Surprises lurk within exchange plans for unknowing consumers


Now that the federal health insurance exchange enrollment process is operating more smoothly, some consumers are finding surprises lurking within plans after they've signed up.

For example, families with Medicaid-eligible children can't include their kids on subsidized family plans sold on the marketplace. This hiccup is leading to many uninsured children, even though their parents have obtained health coverage, reported the Associated Press.

"The children are getting stuck in this spot where we've enrolled the parent, but we can't bring the children back on the family plan," Maria Proulx, senior legal counsel for Anthem Blue Cross and Blue Shield of New Hampshire, told a state advisory board panel this month, the AP noted.

A regional manager for the Centers for Medicare & Medicaid Services said the agency is working to address the problem. "This is an important issue, and we're not taking it lightly," she said. "It's a big deal and we want to get it resolved as quickly as possible."

Meanwhile, some exchange plans sold in Washington state require consumers who weren't previously insured to wait 90 days after coverage starts before they can receive a transplant. Some doctors are accusing insurers of violating reform law provisions that prohibit discrimination against those with specific diseases, The Washington Post reported.

Representatives from insurers implementing the waiting-period rule, including Premera Blue Cross, said they are simply using an option allowed under the Washington state benchmark plan.

After many consumers complained to state officials that the waiting periods are discriminatory, the Washington state insurance commissioner started looking into the issue. "I can't give you a specific time frame yet, but we do take their concerns seriously," Stephanie Marquis, a spokeswoman for the Washington state insurance commissioner's office, told the Post.

To learn more:
- read the Associated Press article
- see The Washington Post article

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