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Waiting for confirmation under Obamacare

InsuranceConsumersAffordable Care Act (Obamacare)

If you managed to sign up for health insurance under Obamacare before the Dec. 23 deadline for coverage that starts Wednesday, you may be wondering what's next.

First, you'll want to be looking for confirmation from your insurance company that you are enrolled. Then you need to pay your first monthly bill. And finally, you will want to get that all-important insurance card. It acts as proof of insurance at the doctor's office, the emergency room or the hospital.

Matt Hamill was one of those concerned about the paperwork for his new health plan. Earlier this year, the 41-year-old independent video editor from Los Angeles was among the 1 million Californians to receive notice that his health plan was being canceled because it didn't comply with the rules of the federal healthcare law. So he went online in search of a new policy and signed up for a Silver plan.

As of last week, he was waiting for confirmation that his policy will be in place Jan. 1, and he had yet to receive a welcome packet or an ID card. And calls to his insurer's customer service line came with long wait times. "I just gave up on waiting on the phone for them," he said.

December is always a busy time for insurers, and the implementation of the Affordable Care Act has only made matters worse this year. "There's a backlog and insurers are overwhelmed," said Carrie McLean, customer service director at online health insurance broker ehealthinsurance.com.

Here are tips for the anxious among us, eager to be officially enrolled and ready. Experts offer insights about how long you should expect to wait to hear from your insurer once you have signed up for coverage, what information you should expect to receive and what to do if the paperwork never arrives.

Give it time. Covered California, the state's health insurance exchange, says it's reasonable to expect to hear from your insurer directly within 10 days of enrolling in a plan.

But there is a lot of paperwork to be processed, and the information being transmitted must be accurately received and then entered into insurers' systems.

Covered California is sending thousands of notices to health plans daily, spokesman Roy Kennedy said. These notices contain the information needed by insurers to establish an account. Although Kennedy said Covered California is confident that anyone who submitted an accurate application for insurance by Dec. 23 will have coverage Wednesday, he acknowledged that about 17,000 applications were subject to data processing delays.

"As of Dec. 18, about 11,500 still needed to be entered into the system," he said. Since then, more than 100,000 people have enrolled in health plans.

Given the backlog, ehealthinsurance.com's McLean suggested that consumers who haven't heard from their insurer not panic until after the week of Jan. 20. "It wouldn't surprise me if people don't get something before then," she said. "We're talking about millions of people trying to get insured at the same time."

What you should receive. If you have enrolled through Covered California you should receive a bill and a welcome letter, which will indicate that your information has been sent to the insurer of your choice and correctly entered into its system. Ideally, it will come within 10 days after you have enrolled. But again, don't worry if it takes longer.

If you bought a plan directly from an insurer rather than through the exchange, you are likely to get just a welcome letter within 10 days because you probably should have already paid your first month's premium.

"If members applied directly to Kaiser Permanente, they will be asked for payment at the time of enrollment," said John Nelson, a spokesman for Kaiser Permanente. The exchange, by contrast, isn't set up to accept payments.

Once you have paid your first month's premium, you will be sent a member identification card by your insurer — regardless of how you applied for coverage.

Make the call. If weeks go by and you still haven't heard anything, you will need to pick up the phone. You can directly contact the insurance company you enrolled with. You should have been provided with contact information and in some cases an identification number after completing your enrollment through Covered California.

If the company doesn't have you on file, Kennedy said, you can call the Covered California service center at (800) 300-1506 or go online to your account to check the status of your application. There you can view a summary page where there will be a box indicating that a plan has been selected and that you are enrolled. If the box is blank, the process isn't complete and you will need to pick a plan to enroll. If you worked with an insurance agent, ask for help.

Make sure you pay your premium. Just because you completed the enrollment process doesn't mean you are all set. "The consumer has to pay their first month's premium before it can take effect," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, an insurer trade group.

In California, the last day to pay your first month's premium is Jan. 6, with coverage retroactive to Wednesday.

"If you miss the deadline to pay, some carriers are making you reapply," McLean said.

Other insurers, however, are giving consumers a little extra leeway under special circumstances. "We will accept payment beyond Jan. 6 for anyone who does not get an invoice from us by the end of 2013," Nelson of Kaiser Permanente said.

If you haven't received a bill from your insurer after 10 days, give them a call.

You can tap into healthcare before your card arrives. If you need to go to the doctor, don't worry that that your insurance card hasn't arrived. Just make sure you have your health plan member number, which confirms that you are enrolled. This is usually enough information for doctors to double-check that your coverage is active and for them to bill your insurance company afterward.

The week before Christmas — five weeks after he had applied — Hamill, the video editor, got the confirmation he'd been waiting for. "I received a welcome packet and ID card … in the mail," he said. Best of all, he's happy with his new policy. "Comparatively, I got a better plan for the same price."

healthcare@latimes.com

Zamosky is the author of a new book, "Healthcare, Insurance and You: The Savvy Consumer's Guide."

Copyright © 2014, Los Angeles Times
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