115 days after payment, NV woman awaits insurance - WBRC FOX6 News - Birmingham, AL

115 days after payment, NV woman awaits insurance


The rollout of the Affordable Care Act continues to have some bumps in the road, but for some Nevadans getting insured feels like an insurmountable obstacle.

"One hundred and fifteen days today that I've been working on trying to get insurance through Nevada Health Link," said Donna Ehlen, a retired human resources professional with a pre-existing condition.

FOX5 first brought you Ehlen's story last week.

Ehlen continues to wait for confirmation she's actually insured, even though she's already paid $283 for coverage back in November.

"At this point I feel like I've given up my life. I'm on hold. I've been on hold for something like nine hours since the first of the year," she said. 

Ehlen's carrier, Nevada Health Co-Op, can only issue her a temporary insurance card for now.

The insurer has done the same for about 600 others in Nevada dealing with similar issues.

"If she needs to go to a doctor, if she needs a pharmacist, we will cover her tomorrow and we've done that with every one of the members that has been covered with us. We've presumed eligibility," said Nevada Health Co-Op CEO Tom Zumtobel. 

The looming issue for Ehlen, those 600 others, and even the Co-Op is that the information buyers submit when purchasing insurance on the insurance exchange website, Nevada Health Link, is not getting to the insurance carriers.

"The complexity of the system to get the data to us has certainly been a challenge," said Zumtobel.

In many cases, Xerox is the third-party holding onto the data. Zumtobel can't explain or get answers for the massive delays.

"We work with the state and with Xerox every single day. But it is just hard to understand how the data just doesn't get here," he said.

Ehlen thanked the Co-Op for doing everything it can, but she's considering filing a fraud claim against the state of Nevada over her $283 payment.

The Co-Op told FOX5 it's doing its best to smooth out a very bumpy road.

"That's why we're comfortable with presumed eligibility. If (buyers) get their service now, it's just money we would have spent later and they're happier, they have a chance," said Zumtobel. "But we have to know they exist, right?"

Another issue many insurance buyers have is over doctors they thought were on their purchased plan, but turned out not to be.

Zumtobel said the issue was due in part to misinformation on Nevada Health Link. But he is working with their customers, including Vicki Haran, who was also part of FOX5's story last week.

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