After numerous problems with the federal Web site, Wisconsin Insurance Commissioner Ted Nickel is encouraging consumers to double check the status of their health insurance.
According to federal reports, thousands of Wisconsinites took advantage of the open enrollment period to purchase coverage through healthcare.gov. But the problems of the Web site are not fully over. The Office of the Commission of Insurance (OCI) has continued to receive reports of consumers enrolled in incorrect plans. This happened when consumers entered their zip codes to show plans and the federal Web site showed plans that should not have been available based on the county in which the consumer lives. Once a consumer enrolled in a plan, the information was sent to the insurer. In some cases, consumers are paying a different premium for the plan they selected because the zip code pulled premium rates for a different area. In other cases, consumers have enrolled in a plan with a network of medical providers that do not practice anywhere near them. This can require significant travel time or more expensive medical care. Consumers were also allowed to purchase a plan not available in their region which will result in having no medical providers in their area.
However, in the most serious cases, consumers were enrolled with an insurer that does not have any plans available in their region. Those cases were sent back to the exchange by the insurer but there is no confirmation that any of those consumers were ever contacted by the exchange. These consumers are left without coverage but may not have been made aware of the problem. OCI is in the process of assuring that those consumers are contacted and that their problem is fixed by the exchange.
“The best thing any consumer can do is be proactive,” stated Insurance Commissioner Nickel. “You’ve shopped around to purchase the best plan for you. Now you should take the next step to verify your coverage. Protecting you and your family’s health is paramount.”
Commissioner Nickel recommends the following steps:
• If you haven’t received your enrollment materials within the expected time frame, check with your agent or the insurer to make sure you have coverage.
• Check to make sure that you have received enrollment materials.
• Verify that you have actually paid for coverage. For example, if paying by automatic withdrawal, check to see that the insurance company has debited your account for the premium you expected.
• Read your policy documents and make sure your deductibles and copays match what you were expecting. Make sure your medical providers are in the insurer’s network.
• If you see any discrepancies, immediately contact your insurer.
“We are here to help,” continued Commissioner Nickel. “We have worked with insurers to make sure all consumers are being treated fairly. If you don’t feel you are being treated fairly, contact our office and we’ll see what we can do to help.”
For more information see the Federal Health Care Law Frequently Asked Questions—Enrollment (opens in new window).