Tuesday, November 12, 2013

Adventures with the ACA, Part 1

A couple weeks ago my insurance agent's assistant called to set up an appointment with my agent and me.  It surprised but also pleased me.  He's a good agent.  He's helped me a lot in the past, and it looks like he's prepared to help me take the best advantage of the ACA. 

I'd already taken note of all the warnings about possible scams targeting mostly older people who have Medicare (not me).  I'd already visited my state's health insurance exchange website and done a cursory comparison of companies.  MNSure, Minnesota's online exchange, has only five companies participating: UCare, Preferred One, HealthPartners, Medica, and Blue Cross Blue Shield.  As I played around, looking at plans picked randomly, I discovered some important information about how I think about my health insurance.  Have you considered how you think about it?

First of all, being able to continue seeing every doctor in my medical team is of primary importance.  It's a deal breaker if any of my team is not in a plan's network.  I realized immediately that this would definitely winnow my choices quickly.  I am not interested in putting together a new team -- my primary physician, my gastroenterologist, my dermatologist, my rheumatologist, and my ophthalmologist.  I also wanted to insure that the clinics and hospitals where they and my preferred GI surgeon practice would be in a plan's network. 

Next of concern is cost.  I pay a high monthly premium right now and have expected to be able to lower that cost.  The deductibles I was seeing were in line with what I have now. 

So, I decided to set up my account at MNSure.  Each step proceeded without any problems.  I completed each one, and after picking my username and password, I clicked on submit.  A page popped up telling me that they were unable to create my account and I needed to try again.  Oh, man.  I tried again, and in the process, managed to get myself locked out.  Meanwhile, an e-mail from MNSure had arrived in my inbox telling me that my account had been created.  Huh?

It would be a couple weeks before I returned to MNSure to try to figure out what had happened.  I called their helpline.  The computer told me that they were dealing with a high volume of calls and I had landed in a queue, and my wait time was over 5 minutes.  I decided to wait, and worked at my computer as I waited. 

A cheerful young woman came on the line finally and asked how she could help me.  I described what had happened.

"And you got an e-mail telling you that your account had been created?" she asked before I could complete my story.


"I know exactly what happened.  So, I'll unlock your account, and we'll reset your password, and you should be good to go."

And I was.  Wow.  The fix took less than 5 minutes and the technical service rep knew exactly what was wrong.  I love calls like that.  So, now, I have my MNSure account and I'm ready to proceed with choosing my new medical insurance.

Yesterday, I returned to MNSure to begin the process of eliminating plans from my consideration.  I already knew that I needed either Gold or Platinum plans, so I worked first with those plans.  Using the Excel spreadsheet MNSure helpfully provides, I began checking to see if my doctors were in the various gold or platinum plans.  I eliminated UCare and HealthPartners quickly.  Taking my agent's advice into consideration, I checked Preferred One and Blue Cross Blue Shield and found plans at both companies that had all my doctors in their networks.  Yay!  Then I checked their drug formularies to see if my medications would be covered.  Yes.  I'll check Medica the next time I'm at MNSure, and then start looking at the details of each plan.

Shopping for medical insurance is not as hard as I'd expected.  It is important, however, to know what's essential to you for insurance coverage because not all plans are created equal.  I'll write Part 2 after my meeting with my insurance agent.....

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