to the other.

“24 to 72 hours.” Gilbert apologizes for the drama, or at least that's what he reads on his cheat sheet sounds like.

He gives me a new eight-digit file number.

My blood pressure rises, if this continues I'll have to see a doctor.

The next open date, says Wanda, would be the end of February.

Source: spiegel

All life articles on 2022-01-11

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