Technical trouble between HealthCare.gov and state hold up thousands of S.C. Medicaid applications

An estimated 12,000 South Carolinians who submitted Medicaid applications between Oct. 1 and late December on HealthCare.gov are still waiting - and must continue to wait - to find out if they qualify for the government's low-income health insurance program.

Apply for South Carolina Medicaid online, www.apply.scdhhs.gov, or by phone, 1-888-549-0820.

Apply for private insurance through the federal health insurance marketplace online, www.healthcare.gov, or by phone, 1-800-318-2596.

But if those applicants are determined eligible, health care services administered since Jan. 1 will be covered retroactively, a spokeswoman for the S.C. Medicaid agency confirmed Tuesday.

Certified Affordable Care Act navigators in the Lowcountry are accepting appointments and walk-in customers from 11 a.m. to 3 p.m. on Tuesdays and Thursdays at the Summerville Community Resource Center, 116 West Second North St., and from 10 a.m. to 5 p.m. Mondays, Wednesdays and Fridays at the YWCA in Charleston, 106 Coming St.

Call Janie Colleton, 879-9508, to schedule an appointment at the Summerville location or Loreen Myerson, 475-2859, to schedule an appointment at the Charleston location.

Navigators, as well as any licensed insurance agent or broker, can help residents enroll in a health insurance plan. The S.C. Department of Insurance warns residents that they should not pay anyone for insurance application assistance.

Medicaid eligibility determinations normally take several weeks. But this months-long delay is the fault of the electronic transfer process between the federal government's health insurance marketplace and the state Medicaid agency.

The federal system wasn't prepared to transfer applicant information from HealthCare.gov to the state when the insurance marketplace launched on Oct. 1. Now, S.C. Medicaid Deputy Director John Supra said the state is still testing this new technology to make sure it works.

"We've got limited resources and lots of new things. We're always balancing what do we do when," Supra said.

While he said applicant data from the federal government is improving each week, it will still take more time to perfect the system.

"Everyone's got to be working and testing it," he said. "They've got to absolutely fix some things and we've got to test it. We've got to work together to make sure it works."

This data transfer problem isn't unique to South Carolina.

Supra said most other states that opted into the federal insurance marketplace instead of creating state-based marketplaces are "working to find ways to overcome the technical challenges of the account transfer process."

Most South Carolinians who have applied for Medicaid since Oct. 1 have not used HealthCare.gov to submit an application. Applications can also be submitted online through the state Medicaid agency's website, in person or by phone.

Supra said South Carolina processes an average 1,000 Medicaid applications every day. The number of applications held up by the transfer glitch between HealthCare.gov and the state represents only a small percentage of the total applications that the agency has received since October, he said.

Reach Lauren Sausser at 937-5598.

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