Is a long wait normal for ACA plan start?

[Fermion]

I signed up on the exchange for a Premera silver plan on December 7, 2015. I called on the 20th and they told me they do have my application from the exchange but that it takes 30 to 45 days for the plan to process and a bill to be sent out for the first premium. They said there is no way I could pay the premium early but I would be covered Jan 1 2016.

Does this sound normal? I have a ultrasound scheduled for Jan 13 and am wondering what insurance number I would give the facility if our policy has not been delivered yet?

Should I pester them again? Not really sure what else I can tell them to do...hurry up?

[MichaelB]

Quote:

Originally Posted by Fermion I signed up on the exchange for a Premera silver plan on December 7, 2015. I called on the 20th and they told me they do have my application from the exchange but that it takes 30 to 45 days for the plan to process and a bill to be sent out for the first premium. They said there is no way I could pay the premium early but I would be covered Jan 1 2016. Does this sound normal? I have a ultrasound scheduled for Jan 13 and am wondering what insurance number I would give the facility if our policy has not been delivered yet? Should I pester them again? Not really sure what else I can tell them to do...hurry up?

Pester them again? Most definitely. You need a policy number and member ID. Proof of coverage.

[Sue J]

We signed up and paid the first payment in late November. We got our ID cards on Dec. 31st. I was getting a little antsy!

[jim584672]

Last year I had to pester the insurance company, paid by credit card, they didn't see the payment. Four calls later they figured it out.

[Fermion]

On the website for Premera I see this:

"
It's currently taking four to five weeks to process applications, review residency documents, and send ID cards. Estimated delivery times for ID cards are as follows:

• If you applied for a health plan between December 1 and December 15, you'll receive your ID card between January 8 and January 22.
• If you applied for a health plan between December 15 and December 31, you'll receive your ID card between January 15 and February 4.
• If we have your email address on file, you'll also receive a welcome email with links to valuable resources once we have successfully processed your application."

Also, I see this:


"

I need to use my health plan, but I don't have my ID card. What should I do?

In-network doctors, hospitals, and pharmacies can confirm your coverage directly with us. Once your application has been processed completely, you can still get care if you need it, even if you don't have your ID card. You can also call us at 800-722-1471, and we'll give you your ID number."




It does seem kind of hard to get treated before they have completely processed your application.

[FUEGO]

We applied for my MIL Dec 7 and received her insurance ID card within 2 weeks. We were given the opportunity to set up payment during the healthcare.gov application, so that undoubtedly helped. Her household also had only SS income so that may have helped expedite the process since income is all verifiable electronically (in theory; not sure if they are configured to do that).

I'm about to apply for healthcare.gov policies for me and DW in a couple days and also need to apply for the state's Health Choice (glorified medicaid) for the kids. Not sure when I should apply for Health Choice since DW's current income is higher than the eligibility limits today (but it won't be when employment ends).

[Fermion]

I am going to rattle the bars on Monday during regular business hours. If I call today I am going to get "Hello my name is Dave" from India (nothing against Dave, but I have found him to be less helpful than regular business hour employees).

[lawman3966]

I signed up for Grouphealth (GH) Silver in WA state using the exchange on Dec. 1, 2015. I just got my card today, January 4.

There were numerous hickups during the signup process, including it taking about four weeks for GH to get my information from the exchange.

My guidance differed substantially from yours. I was told that I would have to make my first payment for the GH system to even begin processing my application. I made that payment by credit card in mid December. About two weeks later, someone at the customer service line was able to give me my Member ID number. And, as stated above, I finally got my card on Jan. 4 - about five weeks after signing up.

[Fermion]

Well I talked to Premera Blue Cross today and got nowhere. They said they had thousands of applications and processing them was taking 5 weeks. I asked what about the appointment I had Jan 13 and they said I had two options. Pay out of pocket and try to submit for reimbursement or postpone my appointment. Really not much I can do. When I asked to speak to a supervisor they hung up on me.

[MichaelB]

Quote:

Originally Posted by Fermion Well I talked to Premera Blue Cross today and got nowhere. They said they had thousands of applications and processing them was taking 5 weeks. I asked what about the appointment I had Jan 13 and they said I had two options. Pay out of pocket and try to submit for reimbursement or postpone my appointment. Really not much I can do. When I asked to speak to a supervisor they hung up on me.

This is not good. You are not insured. Can you call the exchange to report this? Likewise the state insurance commission.

Open enrollment is still available, you still have time to sign up with another insurer.

[MRG]

Quote:

Originally Posted by MichaelB This is not good. You are not insured. Can you call the exchange to report this? Likewise the state insurance commission. Open enrollment is still available, you still have time to sign up with another insurer.

+1

They knew their deadlines and should have had staffing to cover the peak volumes. This isn't rocket science, how long many years of experience do they need? I retired from a j*b that dealt with deadline driven industries, including insurance. This isn't how it's supposed to work.

In addition to what MichaelB suggested, they have a FB page, I'd be posting your experience to a wide number of their friends. Years ago insurance companies started paying close attention to social media, hit em where you know it hurts!

Based on their earlier comments I expected a phone call would get you a policy number, paperwork following shortly. Since that's not occurring it's time to hit them hard.

[John Galt III]

They hung up on you. Wow! I've been noting an increase in incompetence at the insurance companies customer service in the last few years (but at least they are better than the healthcare.gov folks). I finally got my capital blue cross HMO card Jan 2, 2016. I have made my first payment, by check, and someone has cashed the check 2 weeks ago, but their website says they haven't received the first premium and therefore my coverage is currently *undetermined*. There's always a glitch of some sort. Good luck!

[wallygator69]

Open enrollment is still available, you still have time to sign up with another insurer.[/QUOTE]

I found a local agent that had a sign out front touting ACA. Initial meeting I had a bunch of question (thanks to the folks on this board). She answered 90% (got the other answers) gave us info sheets to fill out with a bunch of questions. She specifically explained we needed to be able to report everything broken down monthly not annually.....


I sat down with her on 12/22, she called BCBS with questions twice. Was there 1.5 hours she entered all the data, we paid the first premium ($48.00 )and set up monthly auto pay. Was enrolled then and there and received our cards yesterday.

Smooth as silk. You still have time. I'd seek the help of an Agent.

We are in SC so no state market place.

Good Luck,

Wally

[Fermion]

I did call the state exchange and they were really of no help. They essentially refer all of these type questions to the insurance company. They did confirm that I signed up correctly back at the beginning of December.

I think open enrollment is good until Jan 31, but since I have screen shots and other documentation showing I correctly signed up, I am going to give this policy until the 15th or so to go through. After that I will have to determine how big of a stink I make (lawyer or whatever).


My real emergency fallback plan if they try and screw us over is to forgo the IRA conversion in 2016 and immediately sign up for Washington Applecare (medicaid) and just say *&** you to the ACA. Maybe try for a bronze plan in 2017.

[EastWest Gal]

I had to switch from Highmark to Aetna this year. Went through the national exchange ( mini state exchange in PA). Signed up Dec 8, paid Dec 23 online, got cards Jan 2nd. They assigned a PCP, not mine. Went online with the insurance co on Sun Jan 3, changed PCP. Called them 1/4, was on hold less than 10 minutes, verified the change in PCP and requested new cards. That is the shortest hold time I've ever experienced with an insurance co.

You should be able to go online and verify your registration and pay. It doesn't sound good. To have coverage Jan 1, I think you're supposed to pay in December.

Good luck!


Sent from my iPhone using Early Retirement Forum

[Fermion]

According to Premera I will be covered as of Jan 1 when they process my application, which may take up until Jan 22.

If I panic now and try to sign up with a new policy I am going to guarantee we don't have coverage for Jan. I don't even know who I would sign up with...the Premera Blue Cross PPO silver plan is really the only one I want because of the nationwide network.

I am going to give them until the 10th and then call again and record the phone call and the person's name. This way when they hang up on me I can call back and talk to someone higher up perhaps.

I have until the 15th or is it the 23rd to sign up for a new plan and get coverage starting Feb 1?

I think Medicaid is pretty instant if I want to go that route. I just log on to the website and report my income going to zero and bam they put us on Medicaid.

I <3 ACA

[MRG]

Quote:

Originally Posted by Fermion According to Premera I will be covered as of Jan 1 when they process my application, which may take up until Jan 22.

That makes sense, I'd be OK with that answer. I've seen business processes(especially in insurance) that follow that same pattern.

[MichaelB]

Quote:

Originally Posted by Fermion According to Premera I will be covered as of Jan 1 when they process my application, which may take up until Jan 22.

This is not the ACA, it the insurance company, and they appear to be making an effort to be unhelpful.

For the upcoming appointment, instead of cancelling, ask the medical service provider to call them and confirm the coverage, as you noted is on their website. I wouldn't bet on a positive outcome, because providers need policy numbers, not assurances. No harm in trying, though.

Quote:

Originally Posted by Fermion I need to use my health plan, but I don't have my ID card. What should I do? In-network doctors, hospitals, and pharmacies can confirm your coverage directly with us. Once your application has been processed completely, you can still get care if you need it, even if you don't have your ID card. You can also call us at 800-722-1471, and we'll give you your ID number."

If this doesn't work I'd submit complaints to the State Attorney General along with the Insurance Regulator. You will be charged for a month of insurance without really being able to use it.

[RetireAge50]

Hey Fermion thanks for clearing the trail. I'll be using the same path in a couple years.

[ivinsfan]

I think this is a cautionary tale for people to sign-up as soon as possible during open enrollment, I would guess that at one week before the deadline the pile of paperwork is already knee deep at the insurance companies. Better to be at the front of the line when possible.

MNSure extended their open enrollment deadline for Jan 1 coverage to Dec 28.....the phone lines literally blew out the afternoon of Dec 28. Lots of wailing about how people couldn't get service and how horrible they were treated. Really....some people always wait until the very last minute no matter how many extensions are given.

Hopefully things will eventually calm down.