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The Procrastinator's Guide to Getting Insured

Monday, December 16, 2013

Want insurance coverage in place for New Year's Day, 2014? Time is running out, so here's what you need to do.

You have until Dec 23 to enroll, and with all the computer problems the state-run and federal exchange websites have been having, advocates suggest not leaving it until the last minute.

In theory, for active insurance on Jan. 1, you not only have to have enrolled by next Monday, but you have to have paid the first premium by January 10th. As a practical matter, it's not clear how that will work. Many insurance purchasers on the exchange have reported delays in getting invoices and confirmations of payment.

Every day this week, WNYC is talking with Charles Ornstein of ProPublica about what people need to know about enrollment.

Day 1 — The Basics: If you've put off buying insurance, we tell you how enrollment works: who has to do it, and what happens if you don't.

Day 2 — The Hidden Costs: Getting beyond the premium to understand what insurance will really cost you.

- More from ProPublica: Rate Shock Part Two.

Day 3 — What if my insurance was cancelled? Thousands of New Yorkers and New Jersey residents were told that their insurance was getting cancelled because of the ACA. What options do they have?

Day 4 If I get insurance through my job - what's changing for me?

Day 5 How do you make sure you have insurance if you've signed up? Once you've enrolled, you need to follow up with your insurer to make sure your premium is paid in full.

- More from ProPublica: The Obamacare Deadline No One is Talking about and Healthcare.Gov's Mysterious New Number 834

 

Editors:

Mary Harris

Contributors:

Charles Ornstein

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Comments [7]

Jason W from Manhattan

I have a couple of things to watch out for from my experience buying a plan for just my daughter. I purchased a UnitedHealthcare Silver EPO with Rx and Dental for her in mid-December to start on Jan 1.

1. The NY Website calls it an EPO (which typically means you must use only in-network providers and there are some pre-approvals required); However, I received the detailed plan book in the mail a couple weeks later and it turns out it is an HMO plan (where EVERYTHING must be authorized in advance by your PCP). NY should revise their presentation of these plans to be more realistic.

2. If you buy a child-only plan from UnitedHealthcare they have no way of allowing you to register to their self-serve website myuhc.com. You must be 13 years or older, and you can't register as an adult on behalf of a child. So you completely miss out on all the features (Find a doctor, see your benefits and claims, see your deductible, etc.) and must always call their customer support number for anything.

3. When the ID finally arrived 17 days into the plan, UHC had automatically assigned my daughter a PCP, who is not a pediatrician.

4. Dental coverage on this UHC plan is provided by UHC Dental, but even 3 weeks in UHC Dental has no record of her existence in a plan even though UHC Medical shows UHC dental as her provider. So it requires multiple calls to each of these business lines and the NY State exchange to make sure all info is shared correctly. As such, I have no idea what her Dental benefits will actually be yet, and if they will pay any of the cost of the fillings she had to have performed in early January.

I hope this helps someone, and would love to provide more info if requested.

Jan. 17 2014 03:03 PM
Ariana

I have just begun a new job and there is a three-month wait for health insurance to kick in. Do I still need to enroll in Obamacare for the first 2 1/2 months of the year to avoid penalties? Thanks!

Dec. 22 2013 08:41 AM

Hi everyone: we're going to try to answer Ruth and Susan's comments on the air tomorrow. For Barbara: since you've already paid for COBRA, it sounds like your husband needs to enroll in a new plan in the new year - not by the Dec. 23 deadline, which is just if you want coverage by Jan. 1. But he can start shopping around now!

Dec. 19 2013 04:59 PM
Susan Brenner from New York City

Can you tell me if someone who is not a citizen but has had a green card for many years can get Obamacare?
Person earns a modest amount but has been working & paying social security for years.

Dec. 18 2013 04:51 PM
Brian from Brooklyn

Thanks for this series. One note though, about the Day 3 segment. Early on Soterios says that plans in New York are being cancelled because they weren’t up to the standard of the ACA, and your guest agrees. That's not always the case, though, as I can tell you from personal experience as a member of the Authors Guild. From the Times: “[M]any of the New York policies being canceled meet and often exceed the standards, brokers say. The rationale for disqualifying those policies, said Larry Levitt, a health policy expert at the Kaiser Family Foundation, was to prevent associations from selling insurance to healthy members who are needed to keep the new health exchanges financially viable.” (http://www.nytimes.com/2013/12/14/nyregion/with-affordable-care-act-canceled-policies-for-new-york-professionals.html)

Dec. 18 2013 02:46 PM
Ruth Freidson Kavesh from New York

Are the insurance companies in the exchanges, such as Blue Cross/Blue Shield , the same as those in which member doctors participate? Can a doctor choose not to participate in the BC/BS exchange and accept BC/BS outside the exchange?

Dec. 18 2013 06:56 AM
Barbara Ross Bullough from Verona, NJ

Here's a question for you to address in one of your programs: My husband's COBRA expires in February. He has paid his premium through that time, but he'll need to buy his own health insurance after that. Does he need to enroll in a new health plan now, or when COBRA expires? (This does not affect me, as I'm a little older and just became eligible for Medicare.)

Dec. 17 2013 09:53 AM

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