A reason an enrollment might not be accepted by an insurance plan is mostly for medigap insurance. If you try to enroll without any special enrollment period and have preexisting conditions in most states they can deny you. A reason Medicare might do it is if they think you already have coverage a different way. So, for example, if you tried to enroll in a Medicare Advantage plan that included prescription drug coverage and also a part D insurance plan - Medicare would reject one of those enrollments because you cannot enroll in two part D plans.
You will know you have successfully enrolled in an insurance plan and are setup to get your subsidy from Extend Health if several things happen:
- The insurance plan tells you that you have been enrolled.
- Your profile is updated on Medicare's database . You can call 1-800-Medicare if you want to check your 2014 enrollment because the Medicare website will only show the plan you are using for 2013 - and it only applies to Medicare Advantage and part D insurance. Medigap insurance updates probably won't be accepted until January 2014.
- Your EH website profile shows that your application is completed.
- EH sends you a letter saying you have been successfully enrolled.
I have successfully enrolled. However, my spouse's application is still "open" on the Extend Health website which means EH has not been notified by the insurance company that the policy is accepted. However, my spouse's insurance company sent us a letter on November 8th saying the policy application is accepted. On November 20th I check the EH application status and when I saw it was "open", I emailed Extend Health and they told me it takes a couple of weeks for the insurance company to notify them. I was surprised because the insurance company for my plan was quick to notify Extend Health that my plan was accepted. Well, here it is December 20th and the EH website application status is still "open". I just sent a second email to Extend Health telling them we are concerned about the status. I am doing this to build a case so if they try to deny my spouse's subsidy we have proof we did everything "right" and can complain to IBM so that we can get the subsidy.
I am also doing this so that if something really messes up I can file a grievance with Medicare that Extend Health is not acting as a proper insurance agent on my behalf.
Now that we are in the individual Medicare insurance marketplace, it is extremely important to keep a record of every conversation you have with Extend Health (who is your insurance agent), your insurance provider, Medicare agents, Social Security agents and any other government agency agent you contact. You must get names of the people you talk to and what you heard - down to time of day you heard it. That is the evidence you will need if you have to do an appeal with Medicare for either inappropriate marketing (EH), claims denials (insurance companies), misleading information that caused you to make poor insurance choices (government agencies and/or EH) or grievances such as for poor customer service (EH and/or your insurance provider).
12/26/13 Update: EH responded to my email by calling to tell me they had received notification from my spouse's part D plan so the application process is complete. How coincidental that they got notification shortly after receiving my email. Amazing ... isn't it? I looked on the EH website to be sure it had been updated and it was. Finally, we are both set up to get our HRA subsidies. It only took 2 months of work to do it! I should send a bill to IBM for project management services.