I signed up for Obamacare — and saved big money
Behold my impossibility, oh readers! I am a unicorn and a jackalope, rolled into one.
I'm those imaginary things, at least, because I have done what some are finding unimaginable. I signed up for coverage under the Affordable Care Act, also known as Obamacare.
And I achieved the inconceivable without ever setting digital foot on an exchange.
Since state and federal exchanges went live Oct. 1, the federal exchange has had significant technical hiccups, enough to prevent many uninsured and underinsured people from using it to select health insurance.
Minnesota, where I live, is one of 15 states that built its own exchange instead of opting to use the federal exchange. Overall, the state exchanges have had fewer problems than the federal exchange, although Minnesota is an exception to that rule.
We encountered problems when we first tried to go on the site and sign up for coverage that would begin in January.
So we made a call to Allison Kraus, an insurance broker at Minnesota Health Coverage Inc. in Chanhassen, Minn.
Kraus suggested that we wait a couple of weeks to see if the Minnesota exchange site's technical difficulties resolved. In the meantime, Kraus sent us a short questionnaire, asking our names, ages, genders and priorities.
Do we use tobacco? (Never.)
Do we want access to any particular doctors? (Yes. We're committed to keeping our family doctor and the people I see for sports-related orthopedic issues.)
Do we want dental insurance? (Sure. I didn't even know that was an option.)
We filled out the form. Three weeks later, Kraus sent us a spreadsheet with five possible insurance plans, all fitting our criteria.
To do this, she pulled a nifty trick.
The Affordable Care Act created exchanges, but it also changed the laws around health insurance in other ways. The change that's most important for us is that, for plans that begin coverage on Jan. 1, insurers are not allowed to consider beneficiaries' pre-existing conditions in deciding whether to accept customers or how much to charge — whether or not they sell on the exchange.
A lot of current insurance products meet the ACA's qualifications. The ones that don't soon will.
Kraus represents all the insurance companies that do business in Minnesota. She used her knowledge of their products to find five plans that fit our needs and would accept us under the new ACA rules — without going on Minnesota's exchange or even finding out if these plans are available through the exchange.
This would not have worked, Kraus says, if we had qualified for a health-insurance subsidy. Because our income was more than $78,000 last year, we don't qualify for a subsidy. If we did, we would have to go through the exchange in order to get that help.
Comparing Plans Under Obamacare
These are the insurance options writer Ingrid Case, 45, and her husband, 48, were offered. Plans also cover one child.
|Plan name||Monthly premium||Deductible||Highlights|
|Signature Select+ D||$558.03||$4,000||$35 copay/visit. Up to 5 visits then 0% coinsurance.|
|Ultimate Select+ D||$595.96||$2,000||$35 copay/visit. Up to 5 visits then 0% coinsurance.|
|Compass Silver Copay||$612.02||$4,000||First 3 visits per person per year have a copay: $30 office
visits; $15 convenience care. Then you pay 20% after deductible
|Fairview Silver||$631.03||$3,800||Office visit: $40 copay for first 3 visits. Then 100% until deductible
met. Then 20% Coinsurance. Except $20 copay for all convenience/retail or evisits.
|BlueAccess HSA||$642.93||$6,000||No charge on office visits.|
We reviewed the five plans Kraus sent us and asked her a few questions about how they work. The cheapest product, oddly enough, seems to be the best for us.
It's a platinum-level plan with a $2,000 annual deductible and maximum out-of-pocket expense, a $1,000 per-person deductible and a $35 copay for office visits until we've had five visits. The insurance company pays for visits six through however many we need, without requiring a copay.
There's no copay for lab work and imaging. As is true for all ACA-compliant policies, all our preventative care, including tests and immunization, comes at no additional cost.
The policy does not include dental coverage for my husband or me, but it does include dental coverage for our son. That's fine. In our family, the adults have good teeth that get cleaned twice a year. The kid is the person who needs sealants, fluoride treatment and other extras.
The monthly premium: $595.96, or less than half the amount we pay for COBRA coverage through my husband's former employer, for a policy with lesser benefits. The carrier pays the broker's commission.
Kraus told us that the carrier, Preferred One Insurance Company, had previously been very picky in issuing policies but is now scaling up to take advantage of the market the ACA is creating.
We went to the insurance company's website, which is running just fine, and signed up for coverage. We paid the first month's premium in advance, something that we could do anytime between now and Dec. 15.
I am happy to have this decided, delighted to have avoided the glitch-ridden exchange and thrilled to have just one more month of $1,200 COBRA coverage.
Cutting this bill in half will make a big difference to our monthly budget.