Avoid These 4 Obamacare Mistakes

Here are four costly mistakes you’ll want to avoid.

ByABC News
February 4, 2014, 7:55 AM
In this undated stock image, a doctor is pictured speaking with a patient.
In this undated stock image, a doctor is pictured speaking with a patient.
Getty Images

Feb. 4, 2014— -- Signing up for Affordable Care Act (ACA) insurance coverage may feel a little bit like competing in the Olympics. First, you’ll navigate a slippery slope of data, complete a mountain of paperwork, and finally choose Bronze, Silver, or Gold coverage. You might want to stand on a little box and hum the national anthem when you’re done. To avoid the “agony of defeat,” here are four costly mistakes you’ll want to avoid.

1. Picking a plan before doing your homework

If you have a trusted family doctor, you’ll want to make sure he or she is in the network of physicians available in the coverage you choose. This might be a challenge; to maximize affordability, providers were urged by insurers to lower prices in exchange for the promise of higher patient volume — and some declined. According to research by McKinsey, over two-thirds of the exchange networks analyzed have at least 30 percent of the largest 20 local hospitals declining to participate. Make sure your doctor accepts the plan you choose to avoid out-of-network charges.

You should also be sure to pick the correct metal tier for your health needs. Bronze, Silver, and Gold were mentioned earlier — Platinum and Catastrophic plans are also available. If you are healthy and plan to stay that way, a lower tier plan may be the savviest option. If you require regular prescriptions and frequent doctor visits, however, a Gold or Platinum plan may be best. Consider your current and future medical needs and choose your plan carefully.

2. Misunderstanding — and missing — deadlines

Here are some important dates to remember:

• Enroll by the 15th of the month to have your coverage start by the 1st of the following month. Missing the mid-month deadline means your coverage won’t begin for nearly six weeks.

• This year’s deadline for open enrollment is March 31, 2014. If you or anyone in your household doesn’t have qualifying coverage for three months or more during the year, you’ll owe a penalty — unless you qualify for a special enrollment period.

• For coverage in 2015, the open enrollment period will be from Nov. 15, 2014 until Jan. 15, 2015.

3. Reporting your income incorrectly

You may qualify to receive monthly premium assistance based on your family size and estimated household income for the upcoming year (for example, for the current enrollment period, you will need to estimate your income for 2014). This can be a tough estimation if your income fluctuates yearly, but you should make the most accurate forecast you can. For states on the federal exchange, data will be matched to IRS and Social Security records, as well as verified by data employers provide to Equifax.

A lowballed report of your income could cost you on next year’s taxes, when the IRS withholds some of your tax refund because you received more premium assistance than you should have. On the other hand, an overestimate of your income will cost you now, because you won’t receive the premium assistance you’re actually eligible for.

4. Waiting until the last minute

You really don’t want to be last in line for the ACA. Navigating the government health insurance Marketplace takes time and there are important decisions to make.

Even though government officials are saying HealthCare.gov is finally working to its full potential, a flood of last-minute applications could send the site back into shutdown mode. In that case, procrastination could cost you a penalty and mean that you won’t be able to purchase a Marketplace plan until the end of 2014.

This work is the opinion of the columnist and in no way reflects the opinion of ABC News.

Napala Pratini writes for NerdWallet Health, the consumer finance website that empowers patients to find high quality, affordable health care and insurance.