Health Insurance Info Available for states in Fed Exchange

[Guest Taxed]

http://www.thehealthsherpa.com

Enter your zipcode, your family size and income and see the plans available, cost including subsidy.

This is a private website not affiliated with healthcare.gov so you can't enroll.

[mrichman333]

Thanks for the Link, as I am one who has NOT be able to complete the process on healthcare.gov

So I looked at

AmeriHealth NJ Premium National Access Gold POS+ On their website and go a quote of $1,830.40/ mo

On link you shared the price for the same plan is $1,065.96

That's a good savings if it's correct

[grmy2h]

I have been able to obtain pricing from Healthcare.gov. I compared all the gold plans and on each one the cost was approx $300.00 more on Healthcare.gov

[jklcpa]

I thought I was doing good with the govt site, got right on, had no trouble at all verifying my identity, and completed the application through to being able to review it. I wanted to see the prices before I go to my agent. If any of you complete the application on healthcare.gov, my advice is to NOT go back and edit any info once you've completed the questionnaire. It lost more than half my data because I tried to edit something. What happens if I simply start another application?

Back to the site that Taxed posted above, thank you! What I'm unsure of is how it handles the pricing if I select "you and spouse" vs "only you over 50". What does this site do with the pricing if we are both over 50?

[grmy2h]

Back to the site that Taxed posted above, thank you! What I'm unsure of is how it handles the pricing if I select "you and spouse" vs "only you over 50". What does this site do with the pricing if we are both over 50?

It doesn't state what age it is using for "you and spouse" and I believe that is why my pricing is $300 off on every gold plan. (My husband is 49 and I am 51.)

[Jack from Ohio]

Did everyone check plan deductibles??

[Guest Taxed]

http://gizmodo.com/these-guys-just-built-the-website-healthcare-gov-should-1458215436

Here is a writeup about the site. I would also double check the prices at healthcare.gov to see if they are different and then call the insurance company.

[Guest Taxed]

It lost more than half my data because I tried to edit something. What happens if I simply start another application?

I would wait till Dec 1 to start a new application. I am sure a lot of the old data is probably corrupted.

[grmy2h]

Plan deductibles are not available (that I could find) on the site linked above. I compared by the plan names.. such as -Healthkeepers ccam, Healthkeepers cdda, Optima Foursight 1000, etc. (I have 7 gold plans available)

The linked sight did not ask age, so it can't be totally accurate.

Edit: I have since gone to Healthcare.gov - "see plans now", the page you can access without putting in your information and the prices are exactly the same.

[Guest Taxed]

Once you pick a plan you like, do a Google on the exact plan name and you can see a fact sheet for most plans published by the insurance company. Takes a little bit of digging but check the effective date should be Jan 1 2014.

[Kea]

I originally tried to sign on to the exchange in early October & couldn't sign on. I gave up during the "extension crush". Tried again after the 15th only to find out that they had reset some of the passwords. I fould that out by calling in and talking to a human within a minute! Never finished the call because MY phone died. Started over last week with a new username and password and have not had any problems since then. I'm now reviewing the 76 choices available. On the exchange I do have to look at the policies separately for my husband & me since the website does not let me group us together. (It acts like it's doing it, but then doesn't -- not sure if that might be a TX issue?)

But since I don't qualify for a subsidy, I'm also looking at the various off-exchange websites. The 2 I've used are:

http://www.healthpocket.com/

http://www.ehealthinsurance.com/

HealthPocket seems to have better prices and has policies that are not on the exchange. 80 policies in total. It also shows me the premiums separately for my husband and me.

eHealthInsurance has fewer choices (46), but will let me combine our policies.

Taxed's HealthSherpa will let me combine & also has 80 choices, but it is more expensive than HealthPocket (for the few I checked).

I found the exchange site to be the most useful in comparing policies and finding out the details (deductible, max out of pocket, co-pays, out-of-network coverage). The other websites just show the policy name and metal level. So it's taking a lot more digging to find the details of the plans on the other websites that are not on the exchange. Some policies are easy to find and some are more difficult. Even looking at the companies' websites can give mislieading information. (Some of the summaries on the BCBS show no deductible and no charge for many of the services - then tells you there is no max out of pocket.) I was amazed that so few of the choices cover out-of-network (other than emergency room).

At this point I have an idea which policies I want to include. I'll work with my agent to narrow my list down to 1.

[Guest Taxed]

5 categories of Marketplace insurance plans

When you compare Marketplace insurance plans, they're put into 5 categories based on how you and the plan can expect to share the costs of care:

• Bronze
• Silver
• Gold
• Platinum
• Catastrophic

All Marketplace insurance plan categories offer the same set of essential health benefits. The categories do not reflect the quality or amount of care the plans provide.

The category you choose affects how much your premium costs each month and what portion of the bill you pay for things like hospital visits or prescription medications. It also affects your total out-of-pocket costs —the total amount you’ll spend for the year if you need lots of care.

The maximum out-of-pocket costs for any Marketplace plan for 2014 are $6,350 for an individual plan and $12,700 for a family plan.

Note: Catastrophic plans – which have very high deductibles and essentially provide protection from worst-case scenarios, like a serious accident or extended illness -- are available to people under 30 years old and to people who have hardship exemptions from the fee that most people without health coverage must pay. Learn more about catastrophic plans.

Balancing monthly premiums with out-of-pocket costs

As with all health plans, you'll have to pay a monthly premium. But it's also important to know how much you have to pay out-of-pocket for services when you get care.

• Premiums are usually higher for plans that pay more of your out-of-pocket medical costs when you get care. For example, if you have a Gold plan, you'll likely pay a higher premium, but may have lower costs when you go to the doctor or use another medical service.

• With a Bronze plan, you'll likely pay a lower premium, but you'll pay a higher share of costs when you get care.

• Platinum plans will likely have the highest monthly premiums and lowest out-of-pocket costs. The plan will pay more of the costs if you need a lot of medical care.

• In general, when choosing your health plan, keep this in mind: the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care.

What to consider when choosing your plan

Think about the health care needs of your household when considering which Marketplace insurance plan to buy.

Do you expect a lot of doctor visits or need regular prescriptions?

• If you do, you may want a Gold or Platinum plan.

• If you don't, you may prefer a Bronze or Silver plan. But keep in mind that if you get in a serious accident or have an unexpected health problem, Bronze and Silver plans will require you to pay more of the costs.

[grmy2h]

Has anyone been able to get prices for the SHOP marketplace? Since the credit for 2014 is only available to Small Businesses that use SHOP, I have been trying to price it for my husbands company. I have only been able to get an application and mail it in. I have not heard back from them yet.

[mrichman333]

I got as far as getting my eligibility notice but it would not open and I could not continue because it said I needed to do something with the application but the link did not work.

So I opened an account under my husbands name and was able to open the eligibility notice. It stated He needed to provide information on his income (he's self-employed) Tried to upload his P&L statement for a week or two but that function is one of the "glitches" in the system. So I mailed it to the address provided by certified mail, it was delivered on October 19th. When I log on we still cannot continue because the system is still asking for the information.

Called 4 times or so before I got someone who could tell me what happens after my information is received. Was told it takes up to 3 weeks "after mailing" to enter the information and then I will be able to look at planes. It's been 22 days since the letter was "delivered" and we still cannot get to the point of looking at plans.

[jklcpa]

I'm curious about the self-employment P&L statement that is requested. What period of time is requested, and how detailed would that have to be if the income varies quite a bit throughout the year?

I do believe my original app is corrupted. The site 'found' the rest of my input and allowed me to make an edit. However, now it keeps saying that my husband and I won't be filing a tax return in 2014 no matter whether I edit it or not.

[jklcpa]

The healthsherpa site now has the ability to enter multiple people and their ages. However, the prices aren't changing when checking/unchecking the 'smoker' box.

[mrichman333]

I'm curious about the self-employment P&L statement that is requested. What period of time is requested, and how detailed would that have to be if the income varies quite a bit throughout the year?

I do believe my original app is corrupted. The site 'found' the rest of my input and allowed me to make an edit. However, now it keeps saying that my husband and I won't be filing a tax return in 2014 no matter whether I edit it or not.

On the website you select from a drop down menu the type of document you are up loading, and one of the selections is "Most recent" profit and loss statement. They cannot verify what "2014" income is till a self employed (or anyone for that matter) person files a return or till 2014 closes ; it's all a waste of time and resources. I understand if you receive more of a subsidy then you are entitled to they either take it out of your tax refund or add to your tax due.

[Guest Taxed]

If the Fed exchange operates like the MA exchange, they will base the subsidy on 2012 return filed. I have to submit the complete 1040 including Sch C and if you are unlucky that a newbie is reviewing your application you will get a notice to submit proof of income because that newbie is looking for copies of W2 and can't make heads or tails with the Sch C. I ran into this issue last year and had to make a call and explain what I do and it was solved in one call but the problem is that they train their reps to hunt for W2 and 1099 etc. and not enough training on Sch C in my opinion.

[mrichman333]

If the Fed exchange operates like the MA exchange, they will base the subsidy on 2012 return filed. I have to submit the complete 1040 including Sch C and if you are unlucky that a newbie is reviewing your application you will get a notice to submit proof of income because that newbie is looking for copies of W2 and can't make heads or tails with the Sch C. I ran into this issue last year and had to make a call and explain what I do and it was solved in one call but the problem is that they train their reps to hunt for W2 and 1099 etc. and not enough training on Sch C in my opinion.

It doesn't seem to work that way on the Fed. exchange. They know what our 2012 income is because the system is tied to the IRS and they specifically ask for "2014" income. Makes no sense at all, they are asking people to look a year in advance. The whole site is screwed up, the language is often incorrect and tenses are wrong. It's like it was written by people in India, and the dozens of chats I had, I was certain I was chatting with someone in India.

Here is an exact quote from our eligibility notice " - You need to send the Marketplace proof of your yearly income for 2014" At this late time of year I can come real close to what our final 2013 income will be but not 2014.

[Guest Taxed]

Most of these software development companies get their "cheap" labor from India and other south east asian countries. I think the hourly rate for a programmer is 1/10 of the US standard rate and they don't have to pay any benefits.

One of my clients used to be a systems analyst at a Fortune 500 company. He was sent by that company to train a bunch of Indian programmers in India who they had outsourced some work. Two years later he was given the pink slip and the kid he trained in India is doing his job.

His last W2 from that company, the gross was $108,000.

[mrichman333]

I just logged onto healthcare.gov I then closed the page by hitting the red X above my browser and selecting close current page, after the page closed I hot the back arrow and I was taken back to my account, I was stilled logged in. This is a real LACK of security. Banks and other financial institutions figured that out MANY years ago, if you close a page and try to go back you have to log in again.

[Guest Taxed]

I believe that happens even on this site. The only way to make sure you are truly logged out is to log out and then close the browser and clear the cookies.

On my bank's website you can close a page and use back arrow and still be logged in, but if you go past the initial sign on page by using back arrow you are logged out.

[grmy2h]

The healthsherpa site now has the ability to enter multiple people and their ages. However, the prices aren't changing when checking/unchecking the 'smoker' box.

The prices are matching exactly with the federal site, now that it allows you to put in ages. (I didn't try the smoker box)

[Guest Taxed]

I also found out that these three programmers created another application that lets you compare Hospital costs.

http://www.opscost.com

[Guest Taxed]

Here is an exact quote from our eligibility notice " - You need to send the Marketplace proof of your yearly income for 2014" At this late time of year I can come real close to what our final 2013 income will be but not 2014.

Estimating your income

When you apply for lower costs in the Marketplace, you’ll need to estimate your income for 2014.

You can start by adding up the following items for:

• You and your spouse, if you are married and will file a joint tax return
• Any dependents who make enough money to be required to file a tax return

For each of the following sources, estimate what your income will be in 2014:

• Wages
• Salaries
• Tips
• Net income from any self-employment or business (generally the amount of money you take in from your business minus your business expenses)
• Unemployment compensation
• Social Security payments, including disability payments--but not Supplemental Security Income (SSI)
• Alimony

Other items to include when estimating your 2014 income are: retirement income, investment income, pension income, rental income, and other taxable income such as prizes, awards, and gambling winnings.

DON’T include the following:

• Child support
• Gifts
• Supplemental Security Income (SSI)
• Veterans’ disability payments
• Workers’ compensation
• Proceeds from loans (like student loans, home equity loans, or bank loans)

For more information on reporting your income, see IRS Publication 525.

Modified adjusted gross income and household income

When you fill out the Marketplace application, your estimated household income will be calculated using the information you provide. Your household income determines your eligibility for lower costs on Marketplace coverage.

Your household income is your modified adjusted gross income (MAGI) (joint MAGI if you’re married), plus the MAGI of your dependents who make enough money to have to file a tax return.

MAGI is generally your adjusted gross income plus any tax-exempt Social Security benefits (except for Supplemental Security Income (SSI), which is not counted), tax-exempt interest, and tax-exempt foreign income.

You don’t have to figure out your household income or MAGI yourself when you fill out your application. It will be done for you with the income information you include on the application.