Three weeks into the new year, new health policies under the Affordable Care Act are becoming a reality for millions of Americans, whether they wanted them or not.
Now, as they sort out the complexities, that means lots of calls and lots of time on hold.
Last week, dozens of Blue Cross Blue Shield of Michigan customers — saying they’ve been overbilled, placed on policies they didn’t want, and then put on hold for too many hours when they try to straighten things out — took to Facebook to complain.
When Blue Cross posted a picture of cookies Thursday on its Facebook page urging consumers to eat healthier, the response was immediate:
"Instead of posting pictures of food, please, please answer the phone," wrote one customer.
And in response to a post about the health benefits of taking a vacation? "Need to use my vacation time just for hours of holding ..."
Ed Harden, a spokesman for Flint-based McLaren Health Plan, called it a "call tsunami."
It’s not just the volume of calls — it’s doubled at McLaren, Harden said — it’s the length of them as consumers sort out the details of new policies, according to Harden and officials from other insurers.
Some policyholders had never purchased insurance before health reform policies became available late last year. They’re still trying to understand the basics. Others are sorting out the details of new policies that replaced old ones.
"We’re seeing anywhere from 35 to 45 minutes" a call, Harden said.
Insurers say they’re trying to help customers understand new policies under health reform. They’ve hired extra staff, set up special websites and extended office hours.
Before health reform, Blue Cross took about 4,000 calls a week from consumers who purchased plans on the individual market. Those calls had climbed to about 40,000 a week by mid-December, just before the deadline for signing up for coverage on the Michigan Health Insurance Marketplace that would be effective in January, said Helen Stojic, a Blues spokeswoman.
In fact, the highest call volume for enrollment was Christmas Eve — the day after the original federal deadline for purchasing policies that were effective Jan. 1, said Kirk Roy, who oversees health reform law for Blue Cross.
Both Grand Rapids-based Priority and Detroit-based Health Alliance Plan also reported a big boost in calls.
Many are consumers wanting to make sure they are enrolled or asking about payment processes. Those who signed up for policies on the marketplace through www.healthcare.gov were sent bills and asked to mail payment, said Priority spokeswoman Amy Miller.
"It’s ‘Is my invoice on the way?’ and ‘Did you get my payment yet?’ " Miller said.
There also is lingering confusion at the marketplace and about enrollment dates and when coverage is effective.
And insurers say many consumers purchased the plan with the least expensive premium and now are surprised at higher-than-expected deductibles and co-pays.
Meanwhile, enrollment both on and off the marketplace continues for most people until March 31.
The Blues may be dealing with the largest onslaught of calls. It’s not only the state’s largest insurer, it’s the only one offering plans on the state’s online marketplace in every Michigan county.
Plus, in order to make sure customers did not lose coverage, some customers were "transitioned" — automatically enrolled — into the Blues’ Keep Fit plan, a special plan that was extended through 2014, Stojic said.
Customers who don’t want the Keep Fit policy need not pay, she said. Blue Cross also will provide a refund to those who are enrolled in two plans "because they were transitioning and the records did not catch up," Stojic said.
Mark Gilman, a 55-year-old Clarkston marketing consultant, was among the more than 140,000 Michiganders who last year were told their policies were being canceled because they didn’t meet the requirements of health reform. After checking out his options, he chose a policy with another insurer, he said.
But he recently received $1,200 in bills from Blue Cross for the policy he said he was told was being canceled.
He called Blue Cross several times, was placed on hold, and then disconnected, leaving him with the impression "not only can we not help you, but we’ll probably never be able to help you," he said.
Then early Thursday, a break: Blue Cross called at 8:30.
Not only did Blue Cross tell Gilman he would no longer get bills for a policy he never wanted, "they’re sending me a refund of 20 cents for some overpayment last year," he said with a laugh.
"Apparently, Facebook angst is the best way to get a response," he said.
Contact Robin Erb: 313-222-2708 or rerb@freepress.com. Follow her on Twitter https://twitter.com/FreepHealth.
Source Free Press
No comments:
Post a Comment