Tuesday, October 22, 2013

HHS Encourages Use of Alternative Options to Research and Apply for Marketplace Coverage


Needless to say, the initial roll out of the online application process for getting coverage through the new federal health insurance Marketplace has been very frustrating for people shopping for insurance and also for those of us who simply want to check it out. Although some of the state-operated insurance marketplaces seem to be operating pretty well, the very rocky start for the federal Marketplace brings back memories of early troubles with the Medicare prescription drug coverage program.

As federal officials invest more resources in fixing the computer software, they have also been taking steps over the last couple of weeks to work around some of the problems with the online system and to relieve some of the pressure on that system. One of the measures is something that they should have actively promoted from the outset – encouraging people to do some online window shopping before attempting to apply and purchase coverage in the federal Marketplace. For many of us, that’s primarily what we were interested in doing at this point, and allowing us to explore the options without first setting up a personal account could relieve a lot of pressure on the online system.

You can easily explore the insurance options in your area here. Although the costs you will see there for specific insurance plans in your area don’t take into account the federal subsidies you are likely to be eligible for, the window shopping area of the Marketplace website does enable you to find out what subsidies you are likely to be eligible for.

My favorite interactive tool for exploring the options and seeing what subsidies you may be eligible for is the Kaiser Family Foundations subsidy calculator because it’s very simple to use. It quickly determines how your income compares to the poverty level and whether you appear to be eligible for Medicaid or Marketplace subsidies (based on each state's policy choices). For people who aren’t Medicaid eligible, it calculates how much your premium subsidy will be (if any), how much of the premium you are likely to have to pay for a “silver” or “bronze” level plan in your community, and what the cap will be on out-of-pocket costs for a silver plan (for in-network health care services). However, unlike the Dept. of Health and Human Services (HHS) website referenced above, it doesn’t show you a list of all the plans in your area and their costs.

Not surprisingly, the glitches in the Marketplace computer software have prompted HHS to remind people that there are also several old school options for getting covered through the Marketplace:
  • Apply by phone. Call 1-800-318-2596 to apply for a health insurance plan and enroll over the phone. (TTY: 1-855-889-4325)
  • Apply in person. Visit a trained counselor in your community to get information and apply in person. Find help in your area at LocalHelp.HealthCare.gov.
  • Apply by mail. Complete a paper application and mail it in. You can download the paper application form and instructions from HealthCare.gov.
It’s a shame that the launch of the Marketplace website, HealthCare.gov, has gotten off to such a rocky start. That storyline has distracted attention from many of the very positive aspects of the health care reform law and has given talking points to the law’s critics.

It sounds like the technological fixes for the online applications could be slow in coming, but in the meantime some of the states that developed their own systems are successfully enrolling many people and demonstrating the very valuable role the ACA will eventually play in making quality insurance far more accessible and affordable.

Jon Peacock

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