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On Friday, I was able to successfully get onto the 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.

Originally posted to Libertina on Mon Oct 21, 2013 at 06:53 AM PDT.

Also republished by Three Star Kossacks.

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Comment Preferences

  •  Thanks for this (10+ / 0-)

    This is really what this site is excellent for - people telling their stories about something like this enrollment process. Very well done!

    Seneca Falls, Selma, Stonewall

    by Dave in Northridge on Mon Oct 21, 2013 at 07:01:52 AM PDT

  •  JFC (1+ / 0-)
    Recommended by:

    this already seems like a major pain in the ass.

    I'm not an actuary. I'm not particularly strong with math. I don't know the ins and outs of the insurance industry and do not feel AT ALL comfortable self-selecting a plan (when I had a real job that provided benefits, I always took the one I didn't have to pay for).

    Couple with the fact that the site doesn't work well here in PA and the fact that the hotline operator didn't know anything (she told me to visit the website), I am REALLY bummed out.

    I wanted this to work, and after last week's experience, I hope I never have to go to the ACA website again.

    •  After I finish my journey... (8+ / 0-)

      I will probably recommend that people who are unfamiliar with buying their own insurance or who aren't good navigating the various web sites use the 800 number to apply and then contact the insurance companies directly to choose an option. Sadly, I don't think the web site is for everyone, especially is you've never bought your own insurance before. Hopefully, the navigators can help, but I haven't seen evidence of them in Nashville yet.

      Never interrupt your enemy when he is making a mistake.

      by Libertina on Mon Oct 21, 2013 at 07:09:30 AM PDT

      [ Parent ]

      •  Agreed. (0+ / 0-)

        I spent most of the weekend on it. Like you, I think the website is anything but user-friendly. If you're not conversant with health insurance either? Holy cow!

        Mark Twain: It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so.

        by Land of Enchantment on Mon Oct 21, 2013 at 08:16:27 AM PDT

        [ Parent ]

    •  well, just wait until you have to pick a medicare (10+ / 0-)

      plan b (doctors), supplemental (cover the other 20% of doctors/tests/etc), plan d (prescriptions) and the remaining letters!  (i think e is supplementals, not sure - and i think there are things to pick for long term care)

      as one who has been in the medicaid, food stamps and heap systems in the past (oh yeah, Tanf when my daughter was born 26 yrs ago) as well as now having a daughter on medicare/medicaid, the poor have had to navigate a system that is at least as difficult - and, in the past, take themselves into offices with hard copies of everything.  then come back cuz they were missing something.  then come back again cuz they thought of something else they want.  all, of course, during working hours and with transportation costs they could ill afford.

      yes, health insurance in this country, and the safety net, are complex and difficult to navigate.  

      fortunately for all those in need of the exchanges, there is help out there to navigate it.

      "Don't Bet Against Us" - President Barack Obama

      by MRA NY on Mon Oct 21, 2013 at 07:37:56 AM PDT

      [ Parent ]

    •  I am extremely surprise that (8+ / 0-)

      you had PA problems.  I signed up and enrolled completely in a plan fairly painlessly. The websiteitself was nothing more than annoying.

      Of course understand the insurance industry being horrible hellish devils.

      But I can tell you from experience being self employed and getting my own health insurance for years and also working for 2 different insurance companies in the past....It's the insurance companies, not the government in this case.

      In Western PA Blue Cross has the more comprehensive and cheaper plans (choices are only BC/BS or UPMC)  I'm pretty sure both companies pay people millions of dollars to try and find ways in the insurance language to screw regular people.

      Good Luck, and blame Corbett the most since he pulled both the pre-existing state money forcing those of us on it to go the federal exchange quickly, and for waiting till the last second to say no state exchanges.

  •  Health Care Exchanges (2+ / 0-)
    Recommended by:
    annrose, annan

    I was listening to NPR this morning and they were going on about what a black eye this is for the ACA.  I was waiting to hear that the obstructionism and sabotage before, during and after had taken their toll on the roll-out.  So far, no mention.  The Republicans, and even some in the insurance industry have been working hard to kill this law by any means.  Now were expected to blame the problems entirely on Obama.  I'm not eager to hear how effective the right wing campaign has been, but I think it's an important part of the story that is being left out.

  •  About the doctor and networks (2+ / 0-)
    Recommended by:
    annan, Lawrence

    I'm in a similar situation where my doctor is only in the more expensive plan networks.  Since I'm in pretty good health and only see my doctor for an annual check-up, I'm thinking of signing up for the much cheaper HMO and using their doctor only if I have a problem, and paying cash for my annual check-up and minor problems.  It still works out to be much cheaper.

    •  Got the same problem in Indiana with doctors (4+ / 0-)
      Recommended by:
      Libertina, ybruti, Lawrence, SoCalSal

      in 2 networks that don't overlap at all. Zero coverage out-of-network and the blame falls squarely on Indiana because other states haven't created such extreme networks.

      I freaked out for a couple of days, then realized that it wasn't the end of the world. I'm going with the plan that covers my every day medical needs. If I require something more extensive, I'll adapt.

      AND the good news is that I could change plans next year if I decide that I made the wrong choice. I haven't been able to change plans by choice for 20+ years!!

      "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

      by annan on Mon Oct 21, 2013 at 09:45:37 AM PDT

      [ Parent ]

      •  Agreed! (3+ / 0-)
        Recommended by:
        annan, Lawrence, SoCalSal

        I realized that if the plan doesn't work our or if one of us gets really ill, we could change plans next year. It would mean taking a hit this year, but I'm guessing that the networks will be better next year after the dust dies down anyway.

        Never interrupt your enemy when he is making a mistake.

        by Libertina on Mon Oct 21, 2013 at 10:02:15 AM PDT

        [ Parent ]

  •  I did it all this weekend (5+ / 0-)
    Recommended by:
    Sherri in TX, FG, Libertina, ybruti, SoCalSal

    For some reason, confirmation about the subsidy was not a problem, though overall, it was a mess. I went for Blue Cross, because my life requires me to be in at least 3 different states with some regularity, and Blue Cross PPO providers are in all 50 states, not just my home state. I'll know it's done when I confirm with Blue Cross that I'm in their system, and make my first payment.

    Like you, I was less than pleased with the messaging. I got an email to tell me I had a notice on the site. No hint as to what it was about. I followed the link, which led me to a page, again telling me I had a notice, actually 4 notices. But no link to the actual notices, or any hint where to find it.

    Plus, generally, when you push a button, the page just sits there, so you have no idea if it took. (I'm pretty sure that's why I got 4 notices.) Pretty much all the rest of the internet gives you some kind of response about results. Fail. Succeed. Pending. What next. Something like that. Not, no such thing there.

    With sheer manic stubborn perseverance, I got through it all. I think. I'll have to wait and see whether Blue Cross thinks I signed up, too.

    Mark Twain: It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so.

    by Land of Enchantment on Mon Oct 21, 2013 at 08:15:19 AM PDT

    •  Make sure that you have multi-state coverage in (0+ / 0-)

      your plan. Here in Indiana BCBS sells 2 different plans: one that covers multi-states and one that doesn't. Only the multi-state plan mentions the extra coverage. With the regular plans it's buyer beware, they only cover emergencies out-of-network (whether geographic or not).

      "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

      by annan on Mon Oct 21, 2013 at 09:48:45 AM PDT

      [ Parent ]

      •  Blue Cross PPO (1+ / 0-)
        Recommended by:

        It has interstate coverage, like I said. That's why I chose it. It's the Blue Cross HMO that does not.

        Thanks for your concern. But, like I said, I'm already signed up.

        Mark Twain: It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so.

        by Land of Enchantment on Mon Oct 21, 2013 at 10:32:40 AM PDT

        [ Parent ]

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