New guidance from HHS is designed to prevent gaps in health insurance coverage.
In acknowledgement of the difficulties Americans have faced enrolling in health insurance coverage over the past few months, the Department of Health and Human Services (HHS) has asked insurance companies to make some changes to the way they enroll people in January 1 coverage.
Of the changes, only one is mandatory:
- Health Insurance companies must provide coverage effective January 1, 2014 for any person from whom they receive a premium payment by December 31, 2013.
Insurance companies are encouraged to consider:
- Allowing refills throughout the month of January for prescriptions that were covered under a person’s previous plan.
- Allowing patients to continue to see their current doctor, even if that doctor is not part of the network under their new plan. Furthermore, insurers should treat that doctor as in-network.
- Extending the enrollment deadline past December 23 under “extenuating circumstances”. Furthermore, consider offering expedited service to anyone for whom technical problems with healthcare.gov prevented them from enrolling by Dec 23.
- Accepting partial payment as being sufficient to start coverage on January 1, 2014.
- Activating coverage retroactively to the first of the year for those who sign up after December 23.
Update 12/17/13: Click here for a few clarifications to the above.
Since most of these are only recommendations, it is up to the insurance carriers to decide which, if any, they will implement. We will continue to follow this closely and provide updates as they are available.
In the meantime, if you think you enrolled in health insurance, but have not received proof of coverage, contact your insurance carrier!
Please be patient as we manage a high volume of calls and emails.
