- Posted October 10, 2013 by
This iReport is part of an assignment:
Obamacare: Your story
Breakthrough: Marketplace Exchange - Iohn's Plans
- hhanks, CNN iReport producer
Shortly after uploading my latest report on the rollout of the Marketplace Exchange in compliance with the Affordable Care Act around 8 p.m. Wednesday evening, lo and behold what had been an impossibility became a reality. My life partner Iohn and I were finally about to see what plans are available for purchase in the Cornfield.
I quipped in a comment that the NSA had noticed that report: Were Opponents of the ACA Right? and tipped off the White House and the Department of Health and Human Services. This resulted in HHS hitting a switch and allowing Iohn access to the plans on a web site that is less than stellar to be kind.
When Iohn and I reviewed the plans last night, the premiums seemed extremely reasonable. The premium amounts reflected, according to HeathCare.gov, a deduction of $242, the amount of tax credit subsidy available to Iohn based on working 32 hours per week steadily at $8 per hour.
This morning when logging into the account, the premiums are much higher and it was noted on the plan that seemed the best for Iohn: The pricing has been updated based on your application.
Last night the Silver plan from MDWise after the tax credit subsidy revealed a premium amount of $51.14 per month. This morning the premium amount after adjustment is $293.14. This appears to no longer be allowing the tax credit subsidy since the difference is exactly the amount of the subsidy.
Here in the Cornfield, Iohn was shown 19 available plans. There was 1 Catastrophic plan, 8 Bronze plans, 6 Silver Plans and 4 Gold Plans. There were 0 Platinum Plans.
Of those 19 plans, the one that was most suitable for Iohn was a Silver Plan from MDWise which reflected a $0 deductible and maximum out-of-pocket of $500 per year. All of the plans require use of in-network medical providers and none provided coverage out-of-state.
The deductible amounts ranged from $0 up to $6,350 before the insurance coverage kicked in. The Catastrophic plan and all the Bronze Plans had such high deductibles, the plans were economically infeasible when paying out a monthly premium even with subsidy. Unless one needed major surgery or a prolonged hospital stay, the plans were of no use.
As can be seen in the images, premiums run from $224.82 per month up to $465.80 per month. If the site has glitched (likely), the correct premiums with the subsidy would be $15.41 to $223.80 per month (based on last night's figures).
There are also other deductibles in some of the plans for hospital stays and emergency room visits. Prescription coverage ranges from none to up to $35 co-pays.
The Bronze Plans are a 60/40 split after satisfying the deductible. Silver Plans reflect a 70/30 split after deductibles. Gold Plans provide for a 90/10 split.
Iohn now has until December 15 to make a decision on a plan to have coverage effective on January 1, 2014. Iohn can choose to go with one of the plans through the Exchange in compliance with the ACA to avoid a tax penalty for not purchasing health insurance. He may choose civil disobedience and pay the tax, since it far less that the amount of insurance premiums, even with a subsidy, each year.
There is a new twist to the story for Iohn. He learned last night that his efforts to move up with his company, which announced last week it would not provide health benefits come January except for supervisors and managers, are bearing fruit. Iohn was informed by his general manager he may be eligible for health benefits through the company and should know by October 15.
The letter sent out by the company noted restaurant crew members were specially excluded from benefits. If Iohn is sent the information and enrollment paperwork, it looks like he is moving from crew to supervisor/management.
From the Cornfield, with a system on which millions of dollars have been spent, it seems that if you are patient, eventually you may be able make an informed decision.
Question is how many people will become frustrated as the government exchange lurches from glitch to glitch?
UPDATE: Was just able to log back into Iohn's account. The premiums now range with the tax credit subsidy from $15.18 per month to a high of $224.82 per month. The preferred option premium is $51.14 per month.