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If you won’t get a subsidy, can you buy insurance outside the federal website?

Health Care FAQ
The latest news about the new health care law and how it affects you.

Q. If you’re buying health insurance, and you don’t qualify for a subsidy, do you have to wait until the federal government website, www.healthcare.gov, is working?

A. No. You can buy insurance directly from the insurance companies, at the company websites or through an insurance agent or broker.

The only two companies that are participating in the federal exchange in North Carolina are Blue Cross and Blue Shield of North Carolina and Coventry Health Care of the Carolinas, but you can get the same premiums for plans whether you buy inside or outside of the federal website. (In South Carolina, four companies are participating, including BlueCross BlueShield of S.C., BlueChoice, Coventry and Consumers Choice Health Plan.

Judy Boppe of Mecklenburg County learned this in a roundabout way, and she is pleased with the outcome.

Since 2008, Boppe has health insurance through the North Carolina high risk pool, also known as Inclusive Health, because she had a preexisting medical condition. Before she went with Inclusive Health, she had Blue Cross insurance for almost $1,600 per month. She had received a notice that her premium was going to be even higher, and then she found out about the high risk pool. Her monthly premium decreased to $475-$575 over the last 5 years, and her deductible fell from $10,000 to $3,500.

With passage of the Affordable Care Act, the high risk pool is being discontinued at the end of this year. She tried to apply for coverage at the healthcare.gov website, which hasn’t been working properly since enrollment opened Oct. 1.

Boppe was finally able to submit an application, and after many attempts, was twice able to review the plans. But she found it hard to understand and wanted to make sure she would be covered in some unusual circumstances. For example, she uses a couple of brand-name drugs and gets medical care outside of North Carolina every year. Some plans on the website did not seem like good choices.

To get assistance, she visited Blue Cross’ retail store near Northlake mall and talked to an agent, who helped her narrow down the choices that made sense for her and showed her how to evaluate the Blue Cross quotes that were immediately sent to her by email. As she does more research, the agent will be available to answer questions.

“Unless I have totally missed the news, I was not aware that I could go directly to the providers for policies under the ACA,” Boppe wrote in an email to the Observer. “In fact, I thought I was required to apply via the (federal) website.

“I think it would be helpful for the general public to know that they do not necessarily have to go to the healthcare.gov website to apply for insurance under the ACA. If the Coventry policy is eliminated, as it was for me, I would recommend a visit to the BCBSNC retail outlet, a much more pleasant experience than the frustration of the website, and the cost of the policy will be no different. I think you can apply directly with BCBSNC online, too.”

Here’s one more thing to know. If you qualify for a premium subsidy, you must apply through the healthcare.gov website.

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