Navigating the health marketplace

Krystle Wagner • Jul 21, 2015 at 1:27 PM

The Grand Haven man, along with many throughout the country, are participating in the open enrollment period for health insurance through the Affordable Care Act, which opened Oct. 1.

The deadline to sign up for health care coverage to take effect Jan. 1, 2014, is Dec. 15.

Once the enrollment period ends March 31, 2014, uninsured residents will have to pay a $95 fee per adult and $47.50 for children under the age of 18, or 1 percent of yearly household income. Fees will rise in subsequent years.

Van Heule said he provided the healthcare.gov website with his personal information, but the website crashed when he attempted to look at plans available in Ottawa County.

“I was frustrated the same as everybody else,” he said.

The 58-year-old said he has researched the Affordable Healthcare Act for a few months because he knew his current insurance coverage was running out.

Van Heule previously had health insurance through his small business, but the plan calls for a minimum of two people. Van Heule said an employee opted out of the option and his wife was insured elsewhere, so he's left without coverage for himself.

“Obamacare came around at a perfect time for me,” he said.

Grand Haven resident Bill Hazard said he has also had a difficult time signing up for health insurance. The 58-year-old said he’s had numerous failed attempts to access information on healthcare.gov and complete his registration.

“It’s frustrating because you can’t plan your future,” he said.

After a few days of looking and searching, Van Heule found a premium estimator on the healthcare.gov website that asks a series of questions about types of coverage, number of people on the plan, location and age. It provides how many plans are available in Ottawa County.

People signing up for insurance have the option of choosing between five types of coverage: Catastrophic, Bronze, Platinum, Silver and Gold. The healthcare.gov website states that the maximum out-of-pocket costs for any marketplace plan for 2014 are $6,350 for an individual and $12,700 for a family.

Van Heule, who is in the process of retiring, said he found that Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan, Priority Health and Consumers Mutual Insurance of Michigan are providers for Ottawa County.

After comparing the options, Van Heule said he stuck with the same provider, but switched to a Preferred Provider Organization option because of the coverage. Van Heule said his new coverage is about the same price, if not a little lower, than what he previously paid.

Van Heule said he called the insurance company directly to sign up for coverage instead of using the government's website.

“It’s actually very simple,” he said.

Van Heule said he thinks the focus of the so-called Obamacare has been on the troubled website and not the coverage residents will receive as a result of the new law.

“Why should a law be dependent on a website?” he asked.

Cherry Street Health Services, a Grand Rapids-based nonprofit organization, has been fielding 5-6 calls an hour about signing up for health insurance on the government website. The agency's Michelle Fitzgerald said the first few weeks of the healthcare.gov website rollout were problematic, and few signed up for insurance. She said the website has improved every day, and people are now applying for plans.

Fitzgerald recommends residents weighing their options about the insurance act to call the agency's toll-free number (866-299-1339). She's certain that everyone will be able to enroll for insurance.

“You’re not by yourself,” Fitzgerald said.

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