By Max Friedman
I am one of the so-called “young invincibles;” a young, healthy person, who has typically thought that they didn’t need to purchase health insurance, and would wait until they were more settled to think of such things. Here’s a look at my experience signing up for health insurance, and what I’ve received as we approach the period to sign up again.
Step 1: Signing Up
I first signed up for insurance on a new health care exchange in January. I was living in Washington, DC at the time, so decided to get my own insurance because it was difficult to impossible to rely on my parents’ Connecticut-based insurance although I was still under age 26. There were a few bumps in the road on the way to coverage in Washington, including multiple notices for required income verification which often all arrived at once, and having to reach out to my chosen insurance company to pay the first premium for coverage. Not knowing if I was covered, or always at risk of losing coverage due to a missed piece of mail was very frustrating.
Step 2: Moving to Connecticut and Getting Covered
When I moved back to Connecticut in June to start graduate school at UConn, I realized that I needed to switch my coverage back to a Connecticut-based insurance carrier. I had heard good things about Access Health CT, the state exchange, and was looking forward to enrolling here after the problems enrolling in DC. I knew I could enroll outside of the usual open enrollment period because I had moved states, a “qualifying life event.”
So I logged on, created an account, entered my age and income information, and was presented with the range of choices from several insurers, with Bronze, Silver, and Gold price tiers. I picked a Bronze plan from Anthem Blue Cross Blue Shield. I qualified for a tax credit of $114 per month, and pay a monthly premium of $68.31. I was then contacted by Anthem to pay my first month’s premium, and received an email that my plan information and insurance card would be mailed to me soon. Surely enough, they did and I was an insured Connecticut resident once again.
I was able to use my insurance easily for my annual physical and tests without copays at the new doctor’s office I found near my home in Wethersfield. So far, so good. The process was clear and easy for me, and I never worried if I was falling through the cracks.
Step 3: Reenrollment Shopping Begins
What Anthem Says
In early October, I received a notice from Anthem informing me that Open Enrollment for 2015 is coming soon, and that I can most likely keep my plan, and simply do nothing during the open enrollment period to be put into a similar Anthem plan, or go to Access Health CT to find a “different Anthem ACA-compliant plan.” Anthem provided a six page chart explaining what will be changing between these two plans. I was happy to see that the plans are almost identical, with just a few changes:
- My plan will be changing from the “Anthem Bronze DirectAccess with a Health Savings Account” to the Anthem “Bronze HMO Pathway X Enhanced for HSA.”
- I would see a $100 drop in my in-network deductible, a $100 increase in my in-network out of pocket maximum, and a $300 decrease in inpatient hospital services.
- Mental health and substance abuse coverage would be subject to a copay, while they are not currently.
At the very end of the notice, Anthem tells me that my new premium in January is $64.51, which is a few dollars lower than what I’m paying now. They tell me to go to Access Health CT to see if I can get a bigger tax credit, and all the way at the bottom, mention that I may be able to choose a new health plan from Anthem or another insurance company, as well as HUSKY.
Directions from Access Health CT
A week later, I received a large, bright packet from Access Health CT. It included a guide for reenrollment, with charts explaining the process if I want to stay in my current plan or explore my other options. The packet says that I should log on if I need to change any of my information, and to check out new options from the various insurance carriers participating in the exchange.
There is a lot of information in the packet, with flow charts of necessary steps to take and definitions of health care terminology on the bottom. It’s great that Access Health CT is providing all this information to make sure that people know about this complex system, but I wonder how someone without my knowledge of healthcare reform policy would sift through all of this material. Concepts like copayments, coinsurance, and health savings accounts are not clearly explained.
In the next few weeks, I’ll have to decide what to do for next year. Open Enrollment starts on November 15, and I have until December 15 to change plans, or I’ll be automatically put into the plan Anthem picked for me. In the next week, I’ll receive more information from Access Health CT about my eligibility for subsidies. I’ll definitely want to see if I can get a better plan for next year, while keeping access to my doctor and other services I care about.
Join me in the next few weeks as I explore all of my options, and try to reenroll myself. Will the process go smoothly this time? Stay tuned.