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The Healthcare Exchanges are Open for Business: “Week 2”

The health insurance exchanges or marketplace opened last week but not without problems and drama making headlines.  During the first week, computer glitches due to overwhelming numbers visiting the exchanges seems to be the popular consensus as to why “millions” could not connect.  I made several attempts last week to create an account and each time was met with a new problem; security questions did not populate, I received an inaccurate error message regarding my security answers, and also completed the steps to set up my account just to be met with another error message.  But I kept trying.  This week, I was able to complete setting up an account, got into the sight and begin browsing around, so progress is being made.  If you’ve encountered similar problems, my advice is to keep trying.  There will be a lot to learn and review once you get into the system.  Although you have officially until March 2014 to enroll without penalty, give yourself enough time to learn about your healthcare options so that you select the best plan for you.

The glitches and the headlines are very similar to the ones when Medicare was implemented.  Some initial program design and operational issues are not unusual.  Despite the initial glitches, the exchanges will change the way health insurance is purchased and over the long term, transform the entire health care system.  I have managed employer health care plans for the past 20+ years and each and every open enrollment has been met with its challenges.  And the challenges were always much greater when there were major changes being implemented.  Buying health insurance is not an easy task for most of us and purchasing health insurance through the exchanges will be similar to how we book a vacation on travel sights such as Expedia or Travelocity.  The exchanges allow lots of options to be viewed and compared, as well as provide greater transparency around price, quality and consumer ratings.

If you’re one of the more than 45 million people without health insurance through Medicaid, Medicare or your Employer, the enrollment process began on Oct. 1, and if you elect a plan, your insurance will start Jan 1, 2014. The deadline to purchase (or face a penalty at tax time in 2015) is March 31, 2014.  Ideally you will want to be enrolled before the end of December 2013 to have your healthcare insurance in place by January 2014.  Don’t wait until the last few weeks to get started, the volumes on the site are likely to be much greater as the end of the year approaches.  Below are some tips to help you get started.

Keep trying, they are fixing the glitches and the selection and purchase of your healthcare insurance is important.

  • If you don’t find what you need with the “Help” options on the website, there is a live chat option, a customer service #1-800-318-2596 where you can discuss your options with a trained representative and apply over the phone.  Be patient and persistent with the call wait times.
  • Visit LocalHelp.HealthCare.gov to find personal help in your area.
  • Leave yourself more than enough time to carefully review and fully understand your options
  • The plans that are offered are categorized as bronze, silver, gold or platinum. The cheapest is a bronze plan which covers 60% of an individual’s estimated health care costs, and the most expensive a platinum plan will cover 90% of costs.
  • Consider your health needs in selecting the best option for you.  How often do you see a doctor, or go to an emergency room or urgent care center?  Do you see any specialists or have any specific current health needs?
  • Your cost is more than the premium; you need to weigh in the copays, coinsurance, maximum out-of-pocket cost and deductibles.
  • Make sure all of your doctors, including specialists, accept the specific plan you’re considering
  • If you will need to select a new doctor, make sure the new doctor you select is accepting new patients
  • Make sure the insurance company has enough specialists and hospitals for your specific plan
  • Understand the prescription benefit, whether the copay is a fixed amount or percentage and understand the coverage tiers, ie., generic, preferred and non-preferred.  Ask for the formulary list to find out which coverage tier your medications are on
  • Healthcare insurance is insurance and you are paying for your healthcare needs as well as insuring for the unexpected.

The exchanges will allow people who don’t have coverage through Medicaid, Medicare or their employer to comparison-shop for the best individual plan in their state on HealthCare.gov.  If you’re uninsured, you have to purchase health insurance for 2014 or face a fine on your 2014 tax return of $95 or 1% of your income, whichever is larger.

The experts at WageWatch want you to know how important it is to be aware of the new policies under the Affordable Care Act and their effect on small businesses. Employers need to properly plan for the future by developing accurate budgets that take the changing costs of healthcare benefits into consideration for the year 2014 and beyond. For assistance with your budget, WageWatch offers cost-effective reports, including salary, wages and benefits survey data. To learn more about the services provided by WageWatch, please call 888-330-9343 for assistance or contact us online.

This entry was posted on Wednesday, October 9th, 2013 at 1:25 PM and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.