waiting for obamacare

Healthcare Reform

Heads Up! What Buyers Should Watch Out for on the Exchanges.

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waiting for obamacare

As expected, the first week of open enrollment has been full of speed bumps. Buyers can explore a plethora of new insurance options on websites, ask an expert by phone, or chat online — at least that’s the idea. Some have reported struggling to get portals to load or waiting in line to chat for hours when something goes wrong.

Tech experts are scrambling to fix the bugs and upgrade sites to accommodate the unexpectedly high traffic, and the long lines seem to be thinning somewhat, but the government shutdown is throwing a continuing wrench in the works.

If you’re still trying to buy insurance and it’s trying your patience, here’s a roadmap of what we’ve learned about the trickiest barriers so far.

Traffic Jams

Many bloggers and pundits have pointed out that the biggest challenge for the exchanges so far hasn’t been inherent problems with the system, it’s been unexpectedly large waves of traffic. The best and really only way to deal with a traffic jam? Patience.

Complicated Design

The Washington Post pointed out the major design flaws of Healthcare.gov, the federal exchange site, which are likely making it harder for customers to sign up.

1. The site lacks a clear description of the Affordable Care Act.

2. Some prompts to enter information are inconsistently or redundantly worded, so customers aren’t sure exactly what personal info is relevant and if it’s already in the system.

3. Downloading the form to make a Marketplace account took 30 minutes.

4. The sitemap doesn’t help users visualize the process of enrolling.

5. There isn’t enough warning upfront that glitches and bumps are ahead. The authors suggest honesty about problems from the beginning could head off some frustration later.

Cheapest is not always best

Plans that only cost $40 or $50 per month usually come with high deductibles and other out-of-pocket costs, so keep that in mind when you’re price-comparing, as NPR suggests.

Take extra care with complex medical conditions

You can’t be denied insurance for a preexisting condition anymore, but you may have to pay very high out-of-pocket costs for medications, depending on your home state. Some cancer medications, for example, retail for up to $10,000 per month. New York caps patient co-pay for any medication at $70 per month, but other states, like California, require patients to pay 30 to 50 percent of the total cost.

State residence matters

Some states, including Florida and Tennessee, have banned professional navigators from helping customers understand the Affordable Care Act and utilize the exchanges, putting even more pressure on swamped call centers and online chat functions.

Where you live within a state makes a difference, too

Kaiser Health News has uncovered an urban/rural divide for insurance premiums. Even within the same state, city dwellers will often pay a radically different amount than their country counterparts. In Pennsylvania, for example, a mid-level insurance plan will cost a 40 year old in Philadelphia $300 per month, more than 70 percent more than the same coverage would cost in Pittsburgh. The direction and breadth of the divide varies by state.

Learn from success stories, too

These and other complications could make a tricky process even harder to navigate, especially if you don’t have access to a navigator. But there have been some success stories, and we’re learning from those too.

In Kentucky, the whole process seems to be running a bit smoother than most other states – customers are getting through to the call center in droves, which is a good sign. In case you aren’t so lucky, here are the questions Kentuckians are asking, and where you can find the answers.

From Tuesday through Friday last week, the kynect call center took more than 25,000 calls. Here are the answers to the four most common questions:

How do I apply? Online here for Kentucky residents. For residents of other states, find your online marketplace here. You can also call (but it may take over an hour to complete by phone), chat or apply in person at select locations.

When will coverage be effective? January 1, 2014.

 Am I eligible for special assistance? One in seven callers asked this. Check your  Medicaid and Children’s Health Insurance Program eligibility online.

When do I make my first payment? You make your first premium payment when you are approved for a plan and purchase it on the exchange, at the endpoint of your shopping experience. You’ll need to do this between October 1, 2013 and March 31, 2014.