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New York Consumers Frustrated By Insurance Delays

WebMD News from Kaiser Health News

By Fred Mogul, WNYC

Tue, Jan 14 2014

Last weekend, Rob Cuillo had a severe stomach bug, and he began thinking it might be time for a trip to the emergency room near his home on Long Island.

“I was sick as a dog,” he said. “I was so dehydrated, I was thinking if this goes on another day I might need an I.V. to give me some liquids.”

But then he remembered he hadn’t received his insurance card from Empire Blue Cross. He had enrolled in the plan through the New York State of Health, the state exchange for purchasing coverage under the Affordable Care Act.

Enrollees need to look at which hospitals are in-network with which plans. Mt Sinai Hospital is out-of-network for Empire Blue Cross Blue Shield on the New York State health exchange. (Fred Mogul//WNYC)

“It said I was enrolled, so I thought I was enrolled, but I kept waiting and waiting and waiting for my insurance card or to hear something from the company,” he said.

People have been complaining for months — on Facebook and Twitter and elsewhere — about New York’s state insurance exchange. The problems have been similar to those nationwide: crashing web pages, long wait times on phone lines, customer service representatives who promise to help and then don’t deliver.

But in recent weeks, most companies in New York appear to be processing enrollments more smoothly, and now complaints are centered almost exclusively on Empire Blue Cross.

In an email, an Empire Blue Cross spokeswoman said the complaints could be due to an “overwhelming and unanticipated” number of applications, and that the high number of them in New York was because Empire is the state’s biggest player. Neither Empire nor state officials would discuss the underlying technical problems — or disclose how many people have been affected. Donna Frescatore is the head of the New York State of Health marketplace.

“I don’t have a ballpark number, but I certainly think it’s enough. We’ve heard it enough times to know that it needs immediate action,” Frescatore said, while also acknowledging the problems date back at least to November.

A couple days after his stomach virus ran its course, Cuillo got a letter in the mail, telling him the premium and how to pay it online. But the website wouldn’t open.

“I can mail it in to them, but I feel a little uncomfortable sending a check in the mail to people who don’t answer the phone,” Cuillo said. “How do I know it’ll even get there?”

Elizabeth Benjamin is from the Community Service Society, one of many private organizations around the state helping people enroll.

“I think we were all surprised that New York’s blue-ribbon carrier is the carrier that’s had, apparently, the most bumpy of roll-outs,” Benjamin said. “I think a lot of folks enrolled in Empire because of its incredible reputation, and everyone’s a little flummoxed about why these problems are occurring.”

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