Nevada exchange offering belief-based coverage

In some cases, “the customer [was] asked to pay for the coverage from the stated effective dates, but no cards or even a notice had been sent to the customer showing the coverage was actually effective,” Cila writes. Because the customers have no concrete proof of insurance, they are leery of going to providers for treatment based on their faith in customer service workers’ assurances that they have coverage, Cila says.

Even if the customers did seek treatment, if the providers called the carriers, the carriers would tell the providers that there is no evidence that coverage for those customers is in effect, Cila says. Everyone knows that the Nevada exchange has had system problems, but the idea of billing patients for coverage they were never able to use properly is unfair, Cila writes.

“The repairs to the system may take months, but the people are entitled to get what they have been told they were getting in a timely manner,” Cila says. “They should be able to walk into any doctor’s office that is part of the network and be treated by showing a currently dated insurance card.”

If the exchange does not to provide coverage at this point, it should tell consumers about that in writing, Cila says.

See also: PPACA: Will Exchanges Be Producers?