Brad Woodward of Old Orchard Beach said he signed up for health insurance through the Affordable Care Act several weeks ago, and paid the premium for his first month, but still doesn’t have an insurance card or a way to get health care, a week after coverage started for millions of Americans.
“It’s like I’ve been left in the lurch,” said Woodward, who bought an Anthem Blue Cross Blue Shield “silver” plan on the health insurance marketplace.
Woodward’s problem is not unique, say insurance officials and people who have enrolled through the federal website www.HealthCare.gov. It’s unknown how widespread the problem is in Maine, but some enrollees still don’t have insurance cards that they can take to a doctor’s office, a pharmacy or a hospital.
It’s also unknown whether the problems will be fixed in a few days or weeks, or linger for months, health officials said.
For a small percentage of enrollees, the information is not getting from the federal government to the insurance companies, said Kevin Lewis, executive director of Maine Community Health Options, which along with Anthem Blue Cross Blue Shield is offering insurance on Maine’s marketplace.
“When that happens, we’re working with people to find their file as best as we can,” Lewis said. “It may be a low percentage, but if it happens to you, it’s 100 percent.”
Anthem spokesman Rory Sheehan wrote in an email response to a question that “overwhelming call volume” from customers is causing problems, but anyone who signed up and paid has coverage.
“Our goal is to ensure our members can access their benefits as early as possible in 2014 … we will not be rejecting any January policies where payment has been received by Jan. 15,” Sheehan wrote.
Through Nov. 30, about 1,700 people had signed up for coverage under the Affordable Care Act in Maine. December numbers, which likely will be released by mid-January, are expected to show a surge of enrollments as glitches with the website were largely solved by mid-November.
Customers could start enrolling Oct. 1, but the website was plagued with problems for the first six weeks.
The problems continue, but to a lesser degree, officials said.
Lewis said Maine Community Health Options sometimes hears from a customer, finds no record, then gets the information from the federal government a day or two later.
Insurance companies’ own glitches could also be causing some backlogs. Brad Woodward said he believes that’s what happened to him.
He said he has had to wait for hours on hold before speaking with Anthem representatives, who tell him they can see his file but don’t have a “member number” to give him so that he can access his insurance.
Sheehan wrote that Anthem is taking steps to address the surge in calls.
“Last week, combined call volume across Anthem Blue Cross and Blue Shield in Maine and our affiliated plans in 14 states exceeded one million calls in just over two days. Because newly compressed time frames have led to overwhelming call volume, we are processing enrollments as quickly as possible.”
Sheehan wrote that Anthem is “adding to our large bank of customer call centers – reassigning personnel and training them to accommodate this large influx of calls, extending customer service call center hours through Saturdays” and holidays.
Woodward, 60, said his prescriptions will run out in a few weeks and he doesn’t want to pay out of pocket, then worry about whether he will get reimbursed by Anthem.
Woodward is an independent contractor in the wind energy industry, and like many self-employed people has bought insurance on the marketplace.
The marketplace is a key part of the Affordable Care Act’s intent to increase coverage. For the first time, it’s providing subsidized insurance for people who can’t get insurance through an employer or qualify for Medicaid.
Woodward said his monthly premiums, which used to be $560, were drastically reduced, and his new plan’s benefits are comparable. Woodward would not say how much he’s paying now.
“This program, if I can get coverage, will be a godsend,” he said.
Dan and Mary Unsinn of Kennebunk had an experience similar to Woodward’s, paying Anthem in December for coverage to begin in January but not yet receiving an insurance card.
Dan Unsinn, 62, said he retired last year after 40 years as a math teacher, and he and his wife, a part-time art instructor, need insurance until they can get Medicare when they turn 65.
Unsinn said he was on hold with Anthem for 90 minutes but couldn’t get through.
“I wish I could talk to someone to reassure me that I have insurance,” said Unsinn, who would not say what the couple will pay for their coverage.
Joe Lawlor can be contacted at 791-6376 or at: