Navigating HealthCare Dot Gov

When the hubbub finally settles, and all the remaining web site glitches have been ironed out, and society at large has grown tired of the dull critique from politicians on the sidelines, and the roll-out of “ObamaCare” becomes a done deal across the land, then some 33 million Americans who have not previously had access to any medical care — other than the last chance hospital emergency room — will finally have adequate health insurance they can afford.

I am one of them.

My partner Treesh and I went online at healthcare.gov the day it opened, on the 1st of October 2013, and attempted to create our Healthcare Marketplace account. This is the main portal for the Affordable Care Act (ACA) where Americans from every state can go to explore their health insurance options.

We encountered the same problems that millions of others have reported — error messages, slow servers, unsaved credentials, non-functional email links, bad browser cookies, login failures, page hangs, blank pages, you name it.

7 STEPS TO AFFORDABLE CARE

But over the next three weeks we were able to make our way through the process, which can be described by these 7 steps:

1. Creating your user account
2. Verifying your identity
3. Estimating your 2014 income
4. Receiving notice of your eligibility for subsidy
5. Choosing how to allocate your subsidy
6. Reviewing the plans offered
7. Selecting your plan and enrolling

Within the first week we had a working account that we could actually log into… but our “profile” page was a blank screen.

NOTE: If you’re seeing this problem, try my solution: I deleted cookies from my web browser that were associated with the healthcare.gov web site. (If you want to try this solution, and you don’t know how to delete browser cookies, just post a comment below and I or other readers will be able to help.)

Once we solved that problem, it was another week before Treesh and I returned to the site to make further progress.

The next step — verifying identity — was eye-opening. The HealthCare.gov web site interfaces with Social Security to ensure you are who you say you are. We were asked a series of questions, about previous places we had lived, previous phone numbers, previous employers, and more. What the government already knows about us is, quite frankly, kind of eerie. But within just a few minutes both my sweetie and I were able to assure healthcare.gov of our true identities well enough to satisfy the verification process.

ESTIMATING 2014

Then about a week ago we worked our way through the process to estimate our 2014 income. The Affordable Care Act was designed to ensure that health care should not cost more than 9% of your income. Assuming that 12% goes to taxes, and 12% goes to charities, that leaves 67% for your own use — for your mortgage, utilities, food, car repair, clothing, vacation, cable TV, cell phone plan, computer/internet, gifts for family & friends, and everything else the heart desires.

As it happens, Treesh and I are in a period of transitional income; I am in the midst of reenvisioning my own business, and Treesh is exploring new directions in her career. For the first time in our lives we are living primarily on savings, plus interest, dividends, and capital gains. We’ve set a very frugal monthly budget for our spending, and we anticipate that will continue through 2014.

Many people applying for health insurance will be surprised to learn they are eligible for a health care subsidy, in the form of a tax credit they can apply directly to their monthly insurance premiums. This is the mechanism that ensures healthcare will not exceed 9% of income.

SUBSIDY OR NO SUBSIDY

If you have plenty of income, you may not receive a subsidy; and your health insurance premiums will be affordable without subsidy. But if you earn a more modest income, or your income approaches poverty level, then you’ll discover how the subsidy makes healthcare a truly affordable part of your ongoing cost of living.

So long as your income is not below the poverty line! (For more about a significant oversight that emerged from a Supreme Court ruling regarding the ACA and state mandates for expanding medicaid, read this: “Locked Out of the Insurance Marketplace.”)

As Treesh and I worked through the healthcare.gov step regarding 2014 income, we found the series of questions very helpful to us in guesstimating how much income we could expect to earn from various sources. Thankfully it looks like our income this next year will be above poverty level. 

That done, we received notice within minutes that we are indeed eligible for a subsidy. In fact it is (in our view) a quite generous subsidy. That was very reassuring.

HOW TO ALLOCATE?

Next step, how much of that subsidy should we allocate each month towards our premiums? Our 2014 income is uncertain enough that it seemed prudent to not use it all, in the event that we actually earn more than we’ve anticipated (and consequently see a reduction in our total subsidy.) We chose to hold back 20% of the subsidy, just in case. If we end up earning our estimated income, or earning less, we will get the remaining portion of that subsidy in the form of a tax credit — money back on our taxes.

With that assurance in mind, last night we ate a quick dinner and then went online one more time to peruse the actual plans that have been provided for our state, and make a selection.

52 PLANS

If you haven’t figured it out already, Treesh and I are savers. We have never lived in debt. We have always spent less than we earned. We are on the positive side of interest payments. And we’ve always thought a Health Savings Account would be perfect for us, if only we could get a qualifying health insurance plan that permitted it.

Of the 52 plans we could choose from, there were eight Bronze- and Silver-level plans that allowed medical expenses to be paid out of a Health Savings Account. YES! After some additional online research at insurance web sites, we narrowed it down to two Bronze plans (lower premiums, higher deductibles).

We picked one, clicked “Enroll” … and were finally done. Mission accomplished.

We were not able to pay our first month insurance premium online, but it looks like that will be possible for some selected plans in the future.

We should be receiving paperwork in the mail from our chosen plan provider in just a few days, and we’ll head to our local bank soon to set up our HSA.

THE END OF THE STORY

We’ve had a very basic temporary (6-month) health insurance policy since Treesh left her job earlier this year. That insurance expires at the end of the year, just as our new ACA insurance is scheduled to start. With subsidy applied, our new monthly insurance cost is nearly one third of what we’ve been paying. We’ll take the money saved and use it to fund our new HSA.

MORE INFO: Read the New York Times “Guide to New Exchanges for Health Care.”

What’s your story? Add comments below.

Tags: finance, health, health care, insurance