One Confused ObamaCare Applicant

Affordable Care Act, ObamaCare, whatever. Health care costs are scary. A couple of months ago, and a year ago, I’ve made the trip to the island’s emergency room, thirty miles up-island. Both times, as I watched impressive people tend and care for an injured friend, I’ve also been aware that, even with my health insurance, such an accident would bankrupt me. Finally, America was going to have a better plan that took care of people with financial difficulties. The media makes it sound easy, if you can log in. Here’s the messy details of one person’s attempt at signing up.

All I knew was what I’d read in the news. That isn’t always a help. A typical person should expect this or that, but no one is actually typical. I can hear the head nods from here. So, I knew that whatever I encountered would require lots of note-taking and time stamps so I could backtrack, and also to have a record if I had to contact Help. If the literary nature isn’t up to your expectations, well, welcome to the reality of bureaucracy.

12/20/2013
20:15
Despite the official names, everyone was calling it ObamaCare. What little I’d heard from friends was that they were likely to be directed to Medicaid. Not surprising considering that Medicaid is supposedly for people near the poverty line and a lot of my friends are self-employed, sole-proprietors, or artists.

As if keeping track of the names wasn’t odd enough, Washington State has something called Apple Health, which made it sound like I’m supposed to be an employee of a computer company, or involved in a crop protection plan.

One of the first questions: Monthly income, er, based on what? 2012, 2013, last month?
Someone warned me that my application may have to be re-assessed every month that my income varies by more than $150. Well, that sounds like a monthly chore, or a reason to always pay myself exactly the same each month – if possible.

The site says I’ll probably end up with Medicaid if my annual income is less that $15,856. Before tax? No. After tax, well, it could be.
Ah, but the subsidized insurance kicks in if my annual income is less than $45,960. I’m definitely under that level. That’s the first bit of good news.

Coverage covers ER. That’s another bit of good news.

OK, go find 2012 tax returns before I launch in, just in case.
Dredge up my TurboTax username, password; the eternal struggle
Right, got the number.

Bring up Washington Healthplanfinder.
The site invites me to Find and Compare or Apply for Coverage or Sign In
I’ll Find and Compare because it is on top
Next Find Quality Coverage (but what if I want quantity instead of quality)
Gotta have SSN, birthday, income. See, thinking ahead was handy.

20:35
Find Quality Coverage
For my zip code and income, evidently my current plan isn’t even on the list. That’s okay because they’d just raised my rate by about $100.
But, all the plans are more expensive than the increase I expect to see in my current plan.
Ah, but the tax credits make even the most expensive cheaper than my current bill.
And I get to pick my doctor or hospital. Both are 30 miles away but it let me add Whidbey General anyway.

Choices choices.
HMO vs PPO? I don’t know.
A Goldielocks moment. Gold is too expensive. Bronze has too high of a deductible. Silver is less than I am spending now and has a lower deductible. I think.
Mouse overs and info buttons are vague enough to be useless.

Dive into the dreaded More Details
Ah, what’s Not Covered: Eye and Dental. Rats.

The list is 27 plans long, but there seems to be a lot of duplication under different names.
Multi-State Plan Blue Cross Silver 2500 HSA
LifeWise Essential Silver 2500 HSA
Premera Blue Cross Preferred Silver 2500 HSA
20:57
Group Health – Core Silver
Multi-State Plan Blue Cross Silver 3000
LifeWise Essential Silver 3000
Ah, in the details there are lots of N/As = not good, particularly for Group Health, as I read it.
Premera Blue Cross Preferred Silver 3000
Multi-State Plan Blue Cross Silver 2000
LifeWise Essential Silver 2000
Premera Blue Cross Preferred Silver 2000

So, reorder them because I think I see a code.

Multi-State Plan Blue Cross Silver 2500 HSA
Multi-State Plan Blue Cross Silver 3000
Multi-State Plan Blue Cross Silver 2000

LifeWise Essential Silver 2500 HSA
LifeWise Essential Silver 3000
LifeWise Essential Silver 2000

Premera Blue Cross Preferred Silver 2500 HSA
Premera Blue Cross Preferred Silver 3000
Premera Blue Cross Preferred Silver 2000

Group Health – Core Silver

Compare three that only vary by number, not by name.
Ah, so the coverage doesn’t change but the money does.

21:11
Now, compare across for the same 2500 or 3000 or 2000
Ah Ha! HSA means something Health Savings Account.
Exact same details.

Oh, and Group Health doesn’t like Out of Network and an island is more likely not to be networked.

Down to six: the 2000s and 3000s in two flavors of Premera and one flavor of Lifewise.
An extra $20/month knocks my deductible down by $1,000 and is still almost $100 less than my existing plan.

Okay, I’ve narrowed it down to the Silver 2000s, but can’t see any difference between them.
21:25 That’s enough of that. It’s late. There are two more days to figure this out. No need to hurt my brain.

12/21/2013
Back to working on signing up for health care after a day of working on the computer.

19:00
Is the tax credit only paid out in 2015 for 2014?
“this tax credit provides you the option to either reduce the amount of your monthly health insurance premium; or have a lump sum deduction when you file your annual income tax return”
Wow, a useful FAQ. Thanks folks.

Okay, where’d my doctor go?
The hospital doesn’t mention her, but the WA.gov site does.
Whidbey General = select (because, on the island, we’re really limited to the monopoly of the one hospital)

Glad I took notes last night. What did I decide on?

Go to Premera’s site to figure out the difference between Multi-State and Preferred, because I can’t tell the difference on the State’s site. That doesn’t work, but they have a phone number. Ah, they’re not working tonight.
So, go to the definitive source: Facebook – where, as luck provided, someone asked the right question, they happened to be a friend, and they got a good answer.
“The only difference is that the PBC Preferred plans include coverage for elective termination of pregnancy while the Multistate plans do not.” Not an issue for me.

So, what’s the difference between Lifewise and Premera?
From WAhealth.com (on Google’s Search page)
” Lifewise (a Premera subsidiary) is the leader in catastrophic plans. … network is identical, and other than branding, there is little difference between the two.”
Oddly enough, that description was on the blurb beneath the search term on Google, but I couldn’t find it on the official site.

So, which one sounds better, or looks better on an insurance card?
LifeWise Essential Silver 2000
Premera Blue Cross Preferred Silver 2000
I’ll take the second one.

Ok, ready to go, but there’s a letter from my current provider back home. I should check it first. Who knows, maybe they’ll make me a better offer. Hey, I’m an optimist.

But first, register to beat the WA deadline.
Pain in butt, username rules, yet another username with yet a different set of rules.
try #2
try #3
I’m too tired to come up with a password.
try #4
Finally, a password they’ll accept. The rules are convoluted enough that I won’t be able to remember that. Time to Copy & Paste.
“Do you want to apply for Health Insurance Premium Tax Credit, cost-sharing reductions or Washington Apple Health?” That is the point, isn’t it?
Quit now before I hurt my brain.
19:49

12/22/2013
username and password fail
Access Denied
Due to multiple incorrect attempts, your account has been locked. Contact the Washington Healthplanfinder Customer Support Center to unlock the account at 1-855-WAFINDER (1-855-923-4633) between the hours of 7:30AM and 8PM for help.
We are currently closed.
So much for meeting that deadline.

12/23/2013
8:39
Hurray! Password reset received in the night by email.
Must reset
try #1
Ah ha! The same password I tried to use before was actually an Invalid password. Tell me that the first time, eh.
try #2
Success! Oh wait, all of that was just to set up an account. I haven’t done any real work yet.

Okay, I can go to Dashboard, which was a circular link or learn more which is a video, or – Home?
Clicking on my name – takes me back to the same screen.
1-855-923-4633 Experiencing high call volumes and unable to take your call at this time.
So start back with WAhealthplanfinder.
No good.
Sign out then sign in.
Does password reset require logging out then logging in?
Go To Home Page shows that I am still logged in.
Close window, oh why not close browser, and try again.

Breathe.

8:55
invalid password
Loading HBE application
Ah, Complete My Application – and don’t complain about not knowing how it finally got through.

9:00
According to them I lived on 40TH? When and where was that? Sometime since I’ve moved to Washington I lived on 40th. I’ve lived in Washington for 33 years. That’s a lot of addresses. Even in the last ten years I’ve probably lived in four. I don’t memorize such things. Pick, None of the Above

Fill in more details, like insurance info.

Monthly income, but for when? The previous pages asked for annual, so I assumed they wanted Federal Tax data, but monthly income sounds more current.

It takes three tries to get the employment forms filled out right because I am self-employed and misread one line.

Speaking of self-employment I hit Submit My Application – in a rush because I am doing this during working hours. If I am filling out forms, I am not billing hours.

9:16
I’m eligible. Great. But I haven’t signed up for anything yet.

Back to the screen where I did all the research.
I trust my research, so I should just be able to pick and apply, but I also don’t like to make assumptions. Sure enough, the plans look the same but the numbers are different. The deductibles are much higher. I’m starting to lose the benefit that I saw earlier.
I’m approaching the deadline with no indication of how many more hours this may take. Click now, change later if necessary. Besides, my situation may improve or change.
Premera Blue Cross Preferred Silver 2000
Gulp. The new price no longer includes the monthly rebate and is $200 more than last month’s payment.

Maybe the rebate is applied at the end, like discount codes when shopping online.

9:19
Click Buy.
Pay by eCheck or debit or credit – No personal checks allowed?
Grr, I hate giving someone direct access to my account. It is too easy for someone else to accidentally drain what little money I have.

Where’s the tax rebate? I must trust the system.

Gulp. That has to be paid today! I must trust the system.

So much for the monthly tax rebate. Looks like I’m spending more every month. A benefit next year may be too late considering I’m trying to save my house from foreclosure now.

Must post a warning to Facebook.
“Warning. I just signed up for health care, looking forward to the lower payments, but found no box for the tax assistance. Instead of a ~$300 monthly tax credit applied to my premium, I’m spending even more than the increased rate from my old plan. And yes, this will be a blog post – after I’ve calmed down.”
9:30 Throat clenched. And now have to go to work two extra days per month. I’m already working seven days a week, and I’ve luxuriously taken three days off since the Fourth of July. They were the Fourth of July, Labor Day, and Thanksgiving. In other words, I’ve lost ground, lost time, and lost money – and working harder to catch up, well, that can’t be healthy.

A friend has told me in the past that many of misfortunes have come about from trusting too deeply. Another put it that, from my description, I’ve been betrayed before, even if I don’t use the word. I still don’t use the word, but I do admit that I fell like I’ve witnessed a bait and switch. Maybe this will be resolved, but whether it is or isn’t, how many thousands of people are having a similar experience? At least for now, I’ll pay the extra, be glad that I’ve practiced frugality for decades, and wonder at the strange trip we are in.

About Tom Trimbath

consultant / entrepreneur / writer / photographer / speaker / aerospace engineer / semi-semi-retired More info at: https://trimbathcreative.wordpress.com/about/ and at my amazon author page: http://www.amazon.com/-/e/B0035XVXAA
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8 Responses to One Confused ObamaCare Applicant

  1. A bit of trauma drama. It wasn’t my experience. The WA website was flawless.

  2. Chrystopher Withawhy says:

    My experience was actually worse than yours, Tom, much worse. Do wish to thank you though for your post as you helped me decide which plan to go with. I had a good idea as to which to choose but you distilled it down to what I needed. Thanks.

  3. ashinbleu says:

    Pretty much sums it up! Still deciding on what to choose…thanks for your post.

  4. Debbie says:

    Thank you for the post! I was wondering what the difference was for the two Blue Cross Plans you mentioned. I even called the HealthPlan Finder Customer Service Number and they had no idea the difference, told me to call Blue Cross. I too have had a bad experience with this process. Affordable? With my previous job would have had to pay $300 a month just for me; thankfully had an ok plan with employer that was half that. Also I remember when site was finally up and could see plans, it said included Dental (not anymore…odd). Now have new self employment job, and household income at 80% poverty; have to pay $96/month just for me. Thankfully son still has Apple for free. But husband went with employer so paying $276 month total. Then add coinsurance, deductible ….ok where is this Affordable?? Before “ObamaCare” I would have qualified for free state medical. PLUS dental and vision!!! With $0 cost to me. After finally buying a plan it didn’t back date to when I was approved, in fact it pushed it out a whole month ahead. Calling HealthPlan Finder Customer Service to see what can be done…grrr!

  5. Camerin says:

    Thanks for “The only difference is that the PBC Preferred plans include coverage for elective termination of pregnancy while the Multistate plans do not.”.. I have been looking through paperwork for an about 45 minutes, Google sent me here.

  6. Thanks for this post. Was looking all over to figure out the differences in the Premera plans.

  7. Tom Trimbath says:

    Glad to help. Keep in mind that info was from 2013. Things may change, and maybe not. It is a strange system.

  8. stopcoal says:

    My experience was nearly identical to yours. The site offers comparisons of plans… but two plans from Premera Blue Cross (that have different titles and prices) when compared, appear to offer exactly the same coverage. Brain dead, untested software from Washington… Whats more, one year later, there has been no improvement to the site. So I too went to the premera site… Just like you, I found no help there.

    Between the ‘choices’ of Gold, Silver, and Bronze, the insurance companies want you to buy Silver. Bronze doesn’t actually cover you and Gold is unreasonably expensive. So you have one choice: Silver.

    Thanks for pointing out that among comparable plans, some of them are subsidiaries of the same company. (lifewise and primera)

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