Saturday, October 26, 2013

In Which I Realize I Don't Need To Use The Health Insurance Marketplace (Post No. 6 of Adventures in Health Insurance)

In my continued journey to obtain the private health insurance now available due to The Affordable Care Act/Obamacare, I've been checking the status of my application at After two weeks, it's still "in progress." I called and easily reached a real person at 1-800-318-2596. Unfortunately, he said there was no way to provide potential plan information until the application finished processing. At the very least, I'd hoped for an overview of the differences between plans so I could consider options while I wait.

Then a wonderful thing happened. I received a flyer from Blue Cross. With all the publicity, good and bad, over the government website, it hadn't occurred to me (and maybe it hasn't to many people) that I didn't need the website. As of 1/1/2014, private insurers can't turn down individual applicants, so why not just apply directly? 

I reached a salesperson within seconds who provided lots of information. Plans are categorized under the AFA/Obamacare as Bronze, Silver, Gold or Platinum. The main differences are the co-pays and premiums. With a Platinum plan, 100% of covered expenses are paid by the insurer once you hit your deductible. With a Bronze plan, only 60% are paid by the insurer. Platinum has the highest premiums. Different deductibles, out-of-pocket maximum payments, and plan types (such as HMO, PPO) are available for each category. Also, different networks are available. Based on the network that includes my doctor and the hospital where she has admitting privileges, the Blue Cross salesperson suggested five plans. I chose three with high deductibles to keep premiums down. He emailed me a quote within 10 minutes. At the Blue Cross website, I compared them feature-to-feature.

The next day, I called and applied. No past medical information needed, just age, gender, non-smoking, and where I live. (Chicago - I love an excuse to include a photo of Chicago. This is from the shared deck at my condo building.) Pre-Obamacare, it took hours to apply for an individual health insurance policy because it required a detailed health questionnaire and interview. So half an hour on the phone for this application seemed awesome to me, and it would have been quicker if I'd done it on line myself. I should receive confirmation within 7-10 days and will be insured starting 1/1/2014. I may throw a party.

I don't qualify for federal subsidies for premiums, but I could have applied for them if I needed to through Blue Cross. So it appears the only reason to use the government website is to comparison shop. But that can be done the old-fashioned way, by directly contacting different insurers. Once you're familiar with the plans and deductibles based on the first company you contact, you can then get quotes for similar plans from other insurers. As a guide, I've listed the steps I took below, with the Blue Cross Blue Shield of Illinois references.

(1) Explore basics about the Bronze, Silver, Gold and Platinum plans:

(2) Check whether your doctor or doctors and hospitals are in the networks the insurer offers:

(3) Call or use website for quotes and to compare plans: 1-866-514-8044 or

(4) Apply by phone or website: 1-866-514-8044 or

Rinse and repeat for other health insurers.

I didn't check other insurers because I've had the Blue Cross PPO before and that's the coverage I wanted. But here are a couple other sites: (United Healthcare/Golden Rule) (Humana)


An addendum because I'm excited -- I just received my Blue Cross card in the mail! (You can tell I'm very excited because I rarely use exclamation points, and I was tempted to include two.) I officially have an individual health insurance policy effective 1/1/14. My account on still says "in progress," so I'm glad I took matters into my own hands. I have friends who are self-employed in Illinois who applied later than I did through the site. They've obtained coverage options, then bought coverage through the exchange. So I suspect I'm caught in some sort of technology loop. There's a Remove button that I will probably use to try to take myself out of the system. But I'm a little curious to see if it'll stay in the loop forever. Votes on how long I should wait before alleviating of the burden of my unending application?

Lisa M. Lilly is the author of Amazon occult best seller The Awakening. A short film of the title story of her collection The Tower Formerly Known as Sears and Two Other Tales of Urban Horror was recently produced under the title Willis Tower. Her poems and short fiction have appeared in numerous print and on-line magazines, including Parade of PhantomsStrong Coffee, and Hair Trigger. She is currently working on The Awakening, Book II: The Unbelievers.
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  1. I am in total agreement. Doing the exact same thing directly with BC/BS. Great savings over previous plan! Thank you "ObamaCareS. Just call the insurer directly for heaven's sake. There are 13 plans in my State...published in paper. I checked each individually. Then made PHONE CALL! Remember the phone everyone???

    1. Thanks for your comment. I notice in both my professions -- law and business -- that I use email and on-line resources so much I often forget that it may be easier to call someone for certain things. For those who prefer on-line, a friend referred me to for comparison shopping. I tried the first couple screens and it seems very easy to use. It provided a list of several plans for me (including the one I've already applied for) with a helpful quick comparison of price, deductible, network and carrier.

  2. I have been told there are private plans available through insurance agents that are not on the BCBS website.

    1. Michael, thanks for commenting. It wouldn't surprise me to find there are plans not listed on the site. There seem to be so many options. As you point out, a health insurance agent or broker can be a great resource for helping find the best coverage and price. An insurance agent you use for auto or other policies may have a referral to a good health insurance broker, as might a friend or colleague with a small business or who is self-employed. (I always like to contact someone who is recommended to me.)