Consumers experience delay in insurance ID cards

Jan. 08--People who switched their individual health insurance plan from Blue Cross Blue Shields' Health Maintenance Organization option to United Healthcare's Extended Provider Organization plan have experienced a delay in receiving their identification cards.

Kelly Fristoe, the vice president for the National Association of Health Underwriters and an agent in Wichita Falls, said the situation is causing "chaos" for those needing treatment, procedures or medications. Some have been denied clinical services locally because they don't have their new ID card.

"United Healthcare is about 25-30 days behind on processing these applications in their system," he said. "For example, right now, people who enrolled on Dec. 15 for a Jan. 1 effective date are just now showing up in their system and United Healthcare is requesting more documentation in the form of having to have the insured prove that they are actually losing their coverage at the end of 2015 in order to get that Jan. 1 effective date."

He said there was a special enrollment period Dec. 15-31 for those in this situation to have their coverage begin on Jan. 1.

The Times Record News reached out to United Healthcare. A spokesman said there was not any specific information regarding the matter available Thursday, but the company is looking into the claim.

Fristoe said when BCBS notified clients that their Preferred Provider Organization plan would be canceled and they would be moved to an HMO, a letter accompanied the notification explaining their existing coverage was being canceled. That letter, he said, is what United Healthcare requires before sending out ID cards.

What this does to the consumer is cause them to pay for treatments, procedures and medication out of their own pocket. But, he said, they will be able to file a claim United Healthcare when they receive their ID card, provided they keep all of their receipts.

"The next 30 days will be chaos, both at the provider level and at the insurance level," Fristoe said. "The reason for all this is that the volume of activity of people moving from the Blue Cross Blue Shield HMO to the United Healthcare EPO plans was so high that the insurance company simply could not process everything in a timely fashion."

Fristoe said if consumers don't or aren't able to show proof of insurance, United Healthcare will push their effective date to Feb. 1.

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