Complaints About Covered California Exchange

On July 8, 2014 the Sacramento Bee released a report stating that early 1800 complaints were filed regarding the Covered California exchange processes. It turns out that San Diego residents are not the only ones confused with the provider networks set up under California.

Complaints Filed Entail:

  • Health Cards and Enrollment Information Not Received (many participants on the exchange failed to receive their actually medical health insurance cards and information showing proof of their plans)
  • Narrow Provider Networks (not enough physicians available in certain areas)
  • Inaccurate Provider Lists (many mistakes were made when detailing which providers were covered causing patients to seek help for doctors not covered under their policy which could cause higher costs)

Covered California has been quick to react to these complaints by working with regulators. An exchange representative is working to refer some of the complaints to regulators in hopes to resolve these known issues. In addition, the California Department of Managed Health Care is looking into the accuracy of the network provider lists that were released by health care companies such as Anthem Blue Cross and Blue Shield of California. They are under investigation for violations of the law according to California Health Line.

Under the investigation, health officials are contacting providers in each county that were listed on the network provider lists from the two health companies. Officials will be comparing the provider lists with the actual contracts of the physicians. This investigation is expected to take about 60 days (started on June 23, 2014). The ultimate findings will be sent to insurers who will then have 45 days to respond. The full report will most likely be released to the public sometime in November.

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