Verifying coverage may turn out to be one of the biggest challenges of the federal health exchange.
Despite having an insurance card in his wallet, federal health care exchange enrollee Paul D. Donahue walked out on a flu shot and his prescriptions this week because the pharmacy could not confirm his coverage.
According to the New York Times, this is a daily occurrence across America.
“They had no idea if my insurance was active or not!” Maria Galvez told the Daily Mail outside the Inova Healthplex facility in Springfield, Va., on Jan. 3.
Doctors, hospital executives, and pharmacists told the Times that pushing back the Obamacare enrollment deadline created a heft backlog at state and federal exchanges. Insurance companies can’t process new applications fast enough.
Many insureds, like Galvez, haven’t received a bill, a policy, or an insurance card yet.
“No one has sent me a bill,” said Galvez, who signed up three days before Christmas for a Carefirst Blue Cross bronze plan.
Hilary Danailova, 38, of Los Angeles is eight months pregnant. She purchased an Anthem Blue Cross policy before Christmas and overnighted her premium of $410 on Jan. 3. She says she hasn’t been able to reach Anthem to find out if them 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.
Judy Jacobs, 55, of Connecticut said she received a notice from Anthem on Dec. 9 that they accepted her application, but she has never received a card.
“Everybody that I’ve talked to with Anthem is in the same boat,” she said. “They have not received their cards. They don’t have any policy numbers. They don’t know if they go to the doctor whether they will have insurance or not.”
“The system wasn’t really built to handle this kind of glut of new patients,” Dr. Curtis Miyamoto, a radiation oncologist at Temple University Hospital, told the Times. “So it’s resulting in us having some delays in getting people verified, and therefore delays in their care.”