Computer malfunction causes Covered California to switch coverage for pregnant women

A recent policy change has caused approximately 1,900 pregnant Californian women to be transferred from Covered California to Medi-Cal without their knowledge, according to The Sacramento Bee.

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The policy change, which occurred in October, applies to pregnant women who make between 138 and 213 percent of the federal poverty level — or $22,100 to $34,100 for a family of two people, according to the report.

After the October change, women in this income bracket who were pregnant when they applied for coverage were instantly put in Medi-Cal rather than Covered California.

Women in the income bracket who had Covered California plans before applying were supposed to be given the choice between staying in Covered California — which has out-of-pocket costs — or switching to Medi-Cal, which has no out-of-pocket costs. But Covered California’s computer system accidentally botched the process. Around 1,900 pregnant women weren’t given the choice to switch and were instantaneously moved to Medi-Cal.

“They didn’t receive notice. They just knew from one day to the next that their Covered California insurance didn’t work anymore,” said Lucy Quacinella, an attorney in San Francisco, according to the report. “It’s very stressful, very confusing.”

Certain women were stressed by the transfer because they didn’t want to lose their current provider, but others are happy with the cheaper cost of Medi-Cal, according to Ms. Quacinella.

Covered California said the computer problem will be fixed in September. “We didn’t implement this as well as it should have been implemented,” said Amy Palmer, Covered California’s director of communications, according to the report.

Until then, pregnant women can get their Covered California plans back by contacting the insurer’s customer service center.

More articles on payer issues:
UnitedHealth to exit most ACA exchanges in 2017, remain in only ‘handful’ of states
Fifth Third Bank introduces consumer directed healthcare solution for employers
UnitedHealth to exit Michigan ACA exchange in 2017

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