The Obamacare Insurance Exchanges are Open. Now What? Here’s a Simple Guide
Like it or not, the biggest component of the Affordable Care Act (aka Obamacare) – publicly run health insurance exchanges – have arrived.
The exchanges opened yesterday for public open enrollment, for the first time.
So what I wanted to do here is provide you with a basic guide on what that means for you.
If you tried looking for a plan yesterday, you might have been delayed from doing so with a “please wait” message (pictured below). Apparently interest was so high (over 1 million visitors by 7 am yesterday morning), that servers could not handle the load. Later in the day, the same “please wait” message persisted for me.
Once this bandwidth issue is resolved, what’s next? What does the arrival of the public exchanges mean for your health insurance coverage options? At the most basic level:
- If you have insurance through your employer, Medicaid, Medicare, COBRA – you can keep it.
- If you want to keep or get insurance through a private exchange or individual insurer, you can – nothing changes.
- You now have the additional option to get insurance through a state or public exchange at healthcare.gov. Subsidies, based on income level, are only available for plans purchased from public exchanges.
- If you don’t have health insurance at all, you will now be subject to a tax penalty.
The reality is, in the quest to find affordable health insurance, you really should explore all available options (except #4, which is an incredibly risky move – pre or post Obamacare). When comparing, keep in mind, the ACA offers subsidies for monthly premiums on the health care exchanges for households with income up to 400% of the US poverty line. And you can calculate your subsidy via calculators on your state’s exchange website or via this subsidy calculator.
Affordable Care Act Open Enrollment Deadlines
If you are interested in enrolling in a plan through a public exchange, there are some important dates to keep in mind:
- Oct 1, 2013: first possible date to enroll in a public exchange plan.
- Dec. 15, 2013: if you enroll by this date, your insurance would start Jan. 1, 2014 – the earliest possible date.
- Jan 1, 2014: the first eligible enrolled plans begin.
- March 31, 2014: if you would like to buy insurance through a public exchange for 2014, you need to enroll between Oct 1, 2013 and March 31, 2014. The only way to get insurance for 2014 after March 31 is if you have a qualifying life event (i.e. marriage, divorce, job loss, child birth).
- Oct 1, 2014: open enrollment for 2015 begins.
How can you Find Prices and Enroll in a Plan Through a Public Exchange?
Some states elected to run their own exchanges, in which case, you would need to run through a state exchange. Others deferred to the federal government, and you would enroll in a plan on healthcare.gov.
To find out if your state is running their own exchange or deferred, visit this site.
To find out pricing and enroll, there are 4 steps:
- Set up an account here (if your state has deferred, they will have their own site to enroll on)
- Fill out the online application
- Compare plans and pricing
You will need your SS#, income statements, and other basic personal information when enrolling.
Available Obamacare Plans
Whether state or federal exchange, you will have 4 (possibly 5) available options to choose from. They range from high monthly premium, lower out-of-pocket costs to lower monthly premium, higher out-of-pocket costs. The following aren’t guarantees, but guidance:
- Platinum Plan: highest monthly premium, lowest out of pocket costs
- Gold Plan: second highest monthly premium, second lowest out of pocket costs
- Silver Plan: third highest monthly premium, third lowest out of pocket costs
- Bronze Plan: fourth highest monthly premium, fourth lowest out of pocket costs
- Catastrophic Plan: firth highest monthly premium, fifth lowest out of pocket costs. This plan is only available to those under age 30 or those over 30 with low incomes who have received a hardship exemption from the fee.
In general, the healthier you are, typically, the less coverage you need. If you expect a lot of health care costs, the more coverage you need. Of course, you can’t predict everything, so there is a bit of a guessing game involved in choosing a plan.
That’s it, really. Obamacare at its simplest.
- Do you have employer-sponsored or government run insurance (Medicare, Medicaid)?
- If you have a private plan or no insurance – have/will you be enrolling in a public exchange plan?
- What early cost estimates have you seen on plans comparable to those offered privately?