Three Things That Can Ruin Your Enrollment

 

Number One: But I Thought I Was Through!

The first and most common – not making sure the company has both your enrollment and your first payment. Until you have that card and confirmation of payment from your insurance company, do not consider yourself covered. Things happen – files get corrupted, the nice Customer Service Rep did pretty good for her first day, the insurance company’s computer took a day off – and somehow your enrollment ends up in the digital trash heap.

Once you have completed your enrollment, screen print or print the enrollment page of your account. Check the website or call customer service and find out when to expect the welcome pack from your new insurance company – and then look for it! If it hasn’t shown up when it should have, call customer service (start with the Marketplace) IMMEDIATELY.

Once you have your welcome pack, call the insurance company and confirm either that they received payment (if you had already set it up) or when the first payment is due. Missing that first ‘binder’ payment can result in you losing the enrollment – even if you gave your credit card information when you signed up. Make really sure the insurance company gets paid – they may not be willing to help you correct this later.

Number Two: But I Thought it Was Paid!

I know it’s annoying but check those bank statements each month and make sure your insurance company took what it was supposed to take. Update your card information (usually this is done directly with the insurance company) as soon as it changes. Non-payment is the kiss of death for an enrollment – don’t let it happen to you!

Number Three: But I Didn’t Think the Email was That Important!

Depending on which Marketplace, there can be adjustments made to your plan without your knowledge. This is especially true in state Marketplaces where the determination about your tax credits is made by a third entity (usually Medicaid). Your eligibility can be reviewed and actually changed without your knowledge.

What that can mean is that your tax credits can suddenly disappear – and your insurance company will demand the full premium. Why? You cannot have Medicaid and tax credits at the same time – but you can have an enrollment through the Marketplace and Medicaid at the same time.

Bob’s eligibility is redone as part of Medicaid’s standard redetermination. Unfortunately, the computer zeroes out Bob’s income and places him on Medicaid. The Marketplace computer sends him a nice email that his tax credits will end June 30th – that he never reads. When his July insurance bill comes due, it is $234 more than it was last month – because his $234 tax credit has been removed. OUCH!

Usually, this can be fixed – but in some instances the fix won’t take place until the month after – so Bob could still be left on the hook for the extra $234 for the month of July. That’s one expensive email to ignore!

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