Young, uninsured adults seeking health coverage face challenges
Burbank student Maria Cardenas, 26, has been without health insurance for the last four years, and it worries her.
“I’m really healthy and don’t generally get sick, but there are occasions when it happens,” she said. “I want to be able to go to the doctor when I need to and not worry that I can’t.”
Cardenas works as a chemistry tutor and sometimes as an on-call nanny while she gathers enough credits at Pierce College to apply for medical school. She pieces jobs together to make ends meet, and though she wants health insurance, she can’t afford it. “Even a plan with low coverage was pretty expensive,” she said.
Cardenas’ story is like many heard at Enroll America, an organization started by Obama supporters who are working to maximize enrollment of the nation’s uninsured in health plans.
“It’s really about the affordability issue,” spokesman Justin Nisly said. “I think for most people, if they can afford it, they want health insurance.”
But for younger, uninsured consumers like Cardenas, there are other challenges. Many are newcomers to health insurance, its costs and ways to select a health plan that fits both their lifestyle and their budget.
For young adults who have yet to shop for their insurance options, experts offer some points to consider.
California’s health exchange is open for business. Now is the time to explore your options under the state’s Covered California exchange, pick a health plan and sign up.
For those interested in having health insurance in place at the start of 2014, there’s a sign-up deadline of Dec. 23. But enrollment continues for three more months after that, ending March 31.
Don’t be misled by reports that the healthcare website isn’t working. The state’s website at https://www.coveredca.com has been working since Oct. 1, and 31,000 Californians signed up in the first month. It is the federal website, HealthCare.gov, operating in 36 states, that had been having major problems and frustrating consumers interested in enrolling in a health plan.
Cardenas is among those who were unaware that California’s exchange operates separately from HealthCare.gov. All the reports about the federal website’s problems led her to believe that there was no point in trying to research her insurance options. “That’s why I didn’t look into it any further. From what I heard, it just wasn’t available online,” she said.
In the end, however, Cardenas says she will shop for insurance coverage. And she thinks her friends — most of whom are also uninsured — will too. “I think most of my friends are very responsible. It has been a very pressing concern for all of us.”
Financial help is available. Cardenas is hopeful about her new options for insurance, but says that unless she can find a reasonably priced plan, she may just have to pass.
“I think right now $100 [a month] would be really borderline,” she said. “My income is really low, so that’s stretching it a little bit.”
Most people under the age of 34 will qualify for a subsidy. Single adults earning up to $45,960 a year and families of four earning up to $94,200 are eligible for some level of subsidy.
Under the new law, an additional half a million Californians ages 19 to 29 are estimated to qualify for Medi-Cal, the state’s health insurance policy for people with low incomes.
When young adults learn about government help paying for health coverage, enrolling for insurance becomes more appealing, Nisly said. “We’ve had good success when we’re able to talk very specifically about the tax credits that are available.”
Sort out your options. All health insurance plans sold through Covered California are defined by their “metal levels” — Bronze, Silver, Gold and Platinum. The major differences among them are the cost of the monthly premium and how much of a patient’s medical expenses are covered.
Generally, the less you pay on a monthly basis for your plan, the more you’ll pay each time you visit the doctor. The least comprehensive plans are Bronze and the most comprehensive are Platinum.
If you have a doctor you want to see or a hospital you want to use, make sure they participate in the plan you select. The same is true if you take prescribed drugs; you’ll want to make sure they’re included on the plan’s list of approved medications.
If you’re younger than 30, you can also buy a catastrophic plan intended to cover only major diseases or ailments. It provides the least amount of coverage but is designed to be more affordable on a monthly basis.
However, it doesn’t always work out that way, said Carrie McLean, customer service director at online health insurance broker ehealthinsurance.com. “In some cases you can get a Bronze-level plan [that is] less expensive than the catastrophic plan,” she said, pointing out that the Bronze plan offers better coverage.
Pay attention to the open-enrollment period. So far, enrollment among young Americans has been slow nationally. But in California, the numbers are promising.
Of the nearly 31,000 Californians who enrolled in a health plan in October, 6,900 or 22% were between the ages of 18 and 34, according to reports by Covered California. This age group makes up about 21% of the state’s population.
Experts expect a rush of sign-ups as open enrollment comes to a close, especially among young people.
The experience in Massachusetts, where a similar law was enacted in 2007, is often used as a benchmark for what to expect in the coming months. The data show that “a huge majority signed up last minute,” said Linda Leu, California research and policy director with Young Invincibles, a national organization that seeks to represent the interests of 18-to-34-year-olds.
Just keep in mind that if you want insurance in place by Jan. 1, you need to sign up by Dec. 23. Meanwhile, for latecomers, open enrollment runs through March 31.
If you miss this window, you won’t have coverage next year and will face both a penalty for not having insurance and potentially high medical costs in case of an accident or unexpected illness.
Resources and links
Here are a few websites to explore your options:
California’s health insurance exchange: https://www.coveredca.com
To find health insurance exchange information outside of California: https://www.HealthCare.gov
Zamosky is the author of a new book, “Healthcare, Insurance, and You: The Savvy Consumer’s Guide.”
