3 Band-Aid Solutions to Health Insurance Marketplace Debacle

by Cathy Miller on October 7, 2013

in Health Insurance

bigstock-first-aid-medical-plaster-14756162If you are like me, you have been unable to fully access Healthcare.gov’s health insurance marketplace site.

Along with a whole lot of other Americans.

My current health insurance expires the end of this month.

What’s available in the marketplace for 2014 makes a difference in what I do with my current coverage.

  • I received a 28 percent increase in my premium
  • That’s a 64 percent increase in 3 years
  • The renewal was received October 1
  • My current coverage terminates October 31

How’s that for hurry up and decide?

The following are a few band-aid solutions that may help your situation until Healthcare.gov figures out how to fix its problems. Hey, hope springs eternal.

These tips are for individuals purchasing their own insurance. If you have coverage through your employer, contact your human resources department to see what your options are.

#1 – Contact a broker/agent.

I will admit to a certain bias with this tip. I am a licensed health insurance agent, although I no longer sell or service health insurance.

Health insurance coverage is complicated. While marketplace navigators may be able to help you with the marketplace (although even they cannot help you with the current system problems), a broker or agent knows the ins-and-outs of insurance options.

  • Brokers know who the insurance carriers are for your area
  • Brokers may be able to direct you to the carriers that are available
  • Ask your broker if he or she can provide the rates and plans for 2014

About the only good I can say about the lack of competition in my state is it narrows the number of options I have to review.

If you do not have a broker or agent, you can go to your state insurance site.

The National Association of Insurance Commissioners (NAIC) has a map of the U.S. Click on your state and it will link you to your state. Of course, you can always ask colleagues for recommendations.

#2 – Find other resources for 2014 plans and rates.

If you are a go-it-alone type of person, there are other online options for information. Sites like eHealthInsurance, einsurance, and GoHealthInsurance may help.

Again, my unique state is not in some of the sites’ online data. If you are in a larger state, you shouldn’t encounter the same problem.

  • Enter your zip code
  • Select 2014 plans
  • Enter your gender
  • Indicate if you are covering just you or a spouse and/or children
  • Check if you and/or your spouse use tobacco

I did notice that one of the sites did not have information on another carrier’s plan options for my state. That is one of the reasons I think it makes sense to work with a local agent.

Some sites also estimate if you are eligible for a subsidy to help pay your premium.

NOTE: Only coverage purchased in the health insurance marketplace (at your state site or HealthCare.gov) is eligible for premium subsidy – if you qualify.

You can also go directly to the insurance company‘s site or customer service.

The above band-aid solution will at least give you plan and rate information so you can plan accordingly.

#3 – Wait to log on to the marketplace.

Most of you may not have an immediate need for the information.

Another band-aid is wait to attempt any log-on to the health insurance marketplace. Hopefully, the infamous glitches will go away over the next few weeks.

December 15, 2013 is the enrollment deadline for coverage that is effective January 1, 2014. So, there is still time.

Health reform’s Affordable Care Act allows you to go without coverage for less than three consecutive months, without incurring a no coverage penalty. It’s not something I recommend, but there is that provision.

If you are in the same boat as I am, and need to renew coverage before 2014, look into temporary coverage.

Many insurance carriers offer temporary health insurance at much lower rates. Typically, the plans do not cover pre-existing conditions and are available for a limited time (for example – up to 6 months).

Check with your broker or agent or insurance company for details. It may give you the time you need before selecting 2014 coverage.

No Permanent Cure

There is no guarantee that once the glitches are gone that the health insurance marketplace will fix your needs. The band-aid solutions buy you time. When you do get access to 2014 plans, remember to check the following.

  • Deductibles – high deductibles bring down rates, but increase your out-of-pocket expenses
  • Coinsurance - that’s the amount you pay after your deductible is met – a low rate may mean a high coinsurance, such as 50 percent, which is a lot of out-of-pocket expense on charges like in-patient hospital services
  • Premium subsidy – this could make a HUGE difference in what you pay for premiums – if you are eligible, a portion of the premium will be paid directly to the insurance company
  • Provider network – if you have a family doctor, be sure your doctor participates in the specific plan you choose

I hope this helps ease some of the information gap. We’ll tackle this together.

May the force be with you.

=============================

Helping you Keep it simple, clear & uniquely yours – contact me for help with your business writing needs. Visit my business blog, Simply stated business.

===============================

Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.

BigStock Photo Credit

{ 2 comments… read them below or add one }

Kevin @ Ask for Benefits October 7, 2013 at 12:53 pm

Don’t forget about cost sharing subsidies. People with incomes below 250% of the federal poverty level get assistance with out of pocket costs, turning a silver level plan into a gold or platinum plan.
Kevin @ Ask for Benefits´s last blog post ..The Average Cost of Critical Illness InsuranceMy Profile

Reply

Cathy October 7, 2013 at 1:02 pm

Good point, Kevin. I haven’t included the information as I find many people are confused by the whole percent of federal poverty level. But, if they know they can get the premium cost to something they can afford, additional help like cost-sharing subsidies are icing on the cake.

That’s my perspective – never a sure thing. ;-) Thanks for adding the tip, Kevin.

Reply

Leave a Comment

CommentLuv badge

Previous post:

Next post: