DC, in an effort to pass the buck to someone else, was the first city to switch folks to the expanded Medicaid which will be offered under universal healthcare. Only as the bureaucracy of DC is consistantly awful, this is a quagmire of ick. First some background.
There is Medicaid, which I didn't qualify for, and DC Alliance, which is a filler program of free health insurance for those who don't qualify for Medicaid and don't have other insurance. Then, to make things confusing, DC broke up it's single Alliance plan into DC Unison Alliance, DC Chartered Health, and something else. Basically, three different 'insurance' options to cover the gap. Of course, it didn't matter which one you were on, as all the low-income clinics took all three. The plans were just managed separately.
When Universal Healthcare passed, it expanded who qualified for Medicaid. DC petitioned to preemptively move folks from their system, which they paid for using local taxes, to Medicaid, which the federal government pays for. Either way, the program is managed by DC state government, possibly the most convoluted and systemically broken system of local government I've ever encountered.
Now, the reason I didn't qualify for Medicaid before was because it includes the incomes of those you live with if they are supporting you (i.e. are you a dependent). As I live with my boyfriend and he supports me, his income bumped me well past the poverty line. I have a sneaky suspicion that I don't qualify for Medicaid even under the expanded guidelines, which only seem to have upped the income limit from 'non-existent' to 'pathetic' annual income. DC Alliance doesn't record that I am a dependent (they don't care), so all they put down is my income, which happens to be zero right now. When they moved around 70% of their Alliance members to Medicaid spontaneously, they moved me over as well.
Only they didn't tell me.
My Unison came up for renewal at the end of June. I'd been submitting the paperwork continuously, which no one logged in the system until after I got some public benefits coordinators from my clinic on their butts. I was not alone, apparently they are so backed up at entering paperwork they tend to do it at the last minute, if not late. In the meantime, I was frantic from repeated notices I was receiving telling me I had not refiled my paperwork and my benefits were going to expire.
That problem solved, I got my new card and book. It was actually my FIRST card, as they'd never sent me one to begin with. I'd been using a beat up temporary paper card for nearly two years.
Only, as it turns out, I'd recieved the new card and new member books just after DC had switched me over to Medicaid. What... the... hell...
I found out I had been switched when I went to the low-income pharmacy to pick up my medications. They ONLY take Alliance, so I am no longer eligible to recieve my medications there. I was told I would have to get new prescriptions and go to CVS or Target. (Technically, they can transfer stuff, but this pharmacy is famous for telling you stuff like, "medicine? what medicine?")
I contact CVS, and all they have is my old Unison information, which is expired and they don't accept it anyway. Nothing for the new Medicaid plan. And DC Medicaid people keep saying I need to talk to my caseworker, only I don't have one because you need to be assigned one by the Medicaid people! Half the time Unison people tell me I'm not covered because I'm on Medicaid, and the other half of the time they are telling me I've been renewed under Unison. DC Medicaid either tells me I'm not in their system (speak to imaginary caseworker), I'm in the system (should be recieving my new card shortly), or that I need to go in to prove my citizenship (again). The trial of being born overseas is every time I renew I have to prove I'm American for the bazillionth time.
So where am I supposed to recieve my medication? Who the hell knows? I've been calling around for two weeks now. Unison is great at transferring you continuously from one section to the next, until they either a) hang up on you accidentally while transferring, or b) send you to a line that just rings until your phone gives up.
Today took the cake. I get roused from bed by a Unison survey taker, welcoming me to the Unison plan and asking me questions about what my medical needs would be! Boy, did that poor fool call the wrong person! No, I don't need assistance around my house or getting to my appointments, what I need is my fucking medication you asshats! And maybe for someone to tell me if I'm under Unison Alliance, or Medicaid, or both, or what. I must not have health insurance because I sure can't get any coverage!
In an effort to extract himself from the phonecall, which is quickly spiralling into a venomous rant on my end, he suggests that maybe the system was waiting for the information verification, which is what he has just done. Maybe I should call CVS again. So I do, and get a good bit of retarded going on there as well. (And, before I get nasty comments from the handi-capable folks, by retard I don't mean acutally disabled, I mean people who are too stupid to know how to do their own jobs and yet somehow we are still paying them.) So the first person, after profuse apologies (she can't get my correct information to pull up), gives me a number I need to call. Only, as it turns out, that isn't the number I'm supposed to call, it is the PHARMACY ONLY number that SHE is supposed to call to get my updated information. As I am not even supposed to have or call that line, they immediately transfer me to Unison pharmacy benefits, who realizes the error and transfers me back to the member services number (and, by the way, accidentally hangs up on me while transferring).
So I call member services, and after numerous transfers (including one time where it cycled me back around to the person I was just speaking with), I get a number for the pharmacy to call for my updated benefits... the number that the pharmacist had given me by mistake. I call CVS back and attempt to explain it to a different person, only this guy doesn't seem to understand English all that well and keeps asking me if I want to refill the one medication I normally get from CVS (Unison doesn't cover it). I DON'T NEED A REFILL RIGHT NOW, I NEED YOU TO GET MY CORRECT INSURANCE INFORMATION FROM THIS NUMBER FIRST SO I CAN GET YOU THE REFILLS!!
Which is not to say I'm against Universal Health Care, per se, but that as it is going to be managed by local governments, you had better be sure your local area is up to snuff. I have a mute dread that, after I'm switched all around and get this settled, they are going to discover that I don't actually qualify for Medicaid even under the expanded rules and then they are going to try and switch me back. Then I'll have to do this all over again... a month before I move.