The good: First- the ability to shop online and compare plans is just terrific. I found the info presented in a clear, straight-forward manner that was easy to navigate and understand. I loved it…once I finally got there. More on that in a bit.
Also good- the options and pricing. This will be different for everyone, obviously, but for my family we’ve been waiting for this. My household is entirely self-employed. My wife has been running her own business for over 6 years and while she doesn’t make much she is, by every measure, successful. Earlier this year I left my full-time position to become self-employed which meant that we needed to secure our own health insurance. We currently have an individual (family) plan that covers myself, my wife, and our two children. It has a very high deductible and an even higher out of pocket max. I have a few other add-ons to provide for basic doctor’s office visits and a rider for accidental injuries (I have two little ones, after all) but it really is just a step above catastrophic coverage. I’m paying about twice as much out of pocket as I was when I was employed full-time for a plan with a deductible and out of pocket max 12.5 and 25 times higher than the coverage I had previously. It’s not ideal, but it’s what we’ve been able to afford right now. Admittedly, we’ve cut down on taking the kids to the playgrounds with the really high jungle gyms.
To say that the new coverage I signed up for (that begins Jan 1) is better in every way would actually be an understatement. We now have a very reasonable annual family deductible of only $1000 with an out of pocket max of $3k. We get $10 office co-pays, $8 prescriptions, co-pay free vision exams for all 4 of us and co-pay free routine dental coverage for the kids. And the cost? 30% less than what I’m currently paying. That includes the addition of a small dental plan for my wife and I (the kids are covered under the health insurance we bought, adults aren’t). The monthly outlay for our coverage is now very similar to what I was contributing from my paycheck when I was employed full-time. In the interest of full-disclosure I should share that we are benefiting from some of the tax credits available under the law, which are determined by income level. Even if we weren’t the rates quoted were much lower than when I was shopping a few months ago on my own. I know everyone and their dog has a political opinion on the law, but in our entirely self-employed house, Obamacare is a God-send. Beginning in January we can go back to some of those playgrounds for the daring and fearless.
The bad (ok, not really bad…just less than ideal): I have to switch doctors and hospitals. I’m not thrilled about it, but it’s not because of the law…it’s because of what some want to charge vs. what I want to pay.
In my local marketplace there are two primary healthcare systems, both of which are part of an integrated delivery system with a primary payor. The plan prices for my first choice of healthcare system were much higher than I wanted to pay. In fact I found out this morning they are among the highest costs on the federal exchange in the country. I could have selected my first choice but would have paid a higher premium. I decided to switch healthcare providers and pay less. Fortunately our beloved pediatrician’s office is still in-network for us, so our kids’ doc won’t change. And on the bright-side, the closest hospital to us, which was previously out-of-network, will be in-network beginning Jan 1.
The ugly: The website is a glitchy nightmare. It took me a week to sign up. I’m not even sure I’m completely, fully signed up. All the horror stories you’re hearing on the news…I experienced most of that. Once I finally got an account created (took me 3 tries) it took a solid hour to fill out the application. Keep in mind that I was filling in info for four people. Whoever built the application interface made some very poor choices. First- each question is it’s own page. On a 40 question application that means you have to submit and then wait for a page load….40 times. This will be less of an issue when the background support for the page is beefed up and fewer people are trying to use it at the same time, but still….yikes.
Once I finally filled out the app and got my eligibility results, I couldn’t view them. Still can’t. No idea what that document says. Nobody on the phone could help me and nobody on the live chat could help me. They simply advised me to “try again later.” They are all very nice people but obviously they can’t fix the software issues that the IT folks are (by all accounts) working around the clock to fix. Some of the problems thus far are related to traffic, but others are software and connectivity issues. Here’s hoping they get it all worked out sooner rather than later.
So that’s my story. I’m very happy with the end result, but the journey to get there was rough in spots. I heard on the news this morning that the federal exchange has been altered to allow browsers to compare plans without having to fill out the application, which is definitely an improvement. Also, keep in mind that I live in Pennsylvania, which elected not to set-up it’s own state exchange and to instead direct residents to the federal (Healthcare.gov) site. If you live in a state that has elected to set-up it’s own exchange much of what I described here won’t apply to you.
If you are thinking about signing up and will need to go through the federal exchange, I would recommend doing it in November. That allows some more time to get the bugs worked out while avoiding the backend flood of users (To have your coverage start on Jan 1 you have to enroll by Dec 15. The final 2 weeks before that deadline (Dec 1-15) are going to be heavy traffic times).
So that was my experience…what was yours? Share your story in the comments box below! And let’s work together to keep the discussion free of politics and hyperbole, okay?!