No Obamacare Invoice? Keep Trying to Pay But Don’t Worry, Says Covered California

No one knows just how many Californians have not yet received their insurance invoice. Insurers say they have added staff to deal with large volume of new enrollees. (Getty Images)

The deadline to pay your premium for a health insurance plan bought through Covered California, the state’s Obamacare marketplace, has been extended to Jan 15. While insurance went into effect Jan. 1 for those who enrolled, you must pay the first month’s premium by Jan. 15 or you you will not be covered.

“If there was a good faith effort by an enrollee to start an application by Dec 23, everyone is honoring that,”- Covered California spokesperson Anne Gonzalez

As that date fast approaches, some enrollees who are well aware of the deadline and are ready, willing, and able to pay have been experiencing a problem: they can’t because their insurance company hasn’t sent them an invoice yet.

Until this week, this was my situation. I waited well over a month between the time I enrolled in a plan through Covered California and the insurance company I selected — Kaiser — sent me an invoice. I kept checking with Kaiser, and they kept telling me they had yet to receive the information from Covered California. And Covered California kept telling me to keep checking with Kaiser.

Meanwhile, once January 1 came — the date my new insurance was supposed to take effect — I’d convinced myself that I’d contracted Ebola Virus exactly at midnight, Jan. 1, when my old insurance ran out. And that I was not going to be insured because Covered California computers and Kaiser’s were not speaking.

“If we had not yet received your enrollment information, then you would not appear in our system,” explained Kaiser’s Joe Fragola in an email. “Approximately one-third of our January 1 coverage enrollments came in around the December 23rd deadline. The delayed enrollment and unprecedented volume led to some delays. However it should not have taken five weeks for us to have a record of your enrollment prior to payment.”

Though I finally did receive an invoice this week, thus eradicating my certainty that I had a life-threatening illness, Kaiser said it would research why it had taken so long. The company says that more than 90 percent of its enrollments have been processed, and that the remainder would be completed by the end of this week.

I asked Fragola if someone who has not yet paid because of a delay in invoicing could still obtain covered medical care.

“Yes,” he said. “Kaiser Permanente has taken steps to ensure that all members seeking medical care, including new members, are able to receive the care they need when they need it. We also have begun contacting members to make sure they know that any processing delays do not affect their ability to get care.”

Phones Jammed

I’m not the only one, apparently, experiencing Affordable Care angst as the system has finally come online. KQED’s California Report on Tuesday received this email from an anxious listener:

“I applied before the deadline, and successfully received confirmation of coverage,” she wrote. “Then nothing. No email. No snail mail. I have written, called, waited. There is apparently no phone number on the Covered California website or any of its links that is answered by a human. Same with Anthem, the company I chose for coverage. I’ve stayed on hold for multiple hours. Now Anthem has a recording saying they cannot take calls at this time (9 a.m. Monday). I imagine how frustrating this would be for people who have less time and fewer skills.”

Darrel Ng, spokesperson for Anthem, told us: “We have an overwhelming demand of callers at this point. Not just Anthem, but (all) plans across the country. We received a million calls in the first two business days of the year. That far exceeds what we normally get in a month.”

Ng said the company has hired hundreds of customer service personnel and expanded its hours to deal with the influx of new customers.

Anne Gonzales, public information officer for Covered California, said that it can handle 1,288 callers simultaneously. After that, up to 550 callers can be put into a holding queue. More than that, callers will get a message that no more calls can be taken. And if the system hits 2,577 callers at the same time, some people will experience the ultimate in morale-crushing customer service experiences: the dreaded fast busy signal.

On the plus side, Gonzales said Covered California has now finished all electronic transfers to participating insurance companies and has moved on to the paper applications. Cold comfort if you’re still waiting and anxious. But here’s something to keep in mind: “If there was a good faith effort by an enrollee to start an application by Dec 23, everyone is honoring that,” she said of the insurance companies.

Contact Information for Insurers

In the meantime, Gonzales said, if you haven’t received an invoice yet, you should still try to pay by the Jan 15 deadline. If your insurer will let you, that is.

Covered California has created a page called How to Pay with information on payment methods for all 11 of its plans. We’ve reproduced it here, including phone numbers you can call if you have not yet received your invoice (fair warning that you are still likely to wait on hold):

Health Plan Pay by Phone Pay Online Pay by Mail No Invoice Received?
Anthem Blue Cross (855) 634-3381
Have your Subscriber ID or Social Security number
Visit the payment landing page www.anthem.com/ca/
paymentlanding

for further details
Please reference the information found on the payment letter. (855) 634-3381
Blue Shield of California (855) 836-9705. Have your Case # or Social Security number http://service.health
plan.com/
blueshieldca/binder
. Have your Social Security Number
P.O. Box 60514, City of Industry, CA, 91716-0514

Have your Certificate Number from your Invoice to payment; add your invoice stub

Go to http://service.healthplan.com/ Have your Social Security Number available
Chinese Community Health Plan N/A For first-time payment: log in to your CoveredCA.com account; follow payment instructions 445 Grant Avenue, #700 San Francisco, CA 94108

Add your invoice stub

(877) 224-7808
Contra Costa Health Plan (855) 957-2247
Select Option 2, include Covered CA ID
http://coveredcc.org/
payment

include Covered CA ID
Contra Costa Health Plan
P.O.Box 2390
Omaha NE
68103

include Covered CA ID

(855) 957-2247
include Covered CA ID
Health Net (877) 200-9260
Have your Subscriber ID and payment method.
(If you don’t have your Subscriber ID go to www.healthnet.com/
getmyid
to obtain one)
Online payments accepted only after first payment P.O. Box 60515
City of Industry, CA
91716-0515

Add Subscriber ID to payment

Go to www.healthnet.com/
getmyid
to obtain your ID and call
(877) 200-9260
to make your payment
Kaiser Permanente Have Account number, invoice number, and subscriber last name from invoice available.

Northern California
(866) 475-3920
(866) 733-7787 Spanish

Southern California
(866) 450-5648
(866) 733-7775 Spanish

www.kp.org/paypremium P.O. Box 7192
Pasadena CA 91109-7192

Follow the directions on your invoice.

Northern California
(866) 475-3920
(866) 733-7787 Spanish

Southern California
(866) 450-5648
(866) 733-7775 Spanish

L.A. Care
Health Plan
(855) 270-2327
(TTY/TDD 1-855-576-1620)
Have your Case # or Social Security number
www.lacarecovered.org/
makeapayment

Have your Customer and Invoice Number
L.A. Care Covered
P.O. Box 515389
Los Angeles, CA
90051

Add Case # to payment

(855) 270-2327
Molina Healthcare Inc. (888) 858-2150
Have your Covered CA ID or Social Security number
www.molinahealthcare.com/
payment
P.O. Box 7010
Pasadena, CA
91109-7010

Add Case # to payment

(888) 858-2150
Have your Covered CA ID or Social Security number
Sharp Health Plan (800) 359-2002
Have your Sharp Member ID # or Social Security number
www.sharphealthplan.com/
payment
P.O. Box 57248
Los Angeles, CA
90074-7248

Add Case # to payment

(800) 359-2002
Valley Health Plan N/A N/A Los Angeles Lockbox
County of Santa Clara
PO Box 740300
Los Angeles, CA
90074-0300

Only taking money orders and checks — follow directions on invoice

(888) 421-8444
Western Health Advantage (888) 442-2206
Have your WHA ID #, or Social Security number
For first-time payment: log in to your CoveredCA.com account; follow payment instructions WHA, DEPT 34668
PO BOX 39000
San Francisco, CA 94139
———————————
(888) 442-2206
Have your WHA ID #, or Social Security number

 

Don’t forget: If you haven’t signed up yet, open enrollment runs until Mar. 31. Here is the breakdown in deadlines:

  • Enroll by Jan. 15 for coverage that starts Feb. 1
  • Enroll by Feb 15 for coverage that starts Mar. 1
  • Enroll by Mar. 15 for coverage that starts Apr. 1
  • Enroll by Mar. 31 for coverage that starts May 1

If you don’t sign up for health insurance by Mar. 31, you could have to pay a penalty. In 2014, the amount is $95 per adult or 1 percent of your income, whichever is greater.

Related
  • scottgreene

    Besides Insurance companies having problems being able to accept your payment, what you are paying for is overly expensive unaffordable insurance with extremely high premiums and deductibles for coverages that many people will never use.
    Obamacare hurts hard-workng middle class Americans.
    This is because the government has mandated what coverages you have to pay for regardless of whether you need those coverages or not.
    Grandmothers who don’t drink have to pay for alcohol counseling coverage.
    Gay men and grandmothers who can’t get pregnant have to pay for maternity coverage.
    No insurance company can sell you a policy that does not include these and various other unnecessary coverages.
    And now ALL insurance policies sold in the United States (whether bought on or off the Covered California website) are Obamacare policies.
    You have no more choices!
    You need to contact your representatives and let them know you want the law changed to allow you to OPT OUT of coverages you don’t need.
    That will lead to decreases in your premiums and deductibles.
    Otherwise hard-working middle class Americans will continue to be financially hurt and burdened by being forced by law to pay for ridiculously over-priced insurance that has coverages they will never use.

  • HealthCarebroke

    Where do you (Obama) get off charging these kinds of prices in California just because your over the age of 20? I had acceptable health insurance from Anthem for $470 with dental and a $5000 deductible. Now anything near that is over $700 which doesn’t include dental and a Tier4 drug is $75. Urgent Care is $250. Are you out of your mind but then again I didn’t vote for Obama. I’m an hourly wage paid worker, with a $1500 a month student loan to pay for the next 25 years. Oh by the way, is the subsidy earning AGi or gross wages? My AGI is less.

    • http://blogs.kqed.org/stateofhealth Lisa Aliferis, KQED

      The subsidy is calculated according to Modified Adjusted Gross Income. You can calculate your subsidy on CoveredCA.com or see our guide: kqed.org/obamacare.

  • 12amStrranglers

    My name is Aiden Hill, and I was the project manager in charge of the Covered California call center rollout. Back end gaps between Covered California and the insurers were known as far back as August, but Covered California has hidden this from the public. For an insiders view of what is really going on up there, and why the healthcare exchanges won’t solve our healthcare crisis, read my book – “The Midnight Stranglers: Obamacare, The Tea Party, and a Sleep Apneac’s Fight Against The U.S. Healthcare System.” The postscript: “UnCovered California: I Know What You Did Last Summer,” discusses CC’s secretive culture, and it’s implications for California’s consumers and taxpayers.

  • Ms. Adler

    This is a good article because particularly in the first part it accurately captures the confusion, frustration and angst, as you say, that so many people are experiencing. If you want to feel like you’re in the middle of the storm, check out the Covered California facebook page. People have been trying for months to get through, to get Covered California or their insurers to correct mistakes, or just to hear from anyone what is going on. Covered California and the insurers give these comforting sounding statements about honoring good faith attempts, but privately when someone tells them they applied before December, the insurer denies them a Jan. 1 start date. Covered California has only started admitting this week that apparently a bunch of enrollments never got transmitted to insurers. WIth Blue Shield, if they sent an enrollment and then made a change, the change cancelled the enrollment and then went into a black hole and Blue Shield has no further record of your enrollment. And yet Blue Shield refused to extend the payment date beyond Jan. 15. People who were supposed to get Anthem Silver 93 plans (and did get them, according to their Covered California account) got set up with Silver 87 plans (the difference is zero deductible versus 1500 and higher copays across the board – a big difference). Anthem says it must be Covered California’s fault. Covered California says it can’t have happened. The lack of meaningful customer and tech support on both sides is absolutely astonishing.