Saturday, January 11, 2014

Times: Health Exchange Enrollees Struggle to Verify Coverage

Posted By on Sat, Jan 11, 2014 at 10:00 AM

With fewer technical hiccups being reported from those Americans needing to secure coverage through the health insurance exchange, a much bigger problem has emerged—patients having a difficult time confirming that they're covered even after they've successfully negotiated the application process.

This morning's New York Times reports that interviews with doctors, hospital executives, pharmacists and newly insured people across the nation suggest "that the biggest challenge so far has been verifying coverage." Even Doctors are having difficulty knowing if they're in the network of providers for plans sold on the exchange.

“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.”

Across the country, patients are reporting nightmare stories of having to pay full amounts for their care after doctors' offices are unable to confirm proper coverage. Even in Langley, Wash. one patient said she printed out a temporary identification card from the exchange, but when she tried to fill a prescription for a new asthma inhaler, the pharmacy couldn't verify coverage even though she had paid her first month's premium.

Meanwhile officials at Idaho's health exchange report that enrollment through the Gem State's exchange—Your Health Idaho—has grown to 20,000. That's up from approximately 1,750 who purchased coverage through the exchange by Nov. 30, 2013.

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