Enrolling in a Health Insurance Exchange Plan over the Phone

Open enrollment in the Affordable Care Act health insurance marketplaces began on October 1st, but with great fanfare came high server capacity utilization. From account registration to plan previews, quote estimates, and finally, through to enrollment, the process was subject to delays at every step. 

A week after the beginning of open enrollment, there are still issues accessing plans and accounts, particularly on the federal website healthcare.gov. Visitors attempting the process are asked to wait patiently as each page takes a few moments to load, which can understandably wear users’ patience down. States hosting their own health insurance exchange haven’t had as much of an issue with capacity. 

Applying on the Phone for an Exchange Plan

Another option currently is to apply for a plan on the federal marketplace through the national call center at (800) 318-2596. This telephone number is staffed by a combination of service center employees and contractors from Maximus, a government services outsourcing company. Agents essentially walk consumers through the enrollment process, and can answer any questions or help to explain plan coverage in further details. 

Enrolling over the telephone method still has its issues and kinks though. Our hypothesis that online enrollment would be more efficient than online proved incorrect. Agents don't use a more streamlined and direct internal system to enroll consumers, as we expected. They're oftentimes using the same system and website as consumers, so the same constraints and delays may be faced. We tested a sample of representatives at call centers for Idaho, New York, Illinois, and Florida health insurance plans, and came across widely differing experiences. Our findings are reported below.

A paper application, while available, is a more time-consuming process. Consumers will need to dial the call center and provide a mailing address. Applications will come in the mail four to seven business days later. After the application is mailed back, it may take up to two weeks to process and receive news of your acceptance or eligibility for health care plans on the exchange. Seeing plans and premium quotes may be trickier, however. We’ve heard different answers from call center representatives about how consumers will be able to review plans and quotes. Some have said that applicants need to dial the call center back to see, review, and enroll in plans. Others said that plan benefits and information will be mailed back to consumers. Should you decide to choose this process, know that it can take anywhere from 45 to 60 days.

Idaho Health Insurance Exchange Enrollment

Idaho had the most circuitous and confusing process out of the states we sampled. Idaho was supposed to be a state-based health insurance exchange, but because there wasn’t sufficient time to implement the exchange, the state ultimately joined the federal network. Unfortunately, miscommunication between the state and federal levels have resulted in a less than seamless process to enroll in a health insurance plan in Idaho. 

The first time around, Your Health Idaho sent us to Maximus at (866) 307-1477. They warned that Maximus agents would be confused about the Idaho exchange, and try to redirect us back to Your Health Idaho for enrollment. The number wound up being an internal human resources number for employees of Maximus. The operator said that there were four new offices designated as call centers for Idaho, but no numbers were available. She referred us to the Chicago office at (312) 577-5550, as the next best alternative. That number, unfortunately, led to a voicemail. 

A second call was placed to Your Health Idaho, and this time, we were told to contact the Federal Call Center directly at (800) 318-2596. The representative advised that the call center had previously been directed not to assist with enrollment in Idaho, but this had changed. If there was any resistance or confusion, we should ask for a supervisor and file a complaint. 

The second attempt finally got us to a representative who could enroll us:

Your Health Idaho: http://www.yourhealthidaho.org, (855) 944-3246

  • General questions about health insurance or the marketplace
  • Help locating assistors and navigators to help you with enrollment

Federal Health Insurance Exchange: https://www.healthcare.gov/marketplace/individual/#state=idaho, (800) 318-2596

  • Enrollment in a health care plan
  • If the call center representatives cannot enroll Idaho residents, ask to speak to a supervisor, and then request to file a complaint if that doesn’t work
  • Online enrollment will typically take about 30 - 40 minutes, and require personal information to verify your identity. If your identity cannot be verified online, then further proof will need to be mailed

Florida Health Insurance Exchange Enrollment

The experience with the regional call center for Florida was good. Because the state doesn’t have its own marketplace, health insurance enrollment is hosted by the federal exchange. The representative we spoke with was knowledgeable, helpful, and patient. Our questions on health insurance features and neighborhood assistors and navigators were answered satisfactorily. Representatives suggest allotting one hour to the online enrollment process to account for the website's delays and slow download times.

Federal Health Insurance Exchange: https://www.healthcare.gov/marketplace/individual/#state=florida, (800) 318-2596

Illinois Health Insurance Exchange Enrollment

Our experience with Get Covered Illinois and its regional office of the federal call center was mixed. While the process seems to be efficiently organized with two rounds for qualification and enrollment, its representatives did not seem uniformly well-trained.  

The Get Covered Illinois helpline serves as a filter and referral office. Agents ask a few basic demographic, income, and residential questions to see if people qualify for an exchange plan (as opposed to Medicaid) before transferring consumers to the federal call center.

At the regional call center arm of the federal exchange, however, the representative we spoke to was misinformed and answered basic questions on health insurance incorrectly. For example, the representative described a deductible as a monthly payment to be made, and explained that it was the difference between what insurance pays and what consumers pay. Subsidies were also explained as a form of help from taxpayers, contract brokers, and assistors. Lastly, when asked what their telephone number was in case the line got disconnected, the representative supplied the number of a different agency: (800) MEDICARE.

Get Covered Illinois: http://getcoveredillinois.gov, (866) 311-1119

  • Press 1 for English, and 2 for Spanish
  • For new customers 1, existing customers 2, general information on healthcare coverage 3, employer SHOP 4, main menu 9, and customer service representative 0
  • Answer questions about the status of any applicants in the household as pregnant, below 19, or on Medicaid, etc.
  • Get transferred to the federal call center to enroll in a plan: (800) 318-2596

Federal Health Insurance Exchange: https://www.healthcare.gov/marketplace/individual/#state=illinois, (800) 318-2596

New York Health Insurance Exchange Enrollment

The New York call center had the most well-trained and knowledgeable representatives. They answered a range of basic and complex health insurance plan questions fluidly without needing to research answers. The telephone menu options are extensive and comprehensive, with accommodations made for five different foreign languages. The center even provides a menu option to help users with website issues, going so far as to help in screen share sessions - this seems to be a fairly unique and advanced feature. 

Representatives have reported being able to enroll a few applicants successfully, and observed that the application process could take about an hour and a half over the phone.

New York State of Health: https://nystateofhealth.ny.gov, (855) 355-5777

To get in touch with a representative to apply over the phone, press: 1, 4, your zip code, 1, and 4. To get in touch about an existing application, press: 1, 4, your zip code, 2, and 1. Here is the main menu of options: 

  • Press 1 for English, 2 for Spanish, and 3 for other languages (-> Russian 1, Cantonese 2, Mandarin 3, Haitian Creole 4, and other languages 5)
  • If you’re an employer for Small Business Health Insurance Options, press 1, employee Small Business Health Insurance Options 2, navigator or broker 3, all other callers 4
  • Enter your home zip Code
  • Information about applying for health insurance 1
  • Applications in process, or an existing account or file appeal 2
  • To find certified representatives to apply or enroll with 3
  • For information on child health plus or Medicaid 4
  • General information on the marketplace 5
  • Help with website or to initiate screen sharing session 6

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