The much-hyped health insurance marketplace opened its virtual doors Tuesday, but traffic to www.healthcare.gov quickly swamped the website and led to long delays for many people.
While technical problems prevented an accurate count of how many people attempted to enroll the first day for Pennsylvania and other states with federally-run marketplaces, Kaiser Health News reported some eye-opening numbers from other states just in the early hours of operation: 2.5 million visitors to the New York exchange; more than 1,000 applications in Kentucky; and 10,000 visitors -- but only 22 enrollments -- in Connecticut.
Those who did get into the website faced a four-step process to sign up for coverage: creating an account, applying, choosing a plan and then enrolling. People can also enroll by phone at 1-800-318-2596.
Residents turn out for Obamacare enrollment
The Hill House held an open enrollment event for residents interested in signing up for health insurance through the new Affordable Care Act. (Video by Andrew Rush; 10/1/2013)
The marketplaces, a signature component of the federal Patient Protection and Affordable Care Act, gives people with no or minimal health insurance a way to purchase coverage. The plans being offered fall into four metallurgical groups: bronze -- the least expensive of the four -- then silver, gold and platinum.
All plans are required to include certain "essential" benefits: coverage for hospitalization, emergency services, outpatient services, prescription drugs, laboratory services, preventive care, maternity and newborn care, as well as pediatric care that includes dental and vision care, mental health and substance abuse care and rehabilitation services.
No one can be turned away because of a pre-existing medical condition.
At each level, the insured's cost-sharing varies. So while a bronze plan will have a lower monthly premium and deductible, the patient will be responsible for 40 percent of the cost of hospitalization. As the premiums rise, the patient portion of cost-sharing goes down: to 30 percent for silver plans, 20 percent for gold plans and 10 percent for the highest-cost platinum plans.
People under the age of 30 also can purchase a low-cost "catastrophic" plan that provides three yearly visits to a primary care physician and preventive care, but holds the individual responsible for all other medical costs up to a specific amount.
Marketplace enrollees may be eligible for tax credits based on their income. The Kaiser Family Foundation has a website with a calculator to help people find out if they are likely to qualify for a tax subsidy. The site can be found at http://kff.org/interactive/subsidy-calculator/.
Medicare and Medicaid beneficiaries are not eligible for the subsidies and likely would not benefit from using the insurance marketplace for coverage.
The three major local insurers are offering a range of plans:
• UPMC Health Plan is offering 19 plans but had not decided Tuesday when or if it would make rates publicly available. Deductibles range from a high of $6,350 for a catastrophic plan ($5,000 for a bronze plan) to a low of $1,000 for some gold plans. A listing of UPMC's marketplace plans can be found at http://www.upmchealthplan.com/coverage/find_insurance.aspx?p=viewplans#content_viewplans_grid.aspx, excluding the plans listed under Inside Advantage, Essential and Value Plus.
• Highmark offers 13 plans: three bronze, five silver, three gold, one platinum and one catastrophic plan. Deductibles range from a low of $500 for an individual enrolling in the comprehensive care PPO to a high of $6,350 for the catastrophic plan, with rates ranging from a low of $62.83 per month for a nonsmoker getting the catastrophic plan to $172.05 per month for the high-end platinum plan. Highmark plans can be found online at http://www.discoverhighmark.com/ under "View Plan Details."
• Coventry, parent of HealthAmerica, will offer four plans in the region -- two bronze, which carry deductibles ranging from $5,600 to $6,300; one silver, with a $3,750 deductible; and one gold plan, with a $1,750 deductible. A description of Coventry's offerings in Pennsylvania can be found at http://coventryhealthcare.com/products-and-services/state-serv-overviews/Pennsylvania/index.htm. No rate information was immediately available for the Coventry plans being offered through the marketplace.
Open enrollment runs through March, although people must enroll in a plan by Dec. 15 in order for coverage to begin on Jan. 1.
Steve Twedt: firstname.lastname@example.org or 412-263-1963. First Published October 2, 2013 4:00 AM