Federal officials tried to offer a few extra breaks on Thursday for people struggling to buy health insurance by the new year. They gave people until Dec. 31 to pay their first premiums for coverage starting the very next day, and asked insurance companies to extend other deadlines, too.
It’s the latest in a series of extensions the Obama administration has made to the deadlines for buying health insurance because the federal website, and some of the state websites, work so poorly. The Health and Human Services department also formalized an eight-day extension that gives people until Dec. 23 to sign up for coverage that will start Jan. 1
“Insurers will now be required to accept payment until at least Dec. 31 for coverage that begins on Jan 1,” HHS Secretary Kathleen Sebelius told reporters on a conference call.
She also asked insurers to accept partial or late payments on the first premium, something some say they will already do. Aetna says it will let consumers pay premiums as late as January 8 and still start coverage on Jan. 1. The Connecticut exchange, Access Health CT, said some shoppers can pay as late as January 7. Maryland will not require payment until January 15 and exchanges in Vermont and California also have offered extensions.
“We are encouraging them to offer retroactive cover,” said Mike Hash of HHS’s Office of Health Reform.
The Obama administration has been roundly criticized for the bungled debut of the health insurance exchanges, which were the centerpiece of health reform. They're supposed to be a way for tens of millions of people to buy insurance, many with hefty federal subsidies. But fewer than a million people have managed to sign up because of technical troubles.
Sebelius said the government had dug up the money to cover people with pre-existing conditions for an extra month. The 2010 Affordable Care Act set up a special pool of coverage for people who could not get health insurance because they had various diseases or conditions. They could join this Pre-existing Condition Insurance Plan, or PCIP, starting in 2010 and get health insurance.
That coverage was supposed to run out starting Jan. 1, when rules kick in that forbid insurers from denying coverage to people with pre-existing conditions. But Sebelius acknowledged that not everyone may have had enough time to find new coverage. “We don’t want these folks to experience a coverage gap," she said. “So today we are announcing that their PCIP benefits will continue to be available for an additional month.”
HHS says 85,798 are enrolled in the PCIP, which has a $4.74 billion budget.
The administration also made several big hints to insurance companies. “We are strongly encouraging insurers to treat out-of-network providers as in-network to ensure continuity of care for acute episodes,” HHS said in a statement.
“We are strongly encouraging issuers to treat out-of-network providers as in-network if the provider was listed in their plan’s provider directory as of the date of an enrollee’s enrollment. And we are strongly encouraging insurers to refill prescriptions covered under previous plans during January.“
Hash says insurance companies have been known to do some of these things. He also reminded people that they can get a break if the website really doesn’t work for them. “If a consumer is not able to enroll in a marketplace plan by Dec. 23 because of a system error they could qualify for a special enrollment period,” Hash said.
Reuters contributed to the story.
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First published December 12 2013, 3:17 PM