New enrollees in Obamacare planning a visit to the pharmacy, the doctor or the hospital can avoid headaches by following these key steps
As week one unfolds for the 2.1 million who have signed up for Obamacare, the government is pushing forward to ensure the new health care plan's success. Administration aides are talking to doctors, health insurance providers and establishing working relationships with pharmacies like CVS and Walgreens. But, with a lot at stake for the political reputation of President Barack Obama, the administration is cautioning there could still be some hurdles as consumers encounter the new law.
"Problems that have not gotten attention before, will get some attention now," said Phil Schiliro, a senior White House adviser who is responsible for helping implement the new law.
Under the new provisions of the law, no one can be denied treatment based on pre-existing conditions or occupation. This includes cancer patients. Women cannot be charged higher premiums simply because of their gender. In addition, lifetime caps have been removed, which means insurance companies cannot set a dollar limit on the amount of care you receive for essential benefits—which include mental health and substance abuse disorders.
For consumers, some of whom may be getting health insurance for the first time,here are a few tips you can follow to ensure you receive the best care possible:
Pay your premiums as soon as possible. Anyone who enrolled in Obamacare before Dec. 24, will have coverage beginning Jan. 1. While many health insurance providers, including those in 36 states served by the federal insurance exchange, have delayed the deadline for January's premium to Jan. 10, these deadlines differ by state and provider. For those who enrolled on the federal exchange your coverage will be retroactive to Jan. 1.
Pay close attention to the cut-off dates your chosen provider has set. If you aren't certain, call your insurance provider now to find out.
Call your provider to confirm that your payment has been received and if you have a claim, check that the claim has been received. Because of processing errors on the administrative end of the federal insurance exchange website, some customers' claims were not sent to insurance issuers and some providers were sent incomplete or inaccurate forms. While Schiliro has said he doesn't know exactly how many forms were marked with errors or absent entirely, reported Politico, he did emphasize that the government and insurers had reached out to anyone who might have been affected by the computer glitch. "The population that people have been concerned about have all been contacted," Schiliro told MSNBC. "They've been contacted by the federal government; they've been contacted by the insurers, in some cases, two or three times."
Bring proof of your enrollment with you to the doctor's office, pharmacy or hospital. If you received your health benefits I.D. card in the mail, bring that. If you don't yet have a card some insurance companies will allow you to print a temporary card from their websites.
Call the pharmacy or your doctor ahead of time to see what documentation you will need to prove your enrollment. Both CVS and Walgreens have offered to "bridge" supplies of generic medications to enrolled members, even those lacking I.D. cards, if they can show proof of enrollment in one of the insurance plans.
"We are deeply committed to helping these patients get, stay and live well by helping them to get their medications without interruption," said Kermit Crawford, president of pharmacy, health and wellness for Walgreens, in a release on Monday.
Confirm that your provider is in your network. This was a major point of contention for critics of Obamacare. In October, Watchdog.org
looked at the top 18 hospitals in America as ranked by U.S. News and World Report for 2013-2014. After quizzing hospital staff and speaking with insurance companies, the organization found that most of the best hospitals will accept coverage from one or two specific Obamacare provider plans.