My daughter and her boyfriend are among the million-plus people whose existing health plans are being discontinued at the end of the year. And boy, are they glad! As we had planned, they enrolled in new plans through their state’s marketplace, NY State of Health, while visiting over the Thanksgiving weekend. As Consumer Reports’ resident health insurance wonk, I asked them to let me look over their shoulders to see what worked and what didn’t.
What I saw was a state-run Health Insurance Marketplace that basically worked as it was supposed to and delivered affordable health care options.
After subsidies, my daughter’s plan will cost $94 a month and her boyfriend’s $100. That’s nearly $7,200 year less than they’re paying now. The new plan comes with a $350 deductible, compared with the $5,000 deductible on her current plan and the $1,200 one on his.
They took care of registration and identity verification ahead of time with no problems, though the boyfriend, a classical guitarist, is an Australian citizen living and working in the U.S. on a special visa for artists (noncitizens who are “legally present” in the U.S. are required to have health insurance and can get the same subsidies as citizens).
They also decided ahead of time which hospital they wanted in their plan’s network. We used Consumer Reports’ hospital Ratings and Medicare’s Hospital Compare service to zero in on a hospital system that seemed to score consistently well. Laura also had a doctor she wanted to try to keep.
Once they’d answered the 2014 income questions, a task made easier by the fact that they didn’t expect their income to vary much from what they reported on their 2012 returns, the site quickly calculated their subsidies and informed them they were also eligible for special Silver plans with reduced deductibles, copays, and coinsurance. It’s one of the benefits of being self-employed musicians who tour extensively: a lot of tax deductions that significantly lower their Modified Adjusted Gross Income, which is the basis of the subsidy calculation.
And then it showed them their plan options. All this happened smoothly, with no perceptible wait time.
They hit one annoying snag: The website’s automated find-a-provider feature didn’t work. Instead, they were stuck with the alternative search method: visiting each plan’s website individually. It was tedious, but in the end they found a plan that covered the hospital and doctor they wanted. It’s a start-up called Oscar, created by some young tech entrepreneurs. As generally healthy people who rarely need medical care, they decided to take a chance on it despite the lack of any quality information. If after a year they don’t like it, they can switch to something else during next fall’s open enrollment period.
After they’d picked a medical plan, the site offered the option of buying an add-on $11-a-month dental plan, which they decided to do. It covers up to 10 visits a year at $48 a visit, for everything from routine cleaning to root canals and prosthodontics.
And that was that. The last screen was a confirmation of their plan selections and the information that their chosen insurers would be contacting them about the payment of their first premium. I won’t be 100 percent confident they’ve enrolled until those bills come in, but they are keenly looking forward to having better coverage at a fraction of what they were paying before.
New York's marketplace hasn't gotten as much attention as the star performers of California and Kentucky, but from what I saw, it's doing a good job. The evidence: as of today, it has recorded 284,440 completed applications and 91,103 plan enrollments.
Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can't get enough health insurance news here, follow me on Twitter @NancyMetcalf.
Health reform countdown: We are doing an article a day on the new health care law until Jan. 1, 2014, when it takes full effect. (Read the previous posts in the series.) To get health insurance advice tailored to your situation, use our Health Law Helper, below.
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