On Friday, I was able to successfully get onto the healthcare.gov website and apply for coverage. I related my experience here. My session ended with learning that I had to wait for approval and acknowledgement of my subsidy before I could go on and select a plan. This makes sense since there would be no point in selecting a plan until I knew what my premiums would be. I was told the approval process could take up to 10 days, so I logged off.
I logged back in yesterday and discovered that I had been approved and my subsidy was ready. I did not receive an email letting me know this, so that's a problem. But I'm proactive, so I was ready to go shopping. Join me below the break for a play-by-play.
Before I could do anything else, I was asked to provide some documentation. My husband is a non-citizen with permanent resident status, so they needed proof of his eligibility. I had to scan his green card and attach it. The process was not entirely intuitive and might trip up anyone who doesn't have a scanner or understand how to attach documents. That was the only documentation the system asked for.
As soon as I attached the document, I was able to see our subsidy and start shopping for plans. The explanation of how the subsidy works was very clear. Based on our projected 2014 income, we qualify for a $452 tax credit each month. The web site gave me the choice to apply the entire credit, any portion of the credit I chose, or none of the credit before showing me the premiums on each plan. It also provided examples of why I would choose one or the other. It was interesting to see that the example provided for a person who might choose to not use the credit (and receive the amount as a tax credit when taxes are filed) was for a self-employed person with a fluctuating income.
Another thing that was interesting and very helpful for self-employed people was the implication that I will be able to go in at any time in the future and change the credit. So, if I start making more money than I thought I would, I can lower or eliminate the credit and pay full premium prices. This involves monitoring what you make over the year, and making adjustments, but this is something self-employed people should be doing anyway.
Since we're good savers (more on that later), I chose to take the full tax credit. There doesn't appear to be any penalty for overestimating need and I can always adjust or square up later.
I was also given the choice to select one plan for the entire family or group family members for different plans. This might be helpful if one family member has an ongoing health issue that requires regular doctor visits while the rest of the family is healthy. For us, I chose to stay together.
When I go to a restaurant and the menu is 15 pages long, I'm in trouble. I like to look at every option before I make a choice while my husband and daughter slowly perish from starvation. I hit this problem when I got to the "menu" of options available. Here in Middle Tennessee, I was presented with 72 different health plans to choose from. There are four companies offering plans at four levels (Bronze, Silver, Gold, and Platinum), but within each level, there were several options. Since all the plans are required to cover the same basic things, the differences were mainly in the combination of premiums, deductibles, and maximums. For people who don't understand the implication of these terms, this could be an issue. Since I've shopped for individual health insurance many times, I understand these options, but it's still a bit confusing when presented with so many choices.
Another problem is that the plans are not fully defined within the site. Given that the site is already combining data from Social Security, the IRS, and other government locations,
not altogether seamlessly, it would be too much to ask at this point to have full coverage documentation for each plan. Hopefully, in the future this will be considered. I was provided with links to each provider's web site to get more plan details. Still, it's not especially user friendly right now.
For the Blue Cross plans (which were cheapest across the board), I also had to intuit the difference between plans ending in the letter E and the letter S. I had done some research and know that these letters refer to the preferred provider networks available for each plan, but I imagine most people won't know this and it's not defined anywhere on the Marketplace nor Blue Cross's site. In addition, the links to provider data for Blue Cross are again not intuitive.
I was able to navigate through and see that the doctors that I and my daughter go to are in the E network (set up specifically for the exchange) as well as the S network, but my husband's doctor is only in the S network. This is an issue for us. The S network plans cost $100 to $150 more per month since they provide a much wider network to choose from. I asked my husband if his doctor was worth paying $1200 per year more for insurance. He said he'd get back to me.
So, at this point I had some questions and decided to call the 800 number again. I wanted to know some details about the different plans and confirmation on whether I could change my tax credit during the year, after the open enrollment period. I got a human within 10 seconds (Yay!) who couldn't answer any of my questions (Boo!). She said that I need to contact the providers with any questions about the plans (which I will do and report to you later). The other question I asked, which she should have had the answer to but didn't, was whether I could make changes through the website to my tax credit during the year. She did not really understand my question and gave me information about small businesses, which is not what I needed. So, this is an area for improvement.
Anyway, I will contact Blue Cross before I make a decision, and then report back to you. Onward!
UPDATE: I looked on the BCBST site and it was really helpful. I think I'd send my friends to that site to do the shopping. Of course, if you're comparing plans from different providers, you'll have to do that with each, but the BCBST site is ready to go. Also, here is a great summary/overview of their Marketplace plans.