WEST PALM BEACH - Insurance coverage under the Affordable Care Act was supposed to start January 1st, but some customers still can't see their doctor. Many customers who bought cover through Healthcare.gov say they haven't received their ID card with their insurance number on it. That determines how much your visit will cost. Without it, some patients can't see their doctor.
When Thomas Nabeack needed a prescription refill this month, he had to work out a payment plan with his pharmacy.
"Just on hold again," said Nabeack.
His insurance coverage is on hold. He paid Florida Blue in December, but his ID card hasn't arrived in the mail.
"Hour after hour waiting for someone to pick up and speak to," said Nabeack.
Patients are speaking to their medical providers about the problem, but doctors can't do much to help.
"All the things we do with a patient when they come in checking their insurance is pretty much on hold right now," said Richard Hays, M.D, Chief of Staff at Wellington Regional Medical Center and Family Practice doctor.
Doctors are asking patients to reschedule annual exams until they get their insurance information.
If you need to see the doctor now, you may not like your options.
"We are almost in a situation where they have to pay for their care, and later if we find out we are on the plan we can file claims for them. Some of them are not happy about this," said Hays.
Florida Blue told the watchdog it didn't anticipate these long enrollment delays.
The insurer said it's a complex process to verify all these new customers because information is being shared between a number of government and private groups.
Insurance agent, Joshua Dorman, says at least three insurance companies are backlogged.
"Not only are they getting a lot more people, they don't have the infrastructure to enroll all these people right away," said Dorman of Plastridge Insurance.
Florida Blue said it's adding staff and extending hours to help members with their coverage questions.
Nabeack's questions were answered once the Watchdog got involved.
Even though he couldn't see his doctor earlier this month like he wanted, Nabeack should not expect a refund, like he would if his cable didn't work for several weeks.
"You can use the product. You just can't use it right away. Is that fair? The answer is probably no but is it happening? Yes," said Dorman.
You may not be able to use your insurance for regular doctors visits yet, but the coverage is still active if you have an emergency.
Florida Blue said it's mailing ID cards this week to members who don't have an ID card yet and their coverage started January 1st. You will be getting a call to let you know to check your mail. Your new card should arrive in the next 7 to 10 days.
Florida Blue is working diligently to process the high volume of enrollments that we have received through the Florida Marketplace. We have added staff to work these applications, and have extended service hours both in our call centers and at all of our 18 retail center locations throughout the state to help members with their coverage questions and enrollment issues.
Marketplace enrollment is new to everyone involved. The process relies on the converging of data from a number of independent systems from both government and private organizations. The complexity of this gathering and verifying of data has resulted in the entire process taking much longer than we anticipated.
Florida Blue announced today that it has made significant progress in processing individual member enrollments received through the Health Insurance Marketplace.
For members with a Jan. 1, 2014 effective date who have not received their ID cards, those cards are being processed and mailed this week. Florida Blue will be making outbound calls to notify members that the mailing is occurring. Members should have their card in within 7-10 days.
For members with a Feb. 1, 2014 effective date, they will receive their ID cards from Florida Blue 7-10 days after their payment is received.
We truly appreciate the patience our members have shown. We ask them to continue to reach out to us for help, either by phone, through our website or at our retail centers.