Persistence, off-hours Web use bring insurance enrollment
CHAMPAIGN — It took some persistence and a willingness to be awake at a computer when many other folks are sleeping. But Tony Skaggs is now enrolled in Affordable Care Act health insurance.
Not only that, said Skaggs, 55, of Champaign: His new BlueCross BlueShield plan that will cover him starting next year is relatively affordable, and he's satisfied with it.
A retired librarian, Skaggs has been living without health insurance for several years. He had to take a buy-out from his last job at Newsweek at 2009 and had continued employer coverage through COBRA for a short time.
But his COBRA coverage proved to be worthless when he moved from New York to his home state of Kentucky the next year, because health care services there were out-of-network under his plan, he said.
Skaggs, who later relocated to Champaign, said he first tried to enter the online government health marketplace when it opened at 12:01 a.m. Oct. 1, and immediately hit snags.
He tried again later in the morning, and again many times after that, continuing to receive error messages, and gave up temporarily after four days.
Determination paid off for him: He tried once again to enroll at 2 a.m. Oct. 9 and got through all the steps to get a look at the available health plans, he said.
Skaggs said he knew he was going to be interested only in the "silver" level health plans, and found only a few that looked good to him and two he really wanted to study.
Plans in the government marketplace are assigned metal levels — bronze, silver, gold and platinum — with bronze plans having the lowest premiums and highest out-of-pocket costs, and platinum plans having the highest premiums and lowest cost-sharing for enrollees.
Skaggs said he printed the details of the two plans he wanted to study and went back in the next day to sign up for his choice, a BlueCross BlueShield silver plan.
When he went back into the marketplace a week ago to check on the status of his enrollment, "I was able to click on my application and saw that I was enrolled," he said.
One confusing detail: The system indicated he needed to pay his first month's premium, but before he could call his new insurer and ask about that, the company called him, talked him through the details of his plan and told him he'd be getting a bill.
His monthly premium would have been $469, Skaggs said, but he qualified for an Affordable Care Act subsidy that will be applied to his monthly premium that reduces it to about $51.
Some details of his new plan, Skaggs said: He'll pay $40 to see a primary care doctor and $70 to see a specialist, and he'll have prescription drug coverage.
An emergency room visit is pricey at $500, he said, and the plan also comes with a $1,500 deductible that applies to a hospital visit — but that's also his maximum out-of-pocket for a hospital stay.
"It looked a lot better than the bronze plans, which had pretty high deductibles on them," he said.
Skaggs advises people who have individual health plans with skyrocketing premiums to at least look and see if they can get more affordable coverage through the government marketplace.
To find out if you qualify for a subsidy, you can do what Skaggs did first: Use a simple premium subsidy calculator available on the Kaiser Family Foundation website.
Find the calculator: http://bit.ly/172uCSK
For those frustrated about problems with the federal website: Based on his professional background, Skaggs says he could tell he was dealing with a poorly designed (not just overloaded) system. But there are several community locations to get enrollment assistance from people who have been trained to do that, he said.
"There are several navigators here in Champaign who will help people with advice and will even make an appointment with people," he said.