Midwest Mom Secures Insurance….Off Exchange, Due to Glitch

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Published January 02, 2014

| FOXBusiness

After spending two months and several hours on Christmas Eve trying--and failing--to enroll in a health-care plan for her family on healthcare.gov, Shannon Wendt has secured coverage.

After encountering what one healthcare.gov supervisor told her was “the worst case of the glitch yet,” the mom of five from Grand Rapids, Mich., was able to secure an interim plan for her family directly through Blue Cross Blue Shield.

Wendt said she ran into numerous issues when trying to enroll for health care on the federal insurance exchange, running into a repeated issue on the site that said her children were not U.S. citizens and therefore ineligible for coverage under the Affordable Care Act.

The family had a plan through Blue Cross Blue Shield for five years before it was cancelled earlier this year for not meeting certain requirements under the ACA.

ObamaCare mandates that every individual must have an insurance plan by the end of open enrollment period on April 1 or they will face a fine of up to $95 or 1% of their annual income for failing to comply. Wendt was told, after nearly two months and countless hours on the phone with supervisors for the federal marketplace that her only option was to file a written recourse with the Department of Health and Human Services. HHS would then reply within 90 days, bringing the family right up to the final deadline for coverage at the end of open enrollment period.

Wendt had feared her family would be without coverage for a full year.

“We did find an interim plan with Blue Cross Blue Shield,” she says. “The premium is $400, and the deductible is high as well. We are waiting to get all of our information in the mail.”

Wendt says Blue Cross Blue Shield told her the family was eligible for a subsidy via Healthcare.gov, but they were not eligible to claim it with the interim plan because they are purchasing coverage strictly on their own in the private market. Her old plan, pre- ACA, cost the family $260 per month with a $5,000 deductible.

HHS cannot comment on individual cases, a spokesperson told FOXBusiness.com, but did say it is continuing to work on eligibility determinations on the exchange.

“As part of the technical enhancements to healthcare.gov, we have fixed several issues related to eligibility determinations, and we are working to implement additional fixes soon for bugs that are impacting a limited number of people. Individuals who disagree with their determinations should file an appeal.  As part of our effort to reach out to individuals who may have experienced difficulty using the website, we are reaching out to these consumers so they know their next steps for enrollment, which may include resetting their application and starting over, enrolling in Medicaid/CHIP with their state agency, or filing an appeal. ”

The plan the Wendts now hold is from month-to-month, and Wendt says she plans on cancelling it once they are able to secure coverage via the exchange.

“It’s a bit frustrating, but still a worse plan is better than nothing at all,” she says. “Also there is no one to get mad at, that I can actually speak to. I will keep trying.”

URL

http://www.foxbusiness.com/personal-finance/2014/01/02/midwest-mom-secures-insurance-off-exchange-due-to-glitch/