County Pulse: Covered California removes health provider list from its website

February 7, 2014 

  • ABOUT THE REPORTER
    alternate textKen Carlson
    Title: Staff writer
    Coverage areas: County government, health and medicine, air quality, the environment and public pension systems
    Bio: Ken Carlson has worked 13 years for The Bee, covering local government agencies in Stanislaus and San Joaquin counties. His in-depth reporting has focused on access to health care and public employee pensions.
    Recent stories written by Ken
    E-mail: kcarlson@modbee.com

Too many errors prompted Covered California to discontinue the health care provider list on its website.

Some people who purchased health plans from the exchange, on information their doctors accepted the coverage, later were upset to learn their health care providers were outside the network. The exchange announced Thursday it would disable that function on www.coveredca.com.

A state press release said consumers will be directed to links for the provider directories for each of the health plans. They are advised to click on “View Directory” while previewing the plans. Consumers are always advised to contact their doctors to make sure they accept the chosen plan.

News reporters who cover the Affordable Care Act can’t promise smooth sailing for anyone who seeks insurance through Covered California before the March 31 deadline. Since enrollment began in October, there have been numerous reports of website glitches, customers waiting for hours on the phone and people tearing out their hair trying to get payment requests or cards from insurers.

Many were subject to that treatment after the government canceled their perfectly sound policies that did not meet certain standards. More recently, Covered California confirmed it had employees with criminal records on its payroll and did not intend to fire them.

The Affordable Care Act changed the game for consumers in the individual health insurance market in California when the state’s Democratic leaders went “all-in” with the federal health law.

Covered California reported that 500,000 signed up for exchange health plans before Jan. 1, with a large percentage eligible for premium assistance supported by taxpayers. To keep the premiums affordable, major insurers such as Anthem Blue Cross and Blue Shield narrowed the choice of health care providers for their plans on the exchange.

About 65 percent of enrollees in Region 10 – Stanislaus, San Joaquin, Merced, Mariposa and Tulare counties – chose plans from Anthem Blue Cross. Anthem got the business from people eligible for subsidies and those who were not. Twenty percent of those eligible for premium assistance chose Kaiser Permanente, 14 percent went with Blue Shield and 1 percent chose HealthNet. https://www.CoveredCA.com/news/PDFs/regional-stats- dec/dec-regionals-all.pdf

Covered California did not disclose how many signed up in the region, and it’s not known how many have managed to receive their insurance cards.

Some local residents are glad they fought through the enrollment process, however. The Bee has talked with Laura Hunt of Modesto since her first attempts in early October to obtain coverage. She lost her insurance after her husband was killed in a car crash in 2006. Her job with a long-term care facility does not provide health benefits and a previous health condition had made it difficult for Hunt to buy coverage.

Hunt enrolled in a Silver plan through Covered California and was eligible for premium assistance. From the start, her doctor promised to accept the health plan.

“I used my Anthem Blue Cross insurance for the first time yesterday,” Hunt wrote in an email Friday. “The clerk who handles co-pays congratulated me on having insurance again. My doctor ordered a bunch of blood work and a mammogram (I've never had one.) I had my lab work done in Turlock today, no problems. My doctor is busy penciling me in for a complete physical, EKG and the works. She is calling it ‘delayed maintenance.’”

Modesto resident Janet Cataline was on hold with Anthem for an hour and 40 minutes Friday trying to get a question answered. She and her husband received their insurance cards Jan. 17 after a difficult time completing enrollment in a Covered California plan. She got an appointment with a new doctor at Cornerstone Family Medical Group and her husband is able to see a local specialist that accepts the Anthem plan, she said.

“My bills are coming like they are supposed to,” Cataline said. “It’s going smoother. You just have to wait a long time on the phone.”

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or (209) 578-2321.

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