Insurance companies, worried about potential chaos next month as people begin seeking coverage under the federal health care law without completing the necessary paperwork, have agreed to give consumers an extra 10 days to pay their first-month premiums, according to a statement from the companies’ trade group on Wednesday. þþWhile some state regulators or individual companies could set different deadlines, nearly all the major insurers have agreed to cover their customers retroactively if they go to the emergency room or doctor’s office after Jan. 1, but send in their payment by Jan. 10. þþThe Obama administration has been urging flexibility on the part of insurers, in part because of problems with the federal government’s health insurance website, healthcare.gov. But the companies said they made the decision voluntarily. þþ“Our community is taking an important step to give consumers greater peace of mind about their health care coverage,” Karen Ignagni, the chief executive of the trade association America’s Health Insurance Plans, said in the statement. þþDespite the extra cushion for making payments, customers who want coverage to begin by Jan. 1 will still be required, in most places, to enroll by Dec. 23. Some states, like Maryland, have pushed that deadline to Dec. 27. A bigger deadline looms on March 31, the last day for most people to obtain coverage for all of 2014 through the federal and state exchanges. þþWellPoint, one of the nation’s largest insurers, said in a separate statement on the payment extension that it would also offer more help to consumers trying to sign up for coverage. “Our call centers will be staffed throughout the holidays, and teams of employees will be working to process applications quickly in this compressed time frame,” the company said. Enrollment has been climbing quickly as the technological problems that have plagued healthcare.gov are being solved, and the Obama administration has been urging insurers to be as flexible as possible in helping people who want to begin coverage next month. þþAbout 360,000 people have enrolled in private plans through the new health insurance exchanges, according to the latest federal counts. Earlier government estimates have suggested as many as seven million people could sign up for coverage under the new health law, the Affordable Care Act. “The insurers really want this to work,” said Timothy Jost, a law professor at Washington & Lee University who serves as a consumer representative for insurance regulators. The 10-day extension is unlikely to present any company with much risk, he said. Many plans have large deductibles, requiring people to pay the doctor or hospital out of pocket before insurance payments kick in. þþAdministration officials also praised the move. “We applaud the nation’s health insurers,” said Joanne Peters, a spokeswoman for the Department of Health and Human Services. “We look forward to continuing to work with insurers to find ways to ensure that as many Americans as possible can find coverage in the health insurance marketplace.” þþBecause of a lag in the government system for verifying enrollment, insurers have been concerned that some people might mistakenly think they have insurance when they never completed the necessary paperwork — or paid for the first-month premium. While the quality of the data from the federal government has significantly improved, insurers say they are still dealing with incomplete or inaccurate information about who has enrolled, especially those seeking federal subsidies. þþ“There are going to be issues, and we know that,” said Jon Urbanek, a senior vice president at Florida Blue, which is adopting the new policy. The company has been encouraging people to bypass the federal website and sign up with it directly so it knows exactly who has enrolled in its plans. It is also asking people who sign up through the federal site to keep a record of their transaction. þþThe insurer says it plans to work with hospitals, doctors and pharmacists to make sure customers who are entitled to coverage are not turned away. If customers need treatment, “what we don’t want them to do is put off the care,” Mr. Urbanek said. þþBut many insurers and others say they still expect January to be challenging as some people scramble to find coverage if their plans lapse and others have trouble figuring out their benefits under the plan and which doctors and hospitals they can go to. While federal officials have taken some steps, like extending for a month the coverage under the federal program aimed at people with expensive medical conditions, many people could find themselves surprised. þþInsurers like Aetna and WellPoint say they have policies in place that help people who are in the middle of medical treatments. “These established policies, which in certain instances such as pregnancy, chemotherapy or postsurgical care, allow the member to continue receiving care from an out-of-network provider for a specified period of time,” WellPoint said in a statement. “These policies vary by state and will continue to apply to current members.” þ
Source: NY Times
