HHS says transition to new health insurance easier

Dec. 14, 2013 at 9:19 PM
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BETHESDA, Md., Dec. 14 (UPI) -- The U.S. Department of Health and Human Services says it has taken steps to give those buying individual health insurance for Jan. 1 coverage.

Kathleen Sebelius, secretary of HHS, says the steps include requiring insurers to accept payments received through Dec. 31 for coverage beginning Jan. 1, and urging issuers to give consumers additional time to pay their first month's premium and still have coverage beginning the first of the year.

In addition, HHS is giving people enrolled in the federal Pre-existing Condition Insurance Plan the chance to extend their coverage through Jan. 31 if they have not already selected a new plan. PCIP is a bridge program that provides people who could otherwise be shut out of the insurance market or charged more because of their pre-existing condition with quality, affordable health insurance until options become available in the Marketplaces. The additional month gives this vulnerable population additional time to enroll in a plan and ensure continuity of coverage.

HHS also formalized the previously announced decision giving individuals until Dec. 23, instead of Dec. 15, to sign up for marketplace health insurance coverage beginning Jan. 1.

Sebelius said HHS is strongly encouraging insurers to treat out-of-network providers as in-network to ensure continuity of care for acute episodes or if the provider was listed in their plan's provider directory as of the date of an enrollee's enrollment.

HHS is also strongly encouraging insurers to refill prescriptions covered under previous plans during January.

"We are providing additional flexibility to consumers across the country to ensure they have access to coverage options that begin on Jan, 1," Sebelius said in a statement. "The department is committed to providing consumers with the information they need to pick the coverage option that works for them and their families."

Other ways the administration says it is working to provide consumers with a smooth transition to coverage include:

-- Working with insurers and consumers to make sure they know whether their doctor or prescriptions are covered before they choose a plan, and how to get care they need during the transition -- e.g., receiving a non-covered drug if the patient's doctor deems it medically necessary.

-- Educating consumers who recently received cancellation notices about the possible option to extend their old policy or enroll in a new plan.

-- Continuing outreach to consumers who began the application process through the marketplace and experienced technical difficulties.

-- HHS says it is committed to engaging consumers as they maneuver through the health coverage process, helping them access and shop for a policy.

Consumers with questions are encouraged to call the call center at 1-800-318-2596, Sebelius said.

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