Saturday, January 11, 2014

K-daughter signs up for health insurance

On Christmas night, K-daughter tripped on some stairs and hurt herself badly.  It was bad enough that I called an ambulance; the EMT's checked her out and recommended we drive her to the hospital for an X-ray.  As we pulled into the hospital parking lot, she turned to me and said, "You remember I don't have insurance, right?"

Um, no, I hadn't realized that.

K-daughter is not legally my daughter, so I can't stick her on my insurance.  For most of her life, since her mom died when K-daughter was 8 years old, she's been on Medicaid and/or CHIP (I'm not sure which).  This summer, she aged out of that system when she turned 21.

So with the new year rolling around and a bit of hospital bill for her (fortunately sprained, not broken) ankle beginning to fill her in-box (sigh), we sat down in front of HealthCare.Gov to sign her up for a plan, just in case she decides to sprain her ankle again next Christmas.

In spite of all the publicity, signing up for insurance is not that bad.  I timed it; it took us 1 hour and 20 minutes from beginning to end.  And this time included two fairly large digressions.

One digression was explaining the words to K-daughter.  She wasn't sure about the difference between a premium, a copay, and a deductible.  So we walked through some hypothetical examples together:  "if you sprain your ankle and need an x-ray, then you pay that $400 for the x-ray.  But if you have a major bike accident (like my husband did) and the helicopter ride costs $11,000, then you only pay the amount of the deductible, and the insurance pays the rest."  She had a lot of questions about the deductible: for example, do you have to pay the deductible every year, even if you don't go to the hospital?  (no).  That  discussion probably took about 10 minutes.

Another big digression involved figuring out whether she's still eligible for Medicaid, since she was on it for so long, she's a full-time student, and she's making less than $9,000 per year.   This was a lot like filling out her financial aid forms, and the computer did glitch out on us toward the end.  We hit the chat button, and fairly quickly the person at the other end explained that, in terms of federal regulations, she's eligible for Medicaid.  But the governor in my particular state refused to expand Medicaid, and so she's not Medicaid-eligible in Pennsylvania.  Figuring that out took another 30 to 40 minutes.  And so we went back to the "Marketplace".

I was impressed at the organization of the web site, actually.  There were 55 different plans K-daughter could choose from.  But rather than list all of them and all their details in one confusing mash of data, the site groups them by category:  "Catastrophic"; "Bronze"; "Silver"; "Gold"; "Platinum".  And it explained what each category means.  We decided to search only the "Catastrophic" (available only to people 29-years-old and younger).

Within that grouping, the main page shows the big details (the aforementioned premium, deductible, and copay structure).  If you click on a particular plan, you get much more detailed information.  We searched through those and found one that seems to match her needs.

Then it was time to sign up for the plan.  She added a bit more information (non-smoker, no children, etc), and hit the "confirm" button.  And we were done.

Rather than go on rants or raves, which this topic could certainly inspire, I'll just say that K-daughter knew she wanted insurance, but is generally overwhelmed by paperwork of any kind.  Having a single website listing all her options was a huge help to both her and me.

As for the Medicaid issue . . . well, in her case, it's probably not a tragedy that she's been kicked off.  But that's because she lives with me: she gets housing and most of her food taken care of while she finishes her college degree.  If she gets into a financial bind because of health costs, she knows I've got her back.  Clearly I'm willing to help subsidize this one person that the federal government has declared Medicaid-eligible but who can't actually sign up for Medicaid.

And in fact, I wouldn't mind if my taxes went to help out others in her situation, too: those widows and orphans whom I believe we're supposed to care for.  I don't like to think about what what would have happened to K-daughter if I hadn't snagged her for myself.  I don't like to think about what's happening to other 21-year-olds who don't have the option of being on their parents' plans merely because they don't have parents.

But at least in our own corner of the world, we've got one more person who is happy to have the insurance decision behind her instead of hanging over her.


  1. Sounds like the government learned a lot from making Medicare Part D accessible.

    And yes, it sucks that some governers are refusing to expand Medicaid leaving people who are poor but not quite poor enough in that donut hole that the Medicaid expansion was supposed to fix. (And is fixing in Blue states.) It's reprehensible.

    1. Actually, since K-daughter figures she'll make $300 in 2014, that's the income she listed on the forms. So the "poor but not poor enough" doesn't quite apply to her: on paper, she's plain poor!

      I am trying hard not to be totally upset about this. (There are enough other people who are angry in both directions for me to delegate the grumbling to them). I figure, even if she doesn't get the coverage she would have if Corbett in his gubernatorial wisdom hadn't decided to nix it, she's better off than she would have been if we didn't have this amazing web site to make signing up so easy.

      Okay, maybe I am just a little bit miffed at our gov'ner.

  2. I try to help out the 20-somethings of my acquaintance with financial/frugality matters also--but never anything this important. Wow! I live in one of those medicaid refusing states, btw.

    I don't think I've commented on your blog before--but I do read it!

    1. Thanks for the pat on the back. Likewise! (For example, if I were you, I would totally be asking my dentist, "Is there a reason why I shouldn't switch practices? Or can you work with me on this?") -MM

  3. Thanks for sharing your experience. I hope insurance works well for K-daughter. My brother is over the age limit and had to sign up for insurance (well, he has catastrophic insurance, but he'd like to sign up for subsidies and the like, since he lives in California). I should ask him if he ever got stuff worked out. He has lumpy contract pay, and that was messing him up in terms of the website, since California asks for monthly pay and not yearly.

    Also, I continue to marvel at your impressive support of people in so many ways. You are truly a role model.