WICHITA FALLS, TX (KAUZ) - After Blue Cross Blue Shield announced an end of individual PPO plans for 2016, many people were forced to switch plans and even health insurance companies. But the new insurance is causing problems for some customers.
Those who opted to switch their individual health insurance plan from Health Maintenance Organization, or HMO's through Blue Cross Blue Shield of Texas to Exclusive Provider Organization, EPO's through United Healthcare are experiencing some delays in receiving their insurance identification cards.
"There was so much volume of activity in that movement from the HMO plans to United Healthcare's plans that the insurance companies are backlogged about 20 to 30 days behind on getting all the data entered into the system," Kelly Fristoe, President of Financial Partners said.
Fristoe said during open enrollment there was a 45 day window for those wanting to get coverage with the EPO by January 1st, 2016 to enroll. However, those who were not able to enroll until after December 15th, had to do so manually. Once United Healthcare receives their paperwork, Fristoe said it could take five to seven days before that policy is activated. It could take even longer to receive their insurance ID card.
"People that we enrolled December 15th electronically are just now getting their ID cards. People that were enrolled manually with paper applications after December 15th to United Healthcare in particular, we are just now seeing those people show up in the United Healthcare system but those policies are pending," Fristoe said.
This is causing people seeking medical care to pay for it out of pocket. However, Fristoe said to keep your receipts and you will be able to make a claim once your insurance ID cards are given to you. That money will either be put towards your deductible or the insurance company will get you the money that you're owed. Fristoe said a large part of this problem stems from not having enough time.
"A 90 enrollment period every year to take care of switching everybody that needs to switch plans to a new plan, the systems aren't large enough to accommodate a timely transition during that short period of time," Fristoe said.
Fristoe said he believes the systems will likely be caught up by March.