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EXCLUSIVE: Covered California enrollment debacle wrongly canceled thousands of health plans

 

BY BRIAN HEWS • Saturday March 21, 2020 • 1:25 p.m.

A glitch in the auto-enrollment system for Covered California, the massive state-run system that offers health plans and financial assistance if enrollees qualify, has unnecessarily canceled “ thousands of health policies“ placing tens of thousands of California families in the position of not having health care, Hews Media Group-Los Cerritos Community News has learned.

The cancellations came at a particularly bad time given the coronavirus pandemic.

HMG-LCCN talked to several families, who wished to remain anonymous, who expressed utter frustration, and fear, at the random cancellations.

The cancellations caused those families to be without health care coverage for nearly two months until the situation was rectified.

One family member told HMG-LCCN, “I have been with Covered California for two years, never missed a payment, I was on auto-pay with my credit card, nothing has changed in my family. Around December 15, 2019, I received a letter canceling my coverage, then I got a letter a couple weeks later from Blue Shield notifying me of the cancellation, and thanking me for being a customer.”

“We were shocked, angry, and then fearful for our lack of coverage.”

HMG-LCCN spoke to several Blue Shield agents who indicated the problem was with Covered California and stemmed from the massive agency changing the tax designation portion of the enrollment process.

“The problem was so bad that Blue Shield had to assemble a team to handle all the complaints,” the agent said. Another said, “it’s just a mess.”

The family member also stated the Covered California agents were extremely callous in handling the situation.

“I wanted to get other coverage while waiting for the cancellation to be fixed, I could not even get a letter from them stating that my coverage was canceled, so without that I could not go and get my own insurance while they were fixing the problem.”

After several back-and-forth emails, Covered California spokesperson James Scullary finally admitted the cancellations in a March 13 email, and put the blame administrative snafus.

“Each year there are some cases that cannot be automatically processed, we have processes in place to identify those cases, review them, and if they are eligible for renewal, we manually renew their plans before any interruption in coverage.” 

Contradicting what the Blue Shield agents told HMG-LCCN, Scullary estimated “only 3,500 policies were delayed” and canceled.

Over three months after Covered California customers were cancelled, and the eventual breakout of COVID-19, over 500 remained without health coverage.

“We have identified all the impacted consumers and nearly all of them have had their coverage restored, including those who needed their coverage to apply to services received since Jan. 1. We are still processing about 500 cases and hope to have those completed next week.”

“That’s great,” said the family member, “I know what they’re going through, I was on the phone for a total of five hours at least. My entire family had to go to the doctor and we all have prescriptions that we had to pay full price for, probably over $1000. Now I have to gather all the receipts fill out forms to get the money back. And during those months they never really told me if I was covered from January 1 or March 1, it was very disturbing.”

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