SALT LAKE CITY — Many Utahns find they need to do extensive research to sign up for federal health insurance coverage.
Rob Sanders, 26, dialed the 800 number to talk to a customer service agent at his health insurance company for the first time on Wednesday.
The Utah County man is among millions of Americans and roughly 5 percent of the Utah workforce who have been underemployed in the past couple of years, according to recent labor studies. So, he must provide his own health care coverage.
"I got a letter in the mail that says my health plan is extended through December 31, 2014," Sanders told the customer service agent. "But I'm curious what may happen after that to my plan."
The voice on the other end of the phone told Sanders he would be "walked over" to an Affordable Healthcare plan or "something that's comparable." The agent also told Sanders he could choose a more specific plan.
For now, Sanders pays about $80 a month for his plan and because of the Affordable Care Act requirements for insurers to provide health insurance with more benefits, his plan could jump about $100.
"I'm on your cheapest plan," he told the agent. "I'm concerned because I don't know what plans will be available when this runs out next year," he said.
The customer agent told Sanders he didn't know what rates would be next year because of the uncertainty surrounding the Affordable Care Act requirements, deadlines, and the website.
"The cancellations are real," said W. Brett Graham, partner and managing director at Leavitt Partners. Graham said the health insurance changes affect roughly 15 million people buying insurance on the individual markets or who have bought plans through their employer.
"Not all of those will receive cancellations," said Graham. "It depends on what portion of those people have plans that don't meet those thresholds (Affordable Care Act requirements)."
For the past month, Rochelle Wenger has been on the phone, taking notes, and using her calculator to figure out her healthcare costs and benefits. She received a letter from her healthcare provider notifying her of changes to her coverage.
"When I first received the letter it said my health insurance would still be covered but the plan I was on would no longer be available," said Wenger, 64. "It gave me an option to do nothing and they'd move me or the second option: If I qualified for subsidies, I could consider buying insurance on the marketplace."
Wenger said she's had to learn to become a very savvy health insurance consumer. She looked through her old plan after reading through her letter and talking on the phone with customer service agents of her former health insurance company.
"It was somewhat confusing," said Wenger. "They said I could keep all of my providers but they didn't explicitly say they would be covered the same way as before."
Wenger has been hospitalized in the past for health condition related to heart disease and cancer. It was important for her to have health insurance benefits that fit her needs.
"I need to stay with the doctors in the hospitals that have taken such good care of me," added Wenger. "So I knew right away from the details that I would have to change plans."
After watching a KSL report on ways to sign-up for federal health insurance, the Salt Lake County woman said she was finally able to log onto the federal healthcare.gov website and sign up for health insurance coverage that specifically met her needs.
Wenger said she learned that she qualified for parts of the Affordable Care Act that began in 2010.
"In 2009 when I was in the hospital, I ended up owing over $50,000 that went over my annual and almost lifetime limit," she said. Later, she qualified for credits that "saved me close to $10,000 a year out of pocket," she said.
After all of her research, Wenger said she bought health insurance on the healthcare.gov website that took her health insurance coverage from more than $709 per month with a $5,000 deductible to $517 per month and a $3,500 total out-of-pocket deductible.
"There¹s more covered, there's every single provider that I will need and have used or want," said Wenger. "Total, everything will come out $8,000 less than I have been paying."
Act now, expert says
While some people like Wenger are coming out ahead and other like Sanders will end up paying more, experts say you must act now to avoid a lapse in healthcare coverage.
"Despite all of the uncertainty in Washington," said Graham, "you have to react to what you're given."
Graham added people need to move forward, do research, and consult with "an adviser, a cousin, or a friend." He said Americans should not allow their health coverage to lapse because it is better to have some sort of health insurance coverage.
"The reality is you're in the best position if you have insurance in place and that you continue without a lapse," said Graham.