COLUMBUS — Complications with the federal health insurance exchanges have created challenges for some consumers who have not yet received proof of their insurance coverage. As a result, many consumers are unsure if their medical treatments are covered and are unable to provide their proof of coverage.
“Since open enrollment began on Oct. 1 the federal exchange has struggled to process applications and enroll consumers in coverage,” Ohio Lieutenant Governor and Department of Insurance Director Mary Taylor said. “These delays are making it more difficult and confusing for consumers to use the health insurance plans they have purchased through the federal exchange.”
If you recently purchased a plan, but still haven’t received proof of insurance from your insurance company, Taylor 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. Take detailed notes of conversations and include the representatives names, and date and time they took place. Keep copies of written communication you received from your insurance company such as emails or letters. 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. Ask your insurer for their deadline and keep any records that can serve as proof of payment.
If you are about to buy coverage from the federal exchange, print any paperwork or confirmations that you receive during the enrollment process.
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 effective, 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.
Contact the Ohio Department of Insurance
If you are still having difficulty obtaining proof of coverage from your insurance company, call the Ohio Department of Insurance consumer hotline at 1-800-686-1526 for assistance. Insurance information is available at www.insurance.ohio.gov. You can follow the Department on twitter @OHInsurance and on Facebook.