Applying for Marketplace Health Insurance

Last Saturday I graduated with my Master’s of Public Health! I’m so excited for everything that’s ahead of me, except losing health insurance coverage on May 31st.

A friend and I who help each other get through life’s hurdles, sat down to apply for marketplace coverage together. She just turned 26 and has had to go off of her parents’ health insurance. As for me, my coverage as a student research assistant only extends to the end of May. Because having health insurance is vital for all people, but especially those living with diabetes, I wanted to share my experience with the process.

Website screening tool: First I went to www.healthcare.gov and clicked the big green button that says “SEE IF I CAN ENROLL.”

Turns out after entering all of my info that losing coverage was a ‘qualifying event,’ so I was eligible.

Creating an account: At some point I had to create an account – which I did. The security questions for this process were really funny to me – I would suggest writing your answers down somewhere because they weren’t the easiest to come up with.

What if I don’t know?!?: The hardest part of using the screening tool and applying was estimating my income. I’m at a point where my income is in flux – my hours at work and the way I get paid are changing. I’m also hoping to find full-time employment soon and know that if I do, my annual income will be different than what I’m able to estimate now. Dealing with that uncertainty is hard, but in keeping with all recent blog posts, it’s just a part of life. In this context, the instructions make it clear that it’s important to update your account frequently if your income changes. There is also flexibility with how much of the premium tax credits you can use if you qualify, which can help those whose income might change.

Premium tax credits: Based on my current income, I qualified for a substantial premium tax credit which I could apply towards my premium when selecting a plan. I didn’t realize this before beginning the process, but you don’t have to use your whole tax credit each month, rather you can choose to use only part of it and have the rest applied as a credit at the end of the year when you file taxes. On the flip side, if you use it all and then your income goes up, you may have to pay back in some of it on your taxes. It wasn’t super easy to decide how to use this information, so I just elected to use enough of my credit to make my premium manageable each month.

Selecting a plan: This step involved a lot of reading and deliberating. The website helps to point you in the right direction by allowing you to enter your preferred doctors and prescriptions to see if they are covered under various plans, along with the level of health care you plan to use. For us people with diabetes, that’s a really hard one to estimate. Additionally, I was frustrated that no matter how I wrote ‘test strips’ or with what brand name I used, I could not get the system to register them under preferred prescriptions. Hopefully others will have better luck with this. Ultimately I chose a plan banking on at least one type of test strip being affordable. I’ll report back on my experience with this once coverage starts.

More documents: It seems like there are always more documents. I have to prove that my health insurance coverage is ending, so I have to send in a document/letter to this effect by the end of the month. Oh and I have to pay for the first month, which I can’t fault them for. What I did like about the process is that you could begin the application and revisit it and then select a plan and confirm enrollment before having to send in the supplementary documents or payment. This way, I was able to move forward and secure coverage that will begin June 1st, even while gathering my other resources.

Overall experience: Applying for marketplace health insurance coverage is not easy per se, but it is doable. My personal suggestion (based on my typical approach to things) is to get the process started, create an account, do the eligibility screening, and then know that you can find the information you need and log back in once you have it to complete things. If your situation is not very clear cut, I think it’d be really helpful to have a navigator (i.e. real person) to help you through the process. At our school there is an insurance office above our student health clinic and I’m assuming this is the case at many universities. During open enrollment, volunteer navigators are available to walk you through the process, and although I don’t know if that is true at all times of the year, I suspect real-person assistance is available and would be helpful. If you have experiences with this, please leave a comment with your thoughts!

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