Should You Scream, Cry, Start Over? Practical Advice for Obamacare Sign-Ups.

Who's winning, who's losing, and why.
Dec. 16 2013 5:26 PM

How to Sign Up for Health Care

Practical advice from Slate’s guinea pigs.

purchasing insurance for John Riascos under the Affordable Care Act
An insurance agent speaks with three applicants about purchasing insurance under the Affordable Care Act on Dec. 11, 2013, in Miami.

Photo by Joe Raedle/Getty Images

Three months ago, before healthcare.gov blinked to life, we asked readers of Slate who intended to buy into Obamacare exchanges to share their stories with us. Their stories—lucky for Democrats and the Obama administration—got sort of lost in the tumult of the government shutdown. Suffice it to say that no one could really get online and buy the insurance they’d been dreaming of.

David Weigel David Weigel

David Weigel is a reporter for Bloomberg Politics

Finally, after a much-derided “tech surge” and some ritual congressional torture of administration officials, the website is working. Insurers are starting to invest in the site, actually, buying a reported $500 million of ads for their wares. We’ve checked in again with our human guinea pigs to see whether the system now works. Short answer: The website has improved, but the costs are all over the place. Long answer: Read their stories in their own words below.

Toby Dillon, 36, IT manager, Tooele, Utah

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We were able to get on and get everything set up for enrollment by mid-October, then we had the mind-numbing task of going through the various plans available to us. Not counting “bronze” plans, we still had more than a dozen to pick through. My wife wanted specific care providers, so that further limited the list. I wanted doctor-visit costs that weren’t “$X after deductible.” This put us into the gold plan range, which I expected to be more expensive but turned out to be only $40 more per month than our “benchmark” silver plan, for a total of $257 per month, with a $250 deductible, $5,000 out-of-pocket maximum, which is pretty posh for our family.

Our only hang-up is our new addition, due around Christmas. If we enroll now, we’d still have to do all this again in a month … so we’re going to hold off until January and sign up for February, thereby saving the premium and making sure all the family is on the same plan with as few hiccups as possible.

Eufemia Scarfone, small business owner, Venice, Calif.

I managed to sign up on Oct. 4, and I chose a Blue of California (Blue Shield) 80/20 plan that was $386 a month and has no deductible. I had to choose this somewhat blindly because at the time the health care organization I use did not know exactly what plans from the exchange they would be accepting. Historically, they have always accepted Blue Shield, so I thought this would be a safe bet.

After I successfully signed up online, I got several confusing letters from Covered California. It was a mix of "congratulations, you're covered" and "we're sorry, we can't verify your income so you might not be covered." Because I'm self-employed, they couldn't find any employment data in their state database. I had to estimate my income at sign-up, and my estimate put me outside the range of the available subsidies. Coveredca.com told me that the premiums and any applicable subsidies would be auto-adjusted and applied to my account after I filed 2013 taxes.

Meanwhile, back at my existing health insurance company, they decided to jack up my premium from $617 a month to $730 a month in October and blame Obamacare. As you can imagine, I am anxious to get as far away from this fleecing as possible. I received a letter from Blue Shield on Dec. 9 informing me that I needed to hurry up and pay them no later than Dec. 21 to guarantee my plan. It would have been nice to get some prior notice, but whatever.

I went to their website right then and there and made an online payment. I intended to schedule the payment for Dec. 20, but while I was adding my payment information, their site had reset the date to that day and I didn't realize it until after I clicked "submit." I inadvertently paid them early. At that point I got a little paranoid, so just to be sure I was in good shape for January, I went to my health care provider’s website only to discover that they are not accepting any Blue Shield plans from the health care exchange. At least they will be accepting the Anthem and some Healthnet plans, so all is not lost, and I still might save even more money on premiums.

I had to call Covered California several times due to call volume. I finally got through and ended up on hold for about 20 minutes. When the agent answered, I explained what had happened and that I needed to change my plan to something else. He informed me that, unfortunately, because I had made the payment already, it was now going to be a process to get that canceled. I had to get out of the plan I just paid for and into a new one before Dec. 23 or I would be stuck with the Blue Shield plan.

I called Blue Shield to cancel, and they were a bit confused at first but told me they “started the process” of cancellation and I would receive an email when it was complete, which would take about two days. Great! I call coveredca.com again, but they tell me I need a termination number from the first plan before they can vacate my enrollment from the system and I can choose a different plan. So I wait.

As of Dec. 13, still no email from Blue Shield regarding my cancellation. I call again, and the first agent disconnects me. I call back. Agent No. 2 seems to have a better handle on what needs to happen, so he went through the cancellation process. My guess is that it didn’t get done right the first time I called. I get back on the horn to Covered California. After a nice 40-minute hold listening to the same horrid song over and over, the agent tells me she has to delete my application. Apparently a termination number isn’t necessary. I think I would be far more aggravated by this process if every single person I have dealt with weren’t so incredibly pleasant and trying very hard to be helpful.

Erin Molnar, 25, unemployed, Ferndale, Mich.

So we did the process, and the site seemed to work. It was a little irritating because you couldn't easily go back to correct something, and it asked for things multiple times. Oddly it asked me if I had ever been in foster care, but not my husband. Overall it was an OK experience, though. We compared plans and found a silver plan I think with a deductible of $2,500 at a cost if about $450 per month for our family of three. While I don't think that's an unreasonable price, I'm currently unemployed, and we have a lot of student loan debt as well as upcoming child care costs and medical bills from being uninsured throughout my pregnancy, so I just don't see where we'd get $450 a month. We are not eligible for subsidies even while I'm unemployed. So for now we have decided to take the risk of being uninsured in the hopes that with my new job I'll get employer-sponsored health care. Without a subsidy I still just don't think it makes sense to buy it on the private market.

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