Knucklehead’s guide to the Affordable Care Act: What you need to know to sign up by the March 31 deadline

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By Angela Marler

Young husband and father Richie Woolley decided not signing up for health care was not ideal but was his best option.

He said he may change his mind later but explains that his wife is covered by her parents’ insurance, his child is covered under Medicaid, and he’s satisfied with that for now. Taking the $95 dollar fee for going uninsured this year won’t be too bad, and he will be able to see how health plans work for others before he signs up next year. He’s aware that he’s taking a risk but has faith in preventive care.

“What if something happened?” he mused. “Well … that would be bad.”

Young people have their reasons for not signing up for health insurance. Premiums under the Affordable Care Act are higher than they anticipated. Some ideologically oppose the health care reform. Some think they’re invincible. You might find yourself in one or more of these categories and uninsured as a result.

If you’re having second thoughts about your ability to financially survive appendicitis, here are answers to some questions or concerns you might have about signing up for insurance. After all, “young people are knuckleheads,” as Michelle Obama says, and there is still time to sign up before open enrollment closes on March 31.

So how is the Affordable Care Act different from before, anyway?

The biggest changes affecting young people are that people up to age 26 can be covered by their parents’ insurance, regardless of whether they are married, and all are mandated to have insurance or they will have to pay a penalty fee (this year either $95 or 1 percent of their income, whichever is higher). Next year the fee will increase to 2 percent of one’s income or $325 per person, and in 2016 it’s 2.5 percent or $695 per person. Insurers on the individual marketplace are restricted in what they can ask about a person’s health — limited to knowing only the applicant’s ZIP code, age and whether or not they are a tobacco user. So coverage is open to those with any sort of pre-existing condition. Coverage also includes maternity and mental health care.

Isn’t the website supposed to be awful?

Screen Shot 2014-03-28 at 9.56.10 AMSince its rocky start in October, Healthcare.gov’s many bugs have been greatly reduced. The site offers definitions, videos and cost calculators to help users navigate the system and decide which plan is best for them and their family. There is also live chat assistance (though users may have to wait up to 15 minutes for a response), a 24/7 help hotline and features to match users up with local healthcare professionals who can guide them through the process.

Daralys Patrick, a producer for First West Benefit Solutions, said there is one bug on the website that is still giving people trouble: the system verifies your personal information through a third party, and sometimes the verification doesn’t work. If you’re having trouble, try entering your info in all caps — it seems to work better that way.

OK. What is signing up like?

Signing up online is a four-step process:

  1. Create an online account
  2. Fill out your information (a lot of security questions, address, annual income, etc.)
    1. Be careful that you enter an accurate estimate of your annual income. If it’s too low or too high, you will either receive a refund or have to pay the balance when you do your taxes.
  3. Choose a plan. There are about 90 plans to choose from, with different levels of coverage: Catastrophic, Bronze, Silver, Gold and Platinum. Make sure you sign up for a plan that covers the doctors and hospitals you want to visit.
  4. Enroll!

Bronze? Silver? Gold? Is that like the Olympics?

The different levels determine how much of your health care you will be paying for. You can choose from four plans, which all cover basic preventive care, prescription drugs, doctor’s visits, maternity care and hospitalization.

  • Catastrophic covers less than 60 percent of your health care costs. Only available to those who are under 29 years old or have certain hardships.
  • Bronze covers 60 percent of your health care costs.
  • Silver covers 70 percent.
  • Gold covers 80 percent.
  • Platinum covers 90 percent.

The site has a handy cost estimator that will tell you about how much a monthly premium will cost for each level.

Whoa wait. What’s a copay?

As you’re browsing through plans, there may be some unfamiliar words. Here are a few definitions that might help:

  • Deductible: The amount you have to pay in a year for health care before your insurance will begin helping you pay.
  • Copay: A fixed amount you will pay for services such as a doctor’s visit.
  • Coinsurance: A percentage of the bill you are responsible for, even after you reach your deductible.
  • Premium: The amount you pay every month for health care.
  • Out-of-pocket maximum: The most you could pay for health care every year.

This is more expensive than I thought it would be …

Since health care providers can’t reject those with pre-existing conditions, and maternity and mental health care are now covered, plans may be more expensive for young people than before the reform, said Mark Showalter, an economics professor at Brigham Young University. He said young people might be facing premiums that seem more like a middle-aged person’s, but as more young people sign up the costs should balance out.

I’m already covered by my parents’ insurance. Should I change?

Patrick said this can be a tough question, depending on who your parents work for. If they work for a large business (in Utah, a company with more than 50 employees counts as a large business) then definitely stay on their plan. You being on their plan will not increase their costs. But if your parents work for a small business (50 or fewer employees), their costs may increase significantly for each adult added to their plan. Depending on your income, it might be cheaper to buy your own insurance.

I’m young. I don’t get sick. Ever. And I don’t want to help pay for some old guy’s meds.

Catastrophic plans are available for young people and will keep you from getting totally wiped out from a medical emergency. There are fewer subsidies for catastrophic plans, though, so if you’re young and poor a bronze plan may actually be cheaper.

The choice is yours — sign up or not. Just know that March 31 is the deadline for this year’s open enrollment, and unless you experience a major life event such as getting married or having a baby, you won’t be able to enroll until October of 2014 to receive coverage on Jan. 1, 2015. Good luck in making your health care decisions, and don’t do anything too stupid.

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