7 Tips to Get Enrolled in Marketplace Insurance
By Randy Dotinga
Reviewed by Lisa Zamosky
Latest MedicineNet News
Dec. 9, 2013 -- Ready, set, try again.
If you need to buy health insurance for 2014 through the federal government's web site, Healthcare.gov, you may already know this drill. The site has famously had a variety of technical failures during its rollout.
But the bugs are being fixed, at least partially, and just in time: People who want coverage to start on Jan. 1, 2014, must act quickly and sign up by Dec. 23, 2013. Whether you started an application already and got stuck along the way, or you want to give it another try, here are some tips to get you enrolled.
1. Reset your application.
You can erase old applications. The federal government says you might especially want to do this if you visited the site in October or early November when it was having a huge number of problems.
You can also erase an old application if the web site seems to be stuck.
Here's how: Once you log in, check if the Healthcare.gov site tells you that you already have an application "in progress." If so, select the application and click the "remove" button.
Then quit your browser. Reopen it and start a new application. If you still have problems, call the Customer Call Center at 800-318-2596.
You can also continue an application online if you started it offline with a paper application or phone call. Get details here.
2. Create a new account.
If you had other technical problems while using Healthcare.gov, you may have to create a new account and username. Healthcare.gov offers a few tips.
3. Window shop for plans and doctors.
A new feature gives people more leeway to "window shop" for various types of plans without needing to apply. You'll only need to provide a few basic facts about yourself, such as where you live.
Click on "see plans" on Healthcare.gov to start shopping around. This feature will allow you to review the plans and see if they cover your doctors and medical networks.
Several web sites, such as thehealthsherpa.com and valuepenguin.com, allow users to search for premiums available in their regions. Some brokers and individual insurers allow you to search their web sites for plans, too.
In some cases, you may find these web sites easier to use than the ones run by the government. But be aware that these web sites may not have complete information about all available plans. And they may have made special arrangements that affect where you're sent when you click on a plan. A broker, for instance, may only allow you to get coverage through specific insurers that it works with.
4. Know what counts as income.
It's crucial to remember that the system is not asking for your total income, even though it often uses the general term "income."
Healthcare.gov cares about your modified adjusted gross income. The system uses that income to figure out if you're eligible for a tax-credit subsidy that would lower your insurance cost, or to find out if you're eligible for Medicaid, the federal insurance program for the poor.
In most cases, your modified adjusted gross income will be the same as your adjusted gross income, which you'll find on your IRS tax return. It's on Form 1040 EZ – Line 4, Form 1040A – Line 22, or Form 1040 – Line 38.
There could be complications, though. If you have non-taxable Social Security benefits, for instance, they'll count toward your modified adjusted gross income when they normally wouldn't. Check this WebMD primer for more details.
If your income changes, you should contact your insurance Marketplace as soon as possible.
5. Talk to a person.
You can get guidance from local "navigators" and other assisters whose job is to help people figure out their health insurance options. Their services are free. Visit localhelp.healthcare.gov to find out how to reach an assister in your area. You can also call the Healthcare.gov Customer Call Center 24 hours a day at 800-318-2596.
You can also get help from a licensed insurance agent certified to sell insurance through the Marketplaces. Find one here.
6. Protect against fraud.
If you have concerns about protecting your privacy on Healthcare.gov, you may wish to buy your insurance directly from an insurer. Right now, this is only available in Florida, Texas, and Ohio. Want to shop around? Remember that you can use Healthcare.gov to explore various options without providing your name or address.
Consumers Union offers these other tips:
7. Call the insurance company to check if you're enrolled.
You'll need to contact your insurance company directly for confirmation that you're enrolled and that your premium has been paid. You'll pay your insurer directly, and a premium will be due by Dec. 31 if you're getting coverage that will start Jan. 1, 2014.
If you have any problems, call the Healthcare.gov Customer Call Center at 800-318-2596.
SOURCES: HHS.gov: "The Health Insurance Marketplace: What You Need to Know." Healthcare.gov: "3 tips to remember when you create a Marketplace account," "New and more robust HealthCare.gov tools to help you enroll." WebMD Health Blogs: "Income and Tax Credits: Sorting it All Out." Consumers Union: "White House initiative to prevent and detect fraud in health insurance marketplaces."