Long waits frustrate callers to health exchanges | The Detroit News

Long waits frustrate callers to health exchanges | The Detroit News.

The take away from this account is expectations about how people do business with the health benefit exchange marketplace need some adjusting. While some people are comfortable purchasing health insurance online, many others are not. As California’s experience shows, lots of folks are using the web portal for that state’s marketplace, Covered California, to “showroom” plans — to browse what’s available and on what terms and conditions. They then call the customer service center to get more details before making a purchasing decision, overwhelming staff also pressed to respond to consumers having trouble enrolling online.

But enrolling in health insurance over the phone isn’t easy and quick either, particularly given that the transaction in the exchange marketplace involves an eligibility process to determine if an applicant qualifies for Medicaid or premium and co-pay subsidies. Adding to the enrollment challenge is many households having complex family situations.

Marketplace plan enrollment is proving for many more akin to preparing and filing an income tax return, particularly considering the amount of personal and financial information applicants must provide.

With the benefit of hindsight now that the plan year 2014 open enrollment period is nearly over, it’s clear that instead of heavily relying on web and phone enrollment, the marketplace needs to adjust to one more based on in-person enrollment using assisters, county social service workers and insurance agents.


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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Frederick Pilot

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