My personal ongoing experience with Obamacare - Part VII - The great benevolent "gifts" to plan participants

In my last installment I got a Christmas present of all of the back premium invoices for 4 months due and payable immediately or else. 

After the first of the year, the gifts just kept on coming. A week or so later I got a sheet of premium coupons a "Congratulations, your premium is going down!" notice. The premium was dropped to $400 a month for my age bracket.

Now....normally in a market economy you would expect this in reaction to an overwhelming number of participants driving down costs. In the case of PCIP and a government run program it seems to be in response to the under whelming number of program participants and the Doh! moment of the bureaucrats that if you couldn't afford insurance before their program for $460 dollars a month through a state high risk pool, you probably  wouldn't race out and get it for that price just because they were now offering it. 

After using the program for several months, we did finally start getting statements regarding what the plan had and hadn't paid. The first dispute was when my dermatologist ordered a baseline CT scan after my melanoma surgery for my torso and head to check and see if it had spread. The bureaucrats  had decided the torso scan was necessary but not the head scan since I had not exhibited any neurological symptoms. The dermatologist virtually blew up at this news asking if any of the pinhead decision makers knew one of the most prevalent hiding places of undiscovered melanomas was behind the eyes. Evidently not, but someone in his office did manage to convince them. 

Along about the first of May 2011 I received a rather confusing letter from PCIP that my prescription copayments since the first of the year had been incorrectly calculated and that the plan was going to "fix" this problem. I am a type 2 diabetic and the cost of Lantus alone had burned through my prescription deductable in about March. Of course the next time I went to fill a prescription after this letter I had to pay full price again and I only had four-hundred some odd dollars left to go to fulfill my prescription deductable.  

I called once again to find out why I was now starting over on my deductable when I had already spent well over eight hundred dollars out of pocket since the first of the year on prescriptions. They explained that due to their error in not being able to add, they decided NOT to go after all of the plan participants for the excess paid toward their prescriptions since the first of the year and instead, just reset everybody's deductables back to ZERO as of the first of May.

Further, they told me I should really look at this as a "gift" in that they didn't come after me for all of the excess money they had paid towards my prescriptions all at one time. Funny.. I replied, it didn't keep you from coming after me for 4 months of premiums all at once last year due to the fact you couldn't get you act together and send them out on time. 

I'm sure the gifts will just keep on coming.