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Curmudgeon's Corner

cur-mud-geon: anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner

The 'Real World' of the Affordable Care Act (a/k/a ObamaCare)

Wisconsin, Quality of Life, Healthcare

It is finally ‘real world’ time for the Affordable Care Act (a/k/a ObamaCare).  People who enrolled are to have been covered since January 1st.  Some are and, apparently, some are not.  The real question is just how one determines that he or she is covered.  The Office of the Commissioner of Insurance (OCI) for Wisconsin issued a press release late yesterday (January 6th) that highlights this issue.  Among the issues discussed and suggestions for remedying those issues are these:

Inaccurate Plan Information Posted by Healthcare.gov

In some cases, healthcare.gov is displaying plan information that does not match the information the insurer submitted to healthcare.gov.  This incorrect plan information is the direct result of technical problems with the federal web site and not errors caused by the insurer.  One of the chief errors is in the display of cost-sharing information.  For example, some plans are listed without a deductible when in fact a deductible requirement is tied to the plan.

“The posting of inaccurate plan information is one of the more harmful consumer-facing ‘glitches’ to date,” explained Commissioner Ted Nickel.  “Consumers rely on the information posted to healthcare.gov to choose a plan that meets their medical and financial needs.  Access to accurate information is critical to their decision-making process.”  Specifically, some consumers who purchased a plan on healthcare.gov will not get the plan as described on the Web site due to a technical error by the federal Web site.

OCI strongly encourages consumers using healthcare.gov to verify plan information by reviewing any insurer materials that may be accessible through healthcare.gov.  If there are discrepancies between the plan details in those documents and the summary information provided on healthcare.gov, consumers should contact the insurer directly to avoid purchasing a plan that is inaccurately displayed on the Web site.

For those who have already purchased a plan, OCI recommends reviewing the actual plan document (which shows up on the federal Web site as a pdf file).  If the plan document is different than the information summarized on the federal Web site, consumers should contact the insurer to find out what their options are.  If the plan document is the same as the Web site’s summary, consumers should feel confident that they purchased what they initially intended.  OCI has contact information for all insurers selling health insurance in Wisconsin posted on their web site here.

Federal Government Enrollment Transfers to Insurers

The transfer of enrollment information is another area of concern.  Enrollment information is sent from the federal government to insurers.  OCI has learned that, in some cases, this information transfer is delayed or not occurring at all.  It is extremely important to note that this error in transferring the information from the Web site to the insurer is a technical issue with the federal Web site and that the only way to ensure coverage has been secured is through confirmation from the insurer.  “Consumers who enroll through healthcare.gov but do not receive correspondence from the insurer confirming enrollment should contact the insurer directly to verify they are enrolled and payment has been received,” stated Commissioner Nickel.  If consumers have received confirmation from the insurer, they should feel confident that coverage has been secured.

Welcome to the ‘real world’ of ObamaCare in 2014 versus the world that we are urged to believe by government statements and from press conference responses.

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