No Title
OPEN ENROLLMENT PERIOD for 2023 and 2024:
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2023
1. https://files.catbox.moe/3typr3.png
2. https://www.cms.gov/newsroom/fact-sheets/marketplace-2023-open-enrollment-period-report-final-national-snapshot
3. https://files.catbox.moe/arew5f.png
4. https://www.verywellhealth.com/aca-open-enrollment-2023-6825487
2024
5. https://files.catbox.moe/rkvlzo.png
6. https://www.cms.gov/newsroom/fact-sheets/marketplace-plan-year-2024-open-enrollment-fact-sheet
A. Network Type
B. Metal Level
C. Inclusion of Dental and Vision
D. Service Area
As far as I can tell, the two following plans that I will be talking about, are only cosmetically different and have no foundational difference other than the one that cost me money, is more restrictive. How does that make sense? To me, this seems contrived.
PLANS:
A person qualifies for a DOLLAR AMOUNT under the ACA.
They do not qualify for an insurance plan. Though the following plans have the appearance of different attributes, it is NOT the plan that matters, it is the dollar amount covering the plan that matters. Rather, both plans are 'engineered' to align with the dollar amount approved in the EXACT SAME way. One just charges the customer for no extra benefit and the other one doesn't.
The company sets you up to believe you have a ZERO PRICE PREMIUM PLAN then switches it to a PRICED PREMIUM PLAN. All the while telling you before hand that they will auto-renew you, while having you believe you are ALREADY enrolled for 2024 because you joined during the 2024 Enrollment Drive.....or so you were led to believe. The truth is, they somehow got me enrolled BEFORE the official 2024 Enrollment Drive, duped me, then planted a trail of mixed-message communications for plausible deniability. Then I called them (Dec. 26, 2023), and they tell me to pay and they lie about "law changes", then tell me to cancel. I refused to cancel and I said fix it. To this day I still have no idea for sure what plan I'm in.
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Standard Silver VALUE (plan) - Enrolled page
Provider Network: Value
Network: HMO
Premium: $5.90/month
7. https://files.catbox.moe/tm6zsg.png
(See Red Box - KEY)
Standard Silver (plan) - Actual page???
Provider Network (Metal): Bronze | Silver | Gold
Network: EPO
Premium: $0/month
8. https://files.catbox.moe/nu2osx.png
A DISTINCTION WITHOUT A DIFFERENCE:
The Customer is paying $5.90/month for the exact same plan but with RESTRICTIONS. All Covered Services and Out-Of-Pocket Expenses are the same.
My argument is that the Standard Silver VALUE (plan) should not even exist. But customers are being pushed into it without knowing it. Just like I was.
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Plans Shopping Page:
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Covered Services - Standard Silver - $0/month
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Covered Services - Standard Silver VALUE - $5.90/month
11. https://files.catbox.moe/k0fld1.png
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No Restrictions - Standard Silver - $0/month
12. https://files.catbox.moe/e44lsd.png
Restrictions - Standard Silver VALUE - $5.90/month
13. https://files.catbox.moe/tqlh0o.png
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Side By Side FULL Comparison of Plans
No Restrictions - Standard Silver - $0/month
12a. https://files.catbox.moe/pojknr.png
12b. https://www.hostize.com/v/jp4HrGYCTA/standard-silver-plan-pdf
Restrictions - Standard Silver VALUE - $5.90/month
13a. https://files.catbox.moe/ddn45d.png
13b. https://www.hostize.com/v/ad6qZEpNeC/standard-silver-value-plan-pdf
SPECIAL NOTE:
Other than the Oct. 26, 2023 emails, I never saw a single email UNTIL Dec. 26, 2023 when I received my bill for December dated Dec. 6, 2023 on Dec. 26, 2023. It was then I began my own investigation. It was then I found emails telling me about renewing my enrollment which I didn't even know I had to do because I already thought I was enrolled for the 2024 Enrollment Drive. Even so, my account Enrollment Page (see Link #7) clearly states in the Red Box that if my enrollment information hasn't changed then I need DO NOTHING. Thus any responsibility on my part to watchdog AMBETTER goes out the window. There was ZERO need or responsibility on my part to RENEW or SHOP for a new plan when
1. I already thought I was enrolled in 2024 and
2. AMBETTER literally tells me I don't need to do anything if my information hasn't changed. MEANING......they already know there is NO CHANGE IN THE 2024 ACA LAW regarding QUALIFICATIONS. Thus when they told me over the phone - on Dec. 26, 2023 when I called customer service - that the reason my Plan went from a ZERO Out-of-Pocket Premium to a $5.90 Out-of-Pocket Premium was do to a change in the ACA Law, they were lying. They can't have it BOTH WAYS. They can't say "If you have no household changes" do nothing (see Link #7) and at the same time say "The law has changed making your household qualifications part of a reformulation of ACA benefits for 2024 thus YOU HAVE TO RE-APPLY". The point is moot in either case because as I stated, qualifying for the ACA benefit and making a plan selection are two very separate tasks. The first does not effect the second. But my point is, they are purposely being deceptive.
EMAILS:
14. https://files.catbox.moe/0q764e.jpg - Oct. 26, 2023
15. https://files.catbox.moe/bjyg2a.png - Oct. 26, 2023
16. https://files.catbox.moe/qefvnk.png - Oct. 26, 2023
17. https://files.catbox.moe/n84fsc.png - Oct, 26, 2023
18. https://files.catbox.moe/747j4j.png - Nov. 1, 2023
18a. https://files.catbox.moe/orjmr2.jpg -Nov. 1, 2023
I already have my enrollment card which I was led to believe WAS for the 2024 Enrollment Drive. But no....it was a sneaky enrollment in which I was led to believe my plan was a ZERO PREMIUM PLAN. This set my psychology up to trust that I was all set to go. Wrong. Also note, it says I'm in the Standard Silver VALUE (plan), which according to my Nov. 7, 2023 bills says I have ZERO Premium to pay.
19. https://files.catbox.moe/xochl5.png - Nov. 7, 2023
19a. https://files.catbox.moe/0swy4f.jpg - Nov. 7, 2023
The two above links say I'm enrolled and prove that I was paying zero dollars for my plan.
20. https://files.catbox.moe/hic5cb.png - Nov. 13, 2023
21. https://files.catbox.moe/y76lfn.png - Nov. 15, 2023
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27. https://files.catbox.moe/ci4qhq.png - Dec. 4, 2023
The first time it is clarified that a warning is given about a higher premium but at the same time it is saying I will be enrolled in my current plan which I believe to have a ZERO premium.
28. https://files.catbox.moe/a040nv.png - Dec. 6, 2023
28a. https://files.catbox.moe/ymb572.jpg - Dec. 6, 2023
This bill is dated (Dec. 6) but I don't receive it until Dec. 26, 2023 because I made a note on the envelope. It arrives late but regardless It WAS ALREADY IN THE MAIL BEFORE the first email (Dec. 4) stating anything about an increase in PLAN PREMIUMS. Please tell me this this is not a contrived 'coincidence'. I'm warned of a price increase a day and a half before I get the price increase that was already in the mail. Are they even trying? Remember, I still have until DECEMBER 15th to enroll for 2024 but they have already AUTO-RENEWED ME and bumped me up to an out-of-pocket plan BEFORE even noticing me that this was about to happen. THIS IS A BAIT AND SWITCH.....PERIOD.
28b. https://files.catbox.moe/m8jn75.jpg - Dec. 15, 2023 - FRONT SIDE
28c. https://files.catbox.moe/913sz3.jpg - Dec. 15, 20233 - BACK SIDE
As can be seen from this letter (Dec. 15) dated AFTER the date for the December bill (Dec. 6), AMBETTER essentially fabricates a myth about higher premium rates and encourages me to re-enroll into the Standard Silver VALUE (plan) which they have already auto-renewed me and billed me for as stated prior (Dec. 6). It is as if they purposely locked me into a bait and switch pushing me past the deadline
(Dec. 15) thus making it impossible to use their online site to correct their malfeasance. A malfeasance I didn't even know was occurring because why would I be re-enrolling for the 2024 Enrollment Drive when that is exactly what I thought I was already enrolled in. This isn't a "comedy of errors". This is planned. And I know it was planned because of their defiance over the phone. Making me wait. Making me speak to somebody higher, then telling me "oh the law changed". Yeah it changed. It issued MORE money for the ACA do to INFLATION. But from what I can tell, that is all that changed. All the qualification questions and answers seemed upon examination to be the exact same as what transpired over the phone when I was enrolled by TrueCoverage on behalf of AMBETTER on Oct. 26, 2023 for what I led to believe WAS for the 2024 Enrollment Drive.
Further, looking at the BACK SIDE of the letter (an maybe I'm wrong here) but it seems to clearly state that my premium "change" (rather stayed the same) to ZERO. However the Maximum Out-Of-Pocket apparently DID CHANGE (Implying this is an actual list of active and current changes) from $1,700 on my Membership Card to $1,800
(See #18 Nov. 1).
So what am I supposed to believe? One thing changes but one thing doesn't but I get billed anyway?
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30. https://files.catbox.moe/azf2wj.png
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35. https://files.catbox.moe/k5cl5u.png - Dec. 12, 2023
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42. https://files.catbox.moe/ddjd5g.png
I get billed on Dec. 26, 2023 (Dated Dec. 6, 2023) and I call AMBETTTER customer service where they supposedly corrected the problem but this never seemed clear according to
(Links #7 and #8) and on Jan. 10, 2024 they suspended my account.
43. https://files.catbox.moe/cirrlw.png - Jan. 3, 2024
44. https://files.catbox.moe/p5n05p.jpg - Jan. 9, 2024 - FRONT SIDE
45. https://files.catbox.moe/97a9jp.jpg - Jan. 9, 2024 - BACK SIDE
Documents from the Marketplace saying I'm in the Standard Silver VALUE (plan)
46. https://files.catbox.moe/bsb7c3.png - Jan. 10, 2024
My account was suspended. I'm assuming because I did not pay the December bill, even though I have all the way until Jan. 15 or 16th 2024 to modify my plan selection according to all the Marketplace information I got. However it also says I've been auto-renewed because I didn't select a plan by Dec. 15, 2023 even though I was auto-renewed and billed BEFORE that date without notice as far as I can tell. (See Links #27 and #28)
ARTICLES:
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47. https://files.catbox.moe/g0oek7.png
47a. https://www.centene.com/products-and-services/state-and-national-solutions/marketplace.html
AMBETTER has 3.6 million members of which 84% are in Silver Plans. How many of those people just got their FREE Standard Silver VALUE plan (2023) switched to an Out-of-Pocket Premium Plan (2024) AFTER they have already selected a PCP in an HMO Network and actually gone for a medical visit? How many are now more or less TRAPPED by this deceptive maneuver by AMBETTER?
48. https://files.catbox.moe/dnpnoq.png
48a. https://smartfinancial.com/compare-health/blue-cross-blue-shield-vs-ambetter-insurance
This articles has some information (Green Highlights) about how if the Medical Loss Ratio is below 80% then the balance has to be refunded to the patients. Does this mean AMBETTER owes me
$683.62 for November 2023 and $702.90 for December 2023? And if so, what about January through December 2024 in which AMBETTER will be receiving ACA Premium Payments while denying me coverage because of their suspension of my account? Or will they stop receiving ACA Premium Payments and have to refund the government? Or am I simply not understanding the meaning of the article?
