There are times when you just don’t want or need to verify your account – and other times where failing to verify your account will just complicate things. Know which is which before you dial!
Basic questions can be safely asked anonymously. Things like ‘what is you website address?’, ‘what does Cost Share Reduction mean?’ and ‘how do I find X on your website’ are usually perfectly safe to ask without the rep looking at your account. In that case, you can start the conversation with ‘Hi, I’m Mary. I just have a quick question and prefer not to verify my account.’ The rep may have an inane question or two that they are required to ask but they will honor your request to not verify the account. Answer their questions, ask yours and the conversation will likely be over. Nothing simpler.
It’s tempting to do this every time you have a question – no one really enjoys the verification process and it seems to take forever for the reps to get on to the point – BUT being an anonymous caller also limits what the rep can say to you. The rep may well be looking at your account – especially if you provided information to the call tree or if you have a unique name – but they can’t tell you anything about the account. As far as they are concerned, you aren’t you until verification is complete. This is a good thing – it keeps reps from accidentally giving information to those who aren’t entitled to it. But it also keeps the rep from giving YOU information.
Anytime your question is about something in your existing account or enrollment, it’s a good idea to let the rep pull up the account and verify it. Specifics may let the rep solve the problem for you right then – or spot a problem you didn’t know you had.
For example: Monica doesn’t understand why her insurance company keeps telling her she has Silver Plan ABC 400/20. She looks at her enrollment online on the Marketplace website and it clearly shows Silver Plan ABC 4000/40 – so which is correct? Monica calls the call center and asks anonymously if the insurance company gets the same plan name that the customer sees when the plan is sent to the insurance company. The rep tells her yes and she ends the call.
Monica’s question seemed perfectly reasonable to her but the insurance company isn’t going to change the plan name – because it isn’t wrong. What the Marketplace rep didn’t see because they weren’t looking at the actual enrollment – or saw but couldn’t tell Monica – is that Monica has a Cost Share Reduction. The rep would have known that some insurers rename the plan according to the customer’s actual deductible and coinsurance – and could have explained that to Monica had the rep been able to discuss the account. Silver Plan ABC 4000/40 is the exact same plan the insurance company is now calling Silver Plan ABC 400/20 – the insurance company is showing the cost share reduction changes in the name where the Marketplace shows the same details in the enrollment details.
Another reason to let the representative look at your account is that Marketplace reps are trained to analyze the account in ways you may not think of – or know about.
Johnny just wants to confirm that what he sees in his online account is really what he is enrolled in. He’s been to the doctor and they weren’t able to pull up his insurance. Johnny calls the Marketplace first and asks simply ‘I see a plan in my enrollments in my account – that does mean I have insurance, right?’. The rep, unable to see the account because Johnny didn’t provide any information, confirms that yes, that does mean Johnny has an enrollment.
Two hours later, Johnny and the nice insurance company rep call back to conference in the Marketplace. Now the verification is done and the new Marketplace rep can look at the enrollment. The rep does see an enrollment but knows that the way the enrollment is posted indicates that the plan was terminated. Johnny states he had updated his address a month ago – and when the rep checks, they find that the enrollment had only partially updated. The result was that only the termination and not the updated enrollment was sent to the insurance company.
Fortunately for Johnny, the rep can fix that problem – but it would have been a lot less hassle for Johnny had he let the first Marketplace rep look at the enrollment instead of just asking a ‘simple’ question.
Moral: when in doubt, verify the account so the Marketplace representative has all the information they may need to help you. This little frustration can save you a LOT of frustration later!