Folks:
I find myself in an embarrassing Ted Cruz-style situation. I need to get new health insurance. It is just for me and not through a company group. Does this mean that as a person who has advocated against Obamacare and against the idea of health insurance in general (except perhaps for accidents/catastrophic illnesses that are rare) I will now be forced to be become an Obamacare customer? Or is there in fact a way for a Massachusetts resident to purchase health insurance now other than through the Massachusetts Health Connector? (and maybe I can’t even do that because the “open enrollment” period is over? I was previously covered on the employer policy of the household member who slaves away in the corporate salt mines but she changed jobs recently and her new employer won’t cover me)
Thanks in advance for any ideas!
[Recap: Why do I advocate against health insurance? The American vet care system works quite well. Few animals are insured, which means most care is paid for with a Visa card. Your dog gets a same-day appointment with no waiting time. The prices can be painful but can be as little as 1/10th of what you’d be quoted for the same service rendered to a human. As far as I know, the insurance company doesn’t get a secret discount to pay only 1/5th or 1/20th of what is quoted to a retail customer. It simply doesn’t make sense to insure against a risk that is virtually 100% certain to occur (e.g., against the risk of having to go to a doctor for a checkup).]
Related:
- my health care reform article (advocating a basic government-provided system)
- October 2004 posting about how we would be better off if nobody had health insurance and therefore we were treated like customers by the industry
- May 2010 posting about how a $510 bill was actually $83
- December 2013 posting about why, if we don’t have “food insurance”, we are required to buy health insurance
- December 2013 posting on how even high-end lawyers can’t figure out Obamacare
- March 2014 article on Obamacare in Massachusetts ($30,000 for a family of four)
- February 2015 article on the tax return debacle for Massachusetts Obamacare customers
- February 2015 posting on how health care should now be considered part of government spending
Philip
I think the dicontiuance of coverage is what is called a “qualiftying event”. You should be able to get coverage. My COBRA is ending in July and that is another qualifying event.
I went to the website, started an application, gave them my email address and awaited an email for a confirmation code so that I could start the process. After clicking resend 3-4 times I am still awaiting an email 4 days later.
I called the help line. Hold time 45 minutes and got someone who explained that there were “glitches” in the system and that I’d have to be patient and no, he couldn’t do it for me and I couldn’t speak to a supervisor.
I plan on going in to Boston sometime and trying the walk-in office.
I have gone to the website multiple times since leaving my old job with no good result. As my COBRA is running out, I need to be a little more pro-active.
Let me know if you’d like to go into town for lunch and a visit.
Steve
“I find myself in an embarrassing Ted Cruz-style situation.”
Why should you be the slightest bit embarrassed about being forced, by government diktat, to buy a product or service that you don’t want from a vendor that you don’t choose? If ever there was a reason be be convinced of your righteous opposition to the ACA, this is it.
Steve: Thanks. I decided to play around a little bit with the site. After about 20 minutes I got stuck because it says that I need to provide “proof of loss of insurance”. But I don’t have anything like this. So now I can’t shop further. I do think this is more evidence for how the U.S. is finished as a growth economy. You don’t need to prove to Amazon.com that you’ve run out of dog food before you can buy more dog food. And the government is in so deep with these insurers (a.k.a. cronies) why doesn’t their $1 billion web site already know that I no longer have coverage?
Apparently it is possible to get to the shopping phase even without submitting the proof. Now I am looking at all of the plans (99 are listed but there might be more because the “right arrow for more” button remains live even on the last page, though it does not function). Barack Obama told me that I could keep my doctor, right? But though there is a way to see the difference in annual deductible among plans there does not seem to be any way to check to see “Is Dr. X covered by this plan?” Thus now I get to call up the doctor’s office and waste some of my time and the staff’s time asking “Are you covered by Harvard Pilgrim or Tufts?”
[And of course when I did call the doctor’s office it took about 5 minutes of phone tree issues to discover that they were on lunch break…]
Not sure about MA, but esurance.com works for other states. Second your though on veterinary care. My dog’s ligament surgery was priced below I would attempted to be charged for 10 minutes long CAT scan. If you think, dogs legs are quite complex and could not be much more complex than human leg.
I don’t know why you say catastrophic illness is rare. 100% of the population has one at least once.
I assume the insurance company that isn’t giving you insurance any more can give you the ‘proof of loss of insurance’ document. I’m not saying it’s fun sitting on hold in their voice mail system, but I’m sure you can get it.
Laura: Excellent point! I meant “catastrophically expensive” and “before age 65 when it becomes the taxpayers’ problem”.
Why not test your theory about the superior merits of the veterinarian system and go without health insurance?
The maximum tax penalty is the national average premium for a bronze plan, is about $2,500 a year for an individual.
For a relatively small price, you can adhere to your principles, and experience the advantages of paying out-of-pocket for doctor’s and hospital bills.
Saul: I can’t test my theory in the U.S. because everyone else has health insurance and that has created the 5-20X disparity between retail price and real price. If I could find a set of health care providers that would charge me what they charge Blue Cross then I would glad go without insurance.
“Is Dr. X covered by this plan?”
You do that by going to the Provider Directory on the insurer’s Web site and clicking the “continue without logging on”. For example:
https://findadoctor.bluecrossma.com/
The hard part is finding the correct network, but you just try to match the plan name in the pulldown with a name from the Marketplace. The different tiers and deductibles from the same insurer usually have the same network (an exception is between the normal plans and “multi-state” plans).
Be forewarned: a “multi-state” plan generally provides zero access to non-emergency care outside your home state. It means you can PURCHASE the plan in multiple states, not that you can USE it. So I couldn’t use my “Anthem Blue Cross of Indiana” card to see an Anthem Blue Cross doctor in Wisconsin (except for true emergencies). This is a big difference from corporate insurance plans, where usually they will find a comparable network to serve you while you’re out of state.
PS: To answer your original question, I think you can still buy “ACA-compliant” plans outside of the exchange, for example, through IEEE Member Services, and I think someone else mentioned.
You may have a better chance of getting a plan which is usable outside of your home area by using one of those other sites.
Here’s the IEEE link: https://www.getinsured.com/phixhome?utm_source=Mercer%20Consumer&utm_medium=affiliate&utm_campaign=Institute%20of%20Electrical%20and%20Electronics%20Engineers
You can also check with whatever other insurance agents you deal with (e.g., your friendly neighborhood auto insurance agent and professional liability insurance).
Is animal vs. human medical care really so different. In both the customer is not the one being treated. In both the patient doesn’t really understand there treatment.
I would guess that in most cases it is much easier for a owner to stop treatment and euthanize a pet than they would for themselves. That is one big market advantage vets don’t have.
#2 complaint from pet owners is vet bills. #1 complaint from vets is not breaking even.
Catastrophic equine health insurance is somewhat common.
The one thing Obamacare gives you is the security of knowing you CAN buy insurance. That would not have been certain before.
A key difference between animal & human care is that facing a catastrophic illness a pet owner has the option of doing nothing but we don’t do that for people. Thus society must have some way of paying for that care. Obamacare isn’t very good, but it is an improvement on what preceded it.
I’ve used ehealthinsurance.com to compare policies and premiums, and eventually purchase individual coverage, twice. My business partner also used it. Even for a company, helping staff obtain individual coverage is easier than trying to provide well-thought-out group coverage (like http://boss.blogs.nytimes.com/2013/11/06/a-small-business-starts-to-navigate-obamacare/).
I’m thinking about retiring in four years at age 55. So, I recently set up an account on healthcare.gov to see what health insurance would cost me under obamacare. I got premiums of $300, $400, and $500 per month for the bronze, silver, and gold plans respectively, and with $0 subsidy. Annual deductibles were something like $3000 to $6000. Preventive services were no cost. I suspect those premiums will only go up by the time I’m ready to buy; they’re significantly higher than my current employer-provided $0 premium/$0 deductible well-established HMO.
“As far as I know, the insurance company doesn’t get a secret discount to pay only 1/5th or 1/20th of what is quoted to a retail customer.”
Actually they do – almost always the insurance company has negotiated a rate that is far, far less than what someone off the street pays. Mostly this is done because it is rare that retail customers actually pay and so the provider can greatly increase the size of their “charitable” work by inflating the billing rate.
Alan: That comment was about the veterinary world. I was contrasting it to the human medical world (in which prices paid by insurers are outrageous by world standards and prices quoted to retail customers are 5-20X those already outrageous prices)
Use Health Sherpa to shop for health insurance, unfortunately you would still need to finish the application at healthcare.gov.
Laura said: “I don’t know why you say catastrophic illness is rare. 100% of the population has one at least once.”
Philg answered: “…after 65 it becomes the governments problem!”
Assuming you mean Medicare, philg, no Medicare does not insure against catastrophic expenses. The amount the Medicare trust funds will pay on your behalf is limited both per-incident and lifetime. And Medicare does not even include an annual out of pocket spend limit.
On your Massachusetts question, someone else might have said this but it all depends on what your definition of Obamacare is. I personally only think of it as the insurance subsidized by tax credits. If you are paying full price but using the Health Connector as your insurance agent, that’s not really Obamacare in my opinion. The Health Connector has been acting as an insurance agent (albeit one with very high overhead, a lousy web site and terrible customer service) since 2006.
Just call the health insurer directly to purchase a plan. They will sell you an ACA plan over the phone and you don’t have to deal with government website. At least it works this way in Florida….