Young families who have successfully navigated the government-created maze to obtain their new “affordable healthcare” plan are now finding that their newborn babies are not insured. Babies born after a policy is issued are not automatically covered, and the troubled healthcare exchange website offers no way to add them to an existing plan.
Centers for Medicare and Medicaid Services (CMS) quietly announced this new “glitch” on New Year’s Eve: “We are currently working with insurers to find ways to make changing coverage easier while we develop an automated way for consumers to update their coverage directly through the Marketplace [website].”
In the meantime, the government is telling new parents to contact policy issuers directly. To better understand the process, I contacted CMS and got a link to the website with instructions on how to find the customer service number specific to my state, county, and insurance company. I was in for a long ride.
After 30 minutes of following the instructions and being repeatedly redirected to information for Wyoming (I live in Arkansas), I gave up and powered through the thousands of entries for providers, states, and counties. Finally finding the applicable customer service number, I made the call, but spent 45 minutes on hold before speaking to a polite, young, insurance company customer service representative. Since I didn’t have a real policy, he could only speak in generalities.
He told me a newborn could be added through a “continuation of care policy” within a specified period after birth. CMS currently allows 30 days. He said CMS would determine any change in rate or subsidy caused by adding the baby and send that information back to the insurance company. The parents would then receive a bill for the difference. So the baby would be covered, but at an unknown price.
To be fair, he also said the increase in members could qualify the family for a federal insurance subsidy or even make the family eligible for free Medicaid coverage, depending on the parents’ income and state of residence.
Other “qualifying life events” also will affect the healthcare policy. Adoption, marriage, divorce, death in the family, and even a change in income all fall into this category and are subject to the same 30-day window to complete the cumbersome change of coverage process. In the meantime, CMS told me it is working closely with insurers on interim strategies to address these situations until the online system functionality is available.
The insurers expected all of these “change in circumstances” updates to be available on the website from the beginning. But government-hired computer programmers were busy making sure people could get insured at all, and pushed the issue down the list of “glitches” to fix.
“It’s just another example of, ‘We'll fix that later,’” said Bob Laszewski, an industry consultant who said he’s gotten complaints from several insurers. “This needed to be done well before January. It’s sort of a fly-by-night approach.”