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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


What Happens After Application is Complete?

By on | 45 Comments

Question: What happens after my Covered California application is complete? I have received nothing from them?

Answer: You will not get any response from Covered California (CC) beyond what you can find in you online CC account. Login to your CC account. The “Progress Bar” is that horizontal line across the top of the page with checked boxes.

Confirm Enrollment: The “Enrollment” box should be checked. If not click on the “Eligibility” box and now you should see a check the enrollment box. If your application is complete, you will see an enrollment summary page with the health plan selected, effective date of coverage, and net premium due. You may want to print that page for your records. If you do not see your enrollment summary, your application is not complete. Complete it by going through the plan selection step again.

Confirm Eligibility: From the progress bar, select “Eligibility”. You will see a very busy page with your eligibility results. Each family member is listed separately and you may find that eligibility varies by individual. Most commonly, for example, parent(s eligible for APTC (Advance Premium Tax Credit - AKA Subsidy) and CSR (Cost Sharing Reduction) and child(ren) eligible for Medi-Cal. Do not be concerned if you see that you are “Conditionally Eligible”, that just means that you will have to provide verification documents within 90 days.

Once your enrollment is confirmed, your next contact will be from the insurance carrier you selected by automated phone message and mail, with instructions to pay your initial premium by January 6th.

45 Comments

Thanks Herr,

“Terminate participation” function was not available indeed. I searched everywhere on the COVERED website for something to cancel.

After three hours on the phone the third COVERED operator was able to cancel my plan. Thank God the third lady was very knowledgeable. The first and second were giving absurd indications like: “The site is looked by the Medical call county services” (I was in PPO plan with BlueShield!) “Complete the 2015 application then only we can cancel both 2014 and 2015” Of course no one recognized that something is wrong. I was supposed to know from my childhood that cancelling 2015 application will erase everything starting with 2014! No warning! Anyway they have the data for 2014 but I will not be able to see it. For the system cancelling the application means cancelling a one year history too.

Dan F.

You were supposed to use the “Terminate Participation” function, which is currently disabled in most or all 2014 applications. Cancelling the application should not have erased anything, but then again, the website is apparently not behaving properly today.

N, sounds like your are eligible for Medi-Cal as “They also said I can start seeing a doctor and that they will contact me in 30 days.” which is typical of Medi-Cal eligibility. In that case the enrollment box will not be checked. Reread the eligibility page and I think you’ll find this to be the case.

Impossible to cancel ! One year data erased !

I tried today to cancel my coverage after one year with COVERED (Gold PPO BlueShield). (My wife got a job and has a plan) It was impossible to find a way on the COVERED website. I press “Cancel my application” and all my data for 2104 is erased just my name is there. It was supposed to cancel application for 2015 or insurance from now. I called Covered, waited 30 min and the lady told me to call county Medical (!!) because they took control of my account and she can not see my info. Of course it is impossible to reach them. And I do not think county can solve a web problem. It is insane!

How is possible to remove all the COVERED data after one year of coverage? Nobody thought how can we can cancel? what a mess…

N …

Evidently you did not actually complete the enrollment process and/or there was a data error when you thought you completed the application. You have a couple of choices as to how to proceed. First, you can call CoveredCA (800-300-1506) and talk to a Customer Service Representative for assistance. Or, you can choose a Certified Insurance Agent as your representative by logging into your account and using the “Find an Agent” selection in the “Get Help” menu.

Once the agent accepts you as a client, he/she can look at your account and determine what needs to be fixed. If the agent can correct the matter, your enrollment will be completed, if not, the agent will call CoveredCA to get the issue resolved.

At least that’s what I would do as your agent. It’s what I’ve done for dozens of others in the past year.

I’ve filled out the application and they said I was eligible and I’m covered. They also said I can start seeing a doctor and that they will contact me in 30 days. But then i noticed that my enrollment box is not checked but all the other boxes are. I can’t even access the enrollment column and there is no next button to move on to that column. What does that mean?

Linda …

What problem are you having? If you need assistance, contact me directly. My contact information is posted on my website, which can be accessed by clicking on my name.

I just got a bill today for a payment I have already done twice. I sent a check on mid December, which was only cashed on 1/14/2014, almost one month to cash check. I also paid via credit card on 12/30/2013, and credit card payment was only processed on 1/9/2014. However, neither payment has been posted to my account yet, so they sent me a bill for it. Somehow, Anthem did not post the 2 payments to my account. They sent me a letter with an Application# to make the initial payments, which I did, but they are somehow not correlating the Application# with the plan new ID# issued. I tried contacting them by phone but after more then an hour waiting a message tells me to contact them again on another day. What I mess… Now I have to spend hours on hold on a phone call to prove to them that I’ve already paid. This whole experience has been very frustrating…?!I$:(

Has anyone received an ID from Anthem.

Paid them both a check in the mail and also electronic transfer. Nothing. Phone calls require 2 hour wait or longer, if they don’t hang up on you first.

Thanks everyone. I called CoveredCA Saturday and was on hold for about an hour and 40 minutes. The rep helped me to get my application unstuck. My income qualifies for Medi-Cal. Previously, I was only asked to verify my residency which I did by uploading my California Drivers License but had zero response since December 11. The site is down right now so I can’t confirm what he had me do but I clicked on the button to make a change to my application (or something like that). This had me “Continue” through a couple screens and then click a couple boxes and enter my name and PIN which brought me to a screen requesting me to upload my residency (CA Driver Licnese) AND income (Federal Tax Return) eligibility. I uploaded successfully but the rep was not able to see my uploads because of a buggy system. He said he runs into this issue regularly. After a few tries of me uploading and him unable to see my documents, he forwarded my call to the Riverside County Health or Social Services Dept and the nice lady there was eventually able to see my drivers license and Federal Income Tax Return. She then approved my documents and said my Medi-Cal should start on February 1. After I told her that my current insurance expired on December 31, she used my SS# to lookup something on the state database and discovered that my Medi-Cal was already tentatively approved and a card was issued in late December 2013 (I haven’t received this yet). She said that they have been doing this when an application is virtually complete but awaiting minor eligibility authentication. They will go ahead and issue a 60-day Medi-Cal enrollment pending the receipt of the required documentation. She was able to confirm my documentation and I am good to go! I will call an 800 number on Monday to choose my health care provider network and a primary care physician.

Thanks again for your help. ~David Vaughan

I finally got my Anthem Member ID number! There is hope for everyone in my situation, where you have paid Anthem online but have not yet seen the charge on your credit card.

After almost a 2 hour phone wait, I got through to an Anthem rep today.

She was able to give me my Member ID number. She said my card was mailed to me on Jan 2.

With my Member ID number, I was able to log-in to Anthem.com and see my Silver plan details, and my wife as a Covered Adult. I was also able to print a temporary Member ID card.

As of today, my credit card still has not been charged for my January premium.

One problem that has not been fixed is Anthem’s inaccurate FIND A DOCTOR network lookup. It appears the network info hasn’t been updated since Dec 23. I know for a fact my doctor is not in the Silver/Covered CA network, but Anthem’s Find A Doctor still shows him in Network.

When I called Anthem back on mid December they said their payment web site was having issues and to send in a check. I did send the check, but they haven’t cashed it to date. Then, I went online on Dec.30 and paid using a credit card, got the payment confirmation from Anthem, but credit card hasn’t been charged yet. I tried calling Anthem for the past few days and no luck. I keep getting reminding e-mails from Covered California to do my 1st payment, which I have already done by check and credit card just in case. This is a big mess and very frustrating. There is no communications between Anthem and Covered California. We try to pay and they don’t even process the payments. The Government doesn’t pay their part either…what’s next?

Everyone, please do not believe this story about how Anthem cannot issue ID cards because the Federal government has not paid the subsidized portion of the premium.

Anthem’s obligation to Covered California enrollees is dictated by the contract that they signed with Covered CA (the same contract signed by other insurers who have already been issuing ID cards for 2014 coverage).

Once an insurer has received your premium, the clock starts running on various administrative and contractual obligations - they must report the payment to Covered CA within 3 business days of receipt, Covered CA must reply with a final verification of enrollment, and THEN the insurer must issue the enrollment package and ID card within 10 business days of verification.

Joey may be right - an insurer might say that for whatever reason, they are having difficulty processing payments, and therefore have not technically “received” payment yet. That essentially would stop the clock and who knows when people will receive their ID cards. But that would be a problem with that one insurer, not the federal government payment of subsidies.

David,

I would not recommend Online Chat. I have waited for 30+ minutes 6 times and after watching the queue countdown showing that I am getting closer, it always disconnects as I reach 1st or 2nd in line.

I never received a letter from Anthem Blue in regards to an Application ID to pay my premium by January 6. When I call the number, there’s no option for anyone from the CoveredCA website, so I tried both applicant and member options. Then when I finally get somewhere on the phone, they say they can’t take my call because of Healthcare Reform.

David …

If your eligibility results show you as Medi-Cal eligible, and you successfully uploaded your required document(s), the information will be turned over to the Riverside County Medi-Cal agency for completion. You should not have to do anything more than sign a couple of forms, if that much.

But if you receive a packet of stuff from the agency, you need to make sure you comply with any requests for information they make within 10 days, or your Medi-Cal application will be tossed.

@Dan

Thanks Dan. I haven’t wanted to wait on hold for hours and assumed everything would work out on its own but from what you said, I may need to rock the boat. I let my Anthem Blue Cross plan lapse at the end of the year. My income level qualifies for Medi-CAL.

I uploaded a copy of my California Driver’s License and assume that’s all that they needed.

So, I need to call? Will an Online Chat accomplish anything? Has anyone tried an online chat? Do I just ask them the status of my application?

Thanks,

David

The only recommendation I can make for folks like Dez who should have coverage and need to refill a prescription is to use a network pharmacy and pay the full price for the prescription, save your receipt, and once you have your enrollment secured submit a claim to Anthem for reimbursement. You should receive 100% of what you paid in excess of your prescription copay.

Be aware, however, that if you have a BRONZE plan, 100% of your prescription cost counts toward your $5000 deductible, in which case you would not want to ask for a refund, but simply to have the charge added to your out-of-pocket/deductible expenses for the year (even if it is more than what you should have paid).

In the meantime, you can write letters to Mr. Obama at the White House and Ms. Sebelius at HHS and let them know what you think of the system of having the government pay a portion of your premium and what trouble you are having as a result. I don’t know if they really care. (Don’t bother to write to Ms Boxer or Ms Feinstein — I know they don’t.)

Dez, exactly the same scenario for me. I’ve been on hold for over 2 hours with Anthem Blue Cross right now. Tried talking to a human yesterday and got disconnected twice after an hour each. Very frustrating, I have two doctor appointments next week.

I have a payment verification number dated 12/18 from Anthem Blue Cross for CCA Gold PPO plan but no ID number or card. I tried to chat online with Anthem and they told me I could only get my member ID over the phone. I have called Anthem repeatedly over the past week, including at 7:30 am when Anthem’s line opens, never reaching a live human, trying both the pending applicant option and the pharmacy problems option, and have gone into the hold cue for 45-90 minutes each time until the line disconnected. Twice the robovoice asked for my ssn and said it was not in their system. Several friends have told me CVS will fill prescriptions now before people get their cards but when I went in to CVS this morning, they refused. I tried calling CVS Caremark (mail order) and they were very nice but said I don’t show in their system as having Anthem Blue Cross coverage. If Anthem isn’t going to issue ID numbers until they receive the gov’t share of premium, how do I refill my prescriptions now?

Joey,

I have the same concern: if the government does not pay in time the subsidy is the insurance policy active? My payment by credit card is also scheduled for almost five days now and pending in the bank account. I am with Blue Shield.

This could be a real problem.

Terminator wrote: “once you terminate participation, your account is closed and you MUST create a whole new account”

Not only that, but if you do this now, your coverage cannot begin before February 1. Additionally, the termination date must be at least 10 days to two weeks into the future, and the new plan start date will not be sooner than that.

While this is a “fix” it is rather imperfect one because it does require the process to be started over from scratch as Terminator wrote. This aspect of the CoveredCA website was not well thought out and needs to be reshaped for the future — as do many other aspects.

The powers to be in Sacramento need to enlist agents and others who slogged through the application process to debrief the process and make recommendations for much needed improvements before October 15 rolls around.

One of the other single biggest failures. aside from horrendous wait times by the telephone even at 8:00am, was the Online Chat function. I was dumped off that system more times than I can count. And the one or two times I actually got through to someone … they were not empowered to do anything of value. Chat was a complete waste of time.

kvandry wrote: “Everything is totally screwed up, and I have already given up hope that I will receive my insurance ID card anytime soon, i.e. maybe not even by the end of January!”

Don’t be overly concerned about this. If you paid your share of the premium your coverage became effective on January 1. When will the IRS begin issuing payments to insurers is anybody’s guess — who knows if they have even received any data from CoveredCA?

If you selected an HMO and chose your primary care physician and need to see the doctor, just call and make an appointment. When you get there, the doctor’s office will verify your ooverage and plan benefits with Anthem by phone. You should not have anything to worry about.

Anyone who thought this process was going to be seamless and without incidents was intoxicated at the time.

Joey,

I am in the same boat as you. I “paid” Anthem online with my credit card, and received an email as “an acknowledgement that (my) initial payment has been submitted” on Dec. 10, 2013.

So far, Anthem has not yet charged my credit card, and I have not yet received any insurance ID card.

When I called, Anthem confirmed that I have “paid.” However, I was also told that Anthem has not processed my “pending” payment because the federal government has not yet paid Anthem the APTC (subsidy) portion of my insurance premium.

Sounded like we are being held hostage not only by the insurers, but also by the federal government. Everything is totally screwed up, and I have already given up hope that I will receive my insurance ID card anytime soon, i.e. maybe not even by the end of January!

This is an important reminder for those who want to switch the Health Plan AFTER you have already been enrolled to a health plan. You can do this by using “Terminate Participation” feature. HOWEVER, I have learned through the hard way that once you terminate participation, your account is closed and you MUST create a whole new account. Please make note of this because the page lets you choose another health plan when you terminate participation but that is misleading because your account no longer exists. You MUST create another account and start from scratch after you terminate participation.

My account shows the wrong plan. Either I selected it wrong or there was a site screwup. Either way, how do I change it to the plan I want? (Thanks for all your answers here).

David, Call Covered and talk with them. My application was initially in the same phase as yours, blocked on the eligibility and verified for Medi-Cal instead of private plan. You can solve some things talking with the operator.

I “paid” Anthem on Dec 13 with my credit card, via their online payment site https://shop.anthem.com/sales/eox/ABC/CA/en/payment/enroll/validate/landing?execution=e1s1

However, as of Jan 1, Anthem has not yet charged my credit card.

I have called Anthem about 3 or more times and they keep telling me they are overloaded and I will receive my insurance info/card 7 to 10 business days “after receipt of payment”. They can see in their System I have paid, but they can’t tell me when they will process the payment and charge my bank account.

This is the catch, AFTER RECEIPT OF PAYMENT. Since Anthem has not processed my payment, they can continue to string me along. Of course they cannot tell me when they will process my payment. There is no telling when they will create my member ID and issue me a card. Anthem is totally screwed up.

When I made my credit card payment on Dec 13 I received an email from Anthem confirming they received my payment. Their email said.

“Thank you for choosing Anthem Blue Cross and Blue Shield for your health coverage needs. This email is an acknowledgement that your initial payment has been submitted.

You will soon be receiving confirmation of your enrollment and effective date as well as information about how to register for our secure member website. This web site provides access to your benefit summaries, claims history and many useful tools to help you manage your health. We look forward to the opportunity to service your health coverage needs. If you have questions or need additional information, please call 1-888-556-9929, Mon-Thur. 8:00am - 7:00pm EST, Fri. 8:00am - 6:30pm EST.”

My situation is the same as Phil (posted December 23, 2013). Apparently, I qualify for Medi-CAL and completed everything on December 11, 2013. I submitted a copy of my California drivers license. Have received absolutely no response and my progress bar is stuck on “Eligibility.”

It’s now January 1, 2014.

Covered California’s website indicates that I am enrolled in Anthem Blue Cross Silver Enhanced. Their representatives have confirmed that my application was submitted on 10/14. Blue Cross still has no information by case #, application #, DOB, or Social Security #. I have been through numerous very long waits and talked to agents on both ends. Both say that the problem is on the other end and that there is nothing that they can do. Until today, Blue Cross told me not to worry. Now they say that there is no way that they can insure me for January. Actually, the problem is on MY end now as I had to cancel my (unaffordable) MRMIP insurance in order to be eligible under the ACA. As of tomorrow I will be uninsured for the first time ever. And no one can tell me how to fix that.

We just learned today that Blue Shield, HealthNet and Blue Cross are not showing us (certified agent) as the broker on any of our 24 Cov Cal applications. Now we have to submit attestations on all these, with client signatures. Agents, beware. The work is not done!

Who is paying for CSR (Cost Sharing Reduction)? I have enrolled in Blue Shield PPO using CC and I am eligible for CSR also. Today I got by mail a Benefit Identification Card from healthcare services. Is this card for CSR or is just a mistake because somehow they shifted me in the Medical?

Oau… I have enrolled with Blue Shield PPO through CC on December 18. And could not contact them by phone. No bill no invoice so maybe I will be enrolled by May. Looks like private insurance companies are much worse than the government ! This is a performance!

Signed up Dec 6th. Selected plan with Anthem. We site confirms all. But I have not received a single piece of paper except a useless “eligibility confirmation” letter. It’s now Dec 30th, payment is due Jan 6th, no bill, no card, no information. Been on hold with Anthem for an hour now.

kvandry, it sounds like you got a hold of a cranky service rep. Just try calling again and simply ask when you can expect to receive your ID card. In the meantime, as long as you paid your premium and received confirmation of your payment, you have coverage effective 1/1/14. And you can receive services effective that date even if you have not received your ID card, though it may take some persistence in dealing with Anthem while making your appointments.

Regarding the issuance of ID cards, Covered California’s FAQ states “Your health insurance company will mail you an enrollment package and membership ID cards within 10 business days of the health insurance company receiving your premium payment.” I believe this statement is INCORRECT. The health plans’ contracts with Covered CA actually states that they are obligated to issue the package and ID cards within 10 business days of “receiving enrollment verification from the Exchange.” Your plan first reports that you paid the premium and then is supposed to wait for a final enrollment verification from Covered CA. It is only when this verification is received that the 10 day clock starts running. So as a practical matter, plans can mail ID cards 3 to 4 weeks after payment of the premium and still be in compliance with the terms of their contract.

Here’s my limited knowledge of how a couple of plans have handled their ID card issuance. I paid my Kaiser premium on 11/29 (it was late on a Friday evening, so maybe this could have been considered as a payment on the next business day of Monday 12/2). Kaiser definitely took the contract language literally and waited for Covered CA’s verification on 12/10. Kaiser then mailed my ID card on 12/18. On the other hand, a relative enrolled with Blue Shield and paid her premium on 12/12. She received her ID card on 12/24 (the envelope did not have a dated postmark.)

I picked blue shield. Got a bill, paid the bill, and now I have an insurance card. Also, signed in to blue Shield website . I started October 22 and received card three days ago.

I signed up on 12/23-24 (it took several hours because the site kept timing out), and choose a health plan then; saving every page, etc. At the end it said my application was complete.

Today I went back to check, and found that there was no health plan chosen in my account…apparently the site didn’t save my choice.

I made my choice again, and it took it and saved it this time…at least so far.

kvandry …

Each insurer has its own set of policies by which they play the game. You cannot simply ask, “Has anybody actually been issue[d] a health insurance policy and received an insurance ID card?”

Although Anthem’s response is a bit condescending, it does recognize that until the federal tax credit money has been received, your premium has not been fully paid and you have no coverage according to the law of contracts.

In comparison, Molina Healthcare has told one of my clients that as long as he is qualified for advance premium tax credits (over $400 per month), they are not concerned about the January 6 payment deadline, and that his coverage will be effective on 1-1-2014. (They told him he has until March 1 to pay his first premium, and I told him to pay it now anyway, because if he waited until March 1, he would actually have to pay three months’ premium at one time, which he does not want to do).

You simply have to wait for Anthem to do what it wants to do. As long as you have paid your share of the premium, your coverage will eventually be effective on 1-1-2014. If you have any claims before you receive your ID cards, they will be covered as long as the government pays its share of your premium — or you pay it.

I got a bill from Anthem Blue Cross and paid it on Dec. 10, but have not received any insurance ID card yet.

I called Anthem Blue Cross on Dec. 18 to inquire about the status of my application, and was told that even though I paid my bill, Anthem Blue Cross would not issue any health insurance policy to me until the federal government has paid Anthem Blue Cross the APTC (subsidy) portion of my insurance premium.

Has anybody actually been issue a health insurance policy and received an insurance ID card?

Well, it want easy at first, but I got a bill and paid it.

Now, can I find a doctor?

Deb, call Kaiser Member Services at 1-800-464-4000. If at some point you are asked to press 1 to ask about health care reform, press 1 (otherwise, select the menu option to talk to a service representative and explain your situation).

You will then be transferred to a special unit that is handling inquiries about Covered CA. Tell them what date you enrolled at Covered CA and ask them to check to see if they have received your enrollment data yet and whether they have sent your January billing yet. They will then put you on hold for around 3 to 5 minutes while they check the data that they have received from Covered CA.

If they find your record, verify that they have your correct plan and premium amount, and then ask if it would be possible to pay your first premium right now over the phone.

If they do not find your record, ask them what you can do to insure that you pay your first premium as required by 1/6/14.

Has anybody actually been billed?

I had fun today. After an hour on hold at Anthem (first rep took my information and dumped me into the queue, second rep tried to do the same until I emphasized that I’d already completed the enrollment process and just wanted to know how to pay them), I got an application number from Anthem that bore no resemblance to the application/case numbers I got from CoveredCA. I attempted to pay the binder using that number on a URL that was supposedly Anthem’s enrollment landing page, only to get a 503 error (!) concerning cross site scripting attacks. Calling the tech support line on the 503-error page resulted in an announcement that as of 2:20 ET this afternoon, the tech support line wasn’t taking calls.

Not only are there problems with the HIX sending information to the insurers (I’ve not once received any feedback from either the exchange or anthem without having to call in), it now appears that Anthem’s own web site is presently broken and unable to accept payment.

Phil,

This information does not appear correct, at least for the subset of applicants who are directed to apply for Medi-Cal (and possibly others requesting financia assistance). These applicants are shown a progress bar that reads “your application is complete” but the progress bar itself is stuck on “eligibility” and cannot be clicked. It appears that the only option is to wait until Medi-Cal has reviewed your documents and made a decision as to eligibility.

HORROR OF HORRORS! Today I am discovering that documents previous uploaded with many of my applications have been erased from the Covered CA system (the applications are showing “NONE” where uploaded documents were previously listed).

As a diligent agent, who does not hold on to personally identifiable information any longer than necessary, I dutifully destroyed the scanned documents once they appeared to have been uploaded.

Now, I cannot get through to anyone at CoveredCA to verify whether documents are in the file or not, so I will probably have to contact more than 40 people to obtain new documents to upload.

I have been trying to give CoveredCA the benefit of the doubt, but this is beyond ridiculous. Now they are screwing with some of my compensation.

Additionally, of five silver plan enrollments submitted last week, only two show on my agent portal “dashboard” and I cannot confirm that they have been properly processed because no one can get through to COveredCA by phone or by chat.

My fuse has now burned to within a centimeter of the powder charge.

I completed all of the processes as listed in the quesstion on 12/9. I have heard nothing from Kaiser as today. How do I know that Kaiser has gotten my application?

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