Obamacare Subscribers Take Big Out-of-Pocket Hits

Image: Obamacare Subscribers Take Big Out-of-Pocket Hits Customer service agents at Covered California's Concord call center.

Friday, 10 Jan 2014 11:25 AM

By Drew MacKenzie

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The Obamacare nightmare never ends as scores of frustrated patients are finding out while paying hundreds of dollars out of their own pockets for doctors visits, and drugs even though they have already paid for their insurance premiums.

People who have taken out policies from state and federal healthcare exchanges are now venting their anger at overwhelmed insurance companies while running into a whole new set of problems following the rocky rollout of HealthCare.gov, reports the Los Angeles Times.

The consumers are spending countless hours attempting to contact insurance company call centers — and often don't even get through.

And even if they succeed, they cannot get their coverage confirmed, they cannot get simple questions answered, and they cannot get the vital identification numbers to receive medical care or get their prescription drugs, says the report.

Without the necessary documentation to show that they have paid for the first month of their policy and should be receiving coverage effective January 1, they are instead having to foot their huge medical bills themselves, if they can actually afford it.

The Times says that "the dismal service" is sweeping the insurance industry, posing another crisis that President Barack Obama's signature domestic policy never envisioned. And the newspaper warns that it could "sour" potential consumers from signing up by the first deadline on March 31.

"Health plans have gone above and beyond to protect consumers from disruptions caused by the ongoing problems with HealthCare.gov," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, an industry group. "The last-minute changes to deadlines and rules have made the process more complicated and time-consuming."

Alan Sager, a health policy professor at Boston University, called the insurance company chaos the latest crisis under the Affordable Care Act.

"There's equal opportunity for incompetence by the public and private sector in administering such a large new program," he said. "People are deservedly angry and resentful."

Blue Shield of California, in fact, went as far to apologize to customers on its Facebook page this week for its "unacceptable" performance, says the Times. "While we anticipated and planned for increased traffic, the sheer volume of enrollments has swamped all major health plans," the company said.

In another posting on the page, the company said, "In response to the high volume of inquiries, we are extending our service hours ... to meet the increased demand. We are also tripling our website bandwidth to support new enrollees making payments online. Thanks for hanging in there."

WellPoint, the country's second largest health insurer and parent company of Anthem Blue Cross, also admitted that it's been under pressure from a large volume of callers in California and the 13 other states where it operates.

More than 1,000 employees, in fact, took one million calls over two days last week, roughly the number it usually receives in a month.

WellPoint spokeswoman Kristin Binns blamed the government for the problem, saying that changes to deadlines and regulations "are impacting the timeline for us to process customer applications, issue billing statements, process payment and issue coverage ID cards."

She added, "We greatly appreciate patience during this transitional time and apologize for any inconvenience they may have experienced."

The disastrous Obamacare rollout took another hit on Friday when Forbes revealed that the health insurance giant Humana said it was set to have a bad year in 2014 because of the new law.

The revenue from Medicare will be substantially higher for Humana because of the increased number of enrollees dumped into the federal program because they were ineligible to receive policies from the federal and state exchanges.

But Forbes says, "Any additional business will be fully offset by its bad experience with Obamacare. As a result, its earnings will remain flat this year. The company says that it expects the higher costs will result from the older and less healthy population that's enrolling in its Obamacare plans (the bad 'mix')."

However, there is one small piece of good news for the troubled healthcare reform law. More than three-quarters of visitors to HealthCare.gov who were eligible for insurance are healthy, according to a new survey.

The study by the New York-based Commonwealth Fund, which ran through the end of December, also found a great number of young adults, 41 percent, logged onto the website.

Obamacare depends on a large contingent of young and healthy people to sign up for the system to help cover the medical costs of older and less-abled consumers.

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