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Signing up for insurance through the federal marketplace.

November 25, 2013

 

 

100_0007Fifteen states plus the District of Columbia have set up their own insurance marketplaces for people seeking coverage under the Affordable Care Act (Obamacare).  You can see a nice interactive map describing what each state has in place here.  My state, Texas, is not one of them.  I, like millions of other people have been trying to sign up for individual health coverage for the new year at Healthcare.gov.  So far the news regarding states with their own marketplaces is a lot better than what we are hearing about the federal marketplace.  Despite the reassurances from the Feds that we can sign up on paper or over the phone, the people on the other end of the phone are dependent on the same dysfunctional website that all of us use online.  I recently spoke to an insurance broker who told me the insurance professionals have to use it too in order to sign you up in a way that allows you to use your tax credit to pay a portion of your premiums.

Anyone can sign up for insurance on the individual market directly with any insurance company that offers coverage in your area.  That is the best option for those on the individual market and not eligible for the tax credit (those with income 400% of poverty level).  Those of us who do qualify for the credit (those with income between 100% and 400% poverty) are better off signing up through a marketplace so the tax credit can be applied directly to premiums.  For example, in my situation (according to the Kaiser Family Foundation calculator) my estimated tax credit would be 67% of my maximum premium (6.81% of my family income) on a Silver plan.  That would cut my monthly premium down to less than $200.

Let me share a bit of my experience attempting to use Healthcare.gov.  Before the open enrollment period started October 1st, the website was easy to use.  I signed up for email updates and signed up for my account.  I was able to log in easily and use the pre-rollout features of the website.  Come October 1st, it all went to hell.  Most times I accessed the website I was placed in a cue to even sign in.  Then when I could sign in, some parts of the application worked and some didn’t.  Everything went extremely slowly.  I had time to go out and putter in the garden while waiting for the opportunity to fill in the next page of the application.  Then it would suddenly stop working.  After trying different times of day, I was finally able to complete my application early on a Sunday morning.  I was informed the next step was to read my eligibility letter which would explain my tax credit situation and premiums.  I clicked on the button to read my letter and a pdf file was downloaded to my computer.  The file was a letter informing me that I had the wrong version of Adobe Reader and telling me to update.  I knew I was already updated, but still went to the Adobe site to download the most current version.  The letter still did not download properly.  I chatted with a customer service person at Healthcare.gov who suggested turning off my pop-up blocker.  That didn’t help.  I was informed the letter would also be mailed.  I never received it.  Then a couple days later I could no longer sign in to Healthcare.gov.  Since around mid-October every time I try to sign in to the website, I am taken back to a blank log in page.  If I purposely use the wrong password, I am taken to a log in page with the message that my user name or password was entered incorrectly.  I waited a few weeks then tried calling the phone number for the marketplace, 800-318-2596.  I spoke to a very nice lady who suggested turning off the pop-up blocker or using Firefox instead of Safari.  Then she attempted to help me with my application but was unable to access the system.  She said I could sign up for insurance directly with an insurance provider, but then I would be unable to apply my tax credit to my premiums.

I only need insurance for 3 months next year.  After that I am eligible for Medicare.  The deadline to sign up for coverage starting January 1st is December 15th which is closing in fast.  I will most likely sign up without my tax credit if the problems with the system are not fixed by the deadline and try to get the credit paid to me when I file my taxes for 2014.  I’ll probably need to get help from family to pay the premiums, but at least I won’t have to go to the CommunityCare Clinic any more.  The deductible is very high for the plan I’m looking at, but the copays for doctor visits and medications are quite reasonable.  I’ll hold off on the stuff that has a deductible until April when I’m on Medicare.  I’ll be able to start catching up on some of my “deferred maintenance.”  That’s the stuff either not covered by the program I’ve been using since March 2012 or that I’ve been unable to deal with because I hate going to their doctor.  I have been doing what no chronically ill person should do, putting off seeing a doctor and saving up lots of little problems.

So let me tell you what I think of Obamacare.  Sure, the roll-out of this federal market place is a mess.  From what I’ve heard the state marketplaces have worked somewhat better.  Of course most of the states bowed out from that and left the burden entirely on the federal government.  Any new program serving millions of people will have some bugs.  I am disappointed at the severity of the problems with this one.  What people ignore is that this is a tiny part of the entire Affordable Care Act.  People like me with pre-existing conditions can no longer be denied coverage or be charged more than other people for insurance.  Your insurance company can’t dump you because you’re sick.  Your children cannot be denied coverage of pre-existing conditions and they can stay on your policy until age 26.  Preventative care is covered at no cost to you.  Emergency care will be covered out of network.  There is no longer a lifetime limit on coverage.  That’s nothing to sneeze at!  I remember working at a head injury rehab 20 years ago that cost $30,000 to $50,000 per month.  My health insurance had a lifetime maximum of $1,000,000.  I looked around at the severely injured patients I cared for each day and knew a million dollars wouldn’t last long if something like that happened to me.  For more information on the full benefits of the Affordable Care Act, see the Health and Human Services website.

I am overjoyed about all the benefits we will all gain from this law.  Many of the people complaining about how awful all this is have no idea what Obamacare actually is.  This includes my opinionated and talkative mother-in-law.  She’ll bitch about it all, parroting Fox News, but then when my husband and I have problems getting health care she moans about how “terrible” it is that we have these problems and can’t “someone” do something.  Yet when this country tries to do something, she cries out that the world is going to end and Obama is the worst president we’ve ever had.  Well, I have news for her and all the other naysayers:  I am Obamacare!

 

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