« | »

NYT: O-Care Enrollees Struggle To Prove Coverage

From the New York Times:

Enrollees at Health Exchanges Face Struggle to Prove Coverage

By ROBERT PEAR and ABBY GOODNOUGH | JAN. 10, 2014

FORT WORTH — Paul D. Donahue and his wife, Angela, are among more than a million Americans who have signed up for health coverage through the federal insurance exchange. Mr. Donahue has a card in his wallet from his insurer to prove it. But when he tried to use it to get a flu shot and fill prescriptions this week, local pharmacies could not confirm his coverage, so he left without his medications.

Similar problems are occurring daily in doctors’ offices and drugstores around the country as consumers try to use insurance coverage that took effect on Jan. 1 under the Affordable Care Act.

In addition to the difficulties many face in proving they have coverage, patients are also having a hard time figuring out whether particular doctors are affiliated with their health insurance plan. Doctors themselves often do not know if they are in the network of providers for plans sold on the exchange.

What a joke. But it’s just as we predicted.

But interviews with doctors, hospital executives, pharmacists and newly insured people around the country suggest that the biggest challenge so far has been verifying coverage. A surge of enrollments in late December, just before the deadline for coverage to take effect, created backlogs at many state and federal exchanges and insurance companies in processing applications. As a result, many of those who enrolled have yet to receive an insurance card, policy number or bill.

Many are also having trouble reaching exchanges and insurance companies to confirm their enrollment or pay their first month’s premium. Doctors’ offices and pharmacies, too, are spending hours on the phone trying to verify patients’ coverage, sometimes to no avail…

So how many will suffer or even die because of this latest failure of Obama-Care?

In Los Angeles, Hilary Danailova, who is almost eight months pregnant, said she had to pay $630 for an ultrasound on Thursday after failing to get an ID card or any confirmation of coverage from her new insurer, Anthem Blue Cross. Ms. Danailova, 38, said she signed up just before Christmas and sent her first month’s premium of $410 by overnight mail on Jan. 3. She has repeatedly tried to reach Anthem to see whether the company has processed her payment.

“At this point I am facing the cold dread of not knowing whether Anthem ever recorded my enrollment at all,” she said…

That’s okay. We’ve heard that stress is good for expectant mothers and their babies.

This article was posted by Steve Gilbert on Monday, January 13th, 2014. Comments are currently closed.

One Response to “NYT: O-Care Enrollees Struggle To Prove Coverage”

  1. Everyone on this Forum realize the Madness is fully upon us. Like a bad, bad fever we’re going to have to weather it. Keep the faith, ladies and gentlemen. Keep the Faith ..




« Front Page | To Top
« | »