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Health Insurance Marketplace issues

February 10, 2014
The Daily News

Complications with the Health Insurance Marketplace (Healthcare.gov) along with repeated extensions of the enrollment deadline in 2013 created challenges for some Michigan consumers who have not yet received proof of their insurance coverage.

Since open enrollment began on Oct. 1, insurance companies have encountered multiple problems that have prevented them from being able to enter new members into their systems, reports the Michigan Department of Insurance and Financial Services.

Some companies received incomplete or incorrect information from the insurance marketplace. Additionally, a flurry of last-minute submissions made it difficult to process them all by the time the new plans went into effect, in some cases only one week later.

This delay in providing proof of coverage has many consumers worrying if they really have insurance and wondering what to do next.

If you recently purchased a plan, but still haven't received proof of insurance from your insurance company, the Michigan Department of Insurance and Financial Services offers these tips.

Contact the Company

The first thing you should do is contact your insurance company to verify that you do have insurance coverage. Ask your insurance company for proof of coverage, such as an insurance card or identification numbers. When you speak to your insurance company, take detailed notes of the conversation. Include the date and time that the conversation took place, and the name of the representative. Keep copies of any written communication from your insurance company such as emails or letters as you may need these materials later.

You should also verify that you have paid your first premium on time. Some insurers have permitted late payments for coverage that is retroactively effective to Jan. 1. Find out your insurer's deadline and keep any records that can serve as proof of payment.

Payment Options

You may need to get a prescription filled or see your doctor before you receive your insurance card.

Your provider (hospital, doctor, pharmacy) may be able to verify your coverage by contacting your insurer directly.

If verification of coverage cannot be obtained, you still have options. One option is to pay for expenses out of pocket. Once your insurance coverage is established, your insurance company should reimburse you to the extent that the service or medication is covered under your policy.

You may also be able to work with your doctor's office, hospital or pharmacy to delay payment or set up a payment plan until they can verify that you're insured. Keep your receipts and any bank statements that show that you've paid for the services.

The Michigan Department of Insurance

and Financial Services Can Help

If you are still having difficulty obtaining proof of coverage from your insurance company, you can contact the DIFS toll-free hotline at 877-999-6442. DIFS staff can help resolve any questions or complaints you may have with your insurance company.

More Information

If you have further questions about the Health Insurance Marketplace, the recent federal changes to health insurance, or general questions about insurance coverage visit www.michigan.gov/difs.

 
 

 

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