Obamacare – Begin Your Application

The purpose of this page is to help Oregonians renew their Healthcare.gov private health insurance plan for 2016. It will also help people who are creating their account and enrolling in private insurance through healthcare.gov for the first time. I’ll provide short videos and screenshots to walk you through the tricky parts.

Intro Video:

When you’re ready, you can use the tutorial below to enroll/re-enroll for an ACA qualified plan through healthcare.gov.

Warnings and lessons regarding the 2016 application:

  • Enter all income monthly. If you entered income annually last year, change it to monthly for this renewal application. Even if it’s a once per year 401(k) distribution or something similar. I have found that healthcare.gov gives incorrect outcomes for 2016 when income is entered as annual rather than monthly. The system will show you annualized numbers a little later in the process.
  • Shut off pop up blockers and ad blockers during this time.
  • If you get a ‘bad request’ message from your browser, clear your cookies and then re-start by logging in via the upper right corner of the hc.gov home page.
  • The healthcare.gov site seems to prefer the Chrome browser.
  • You’ll need your best estimate of income for all household members for 2016. You’ll also need everyone’s Social Security numbers and dates of birth, addresses, etc. You’ll need this information for family members who are included on your Federal tax return.
  • I use the terms ‘tax-credit’ and ‘subsidy’ interchangeably.
  • As an adult, if you are eligible for employer-based coverage, you generally won’t get a tax credit/subsidy. It’s different for kids. OHP eligibility is based on income and nothing else.
  • I’m not walking you through every single page or every version of the pages you might see. I’m walking you through the most commonly misunderstood parts and problem areas.
  • If you received a tax credit in 2014 (through Cover Oregon) but have not filed your 2014 tax return or paid your taxes, you won’t qualify for a 2016 tax credit.

If you prefer, go to healthcare.gov. or hc.gov. For 2016, healthcare.gov has created all sorts of paths to your application, depending on your 2015 situation. Maybe your policy lapsed part way through the year due to non-payment. Maybe your subsidy/tax credit was taken from you because you didn’t respond to their requests for income documentation, etc. Depending on your current status, you could see all sorts of pop-ups on the healthcare.com home page. I recommend reading then dismissing all pop-ups.

Next go to the upper-right corner of the page and click Log in.

You’ll find that the upper-right corner is your friend, especially when it comes to fixing errors or submitting a new application. For those of you who don’t have an account, click ‘create one now’ under the big green LOG IN button. Select Oregon from the drop-down list, and create an account. After you create your User ID and password, and answer three security questions, healthcare.gov will send you an ‘account creation confirmation link’. Click that link. It will take you back to the log in page. Go ahead and log in.

If you are new to healthcare.gov, you should see this:

Go ahead and click the green button.

If you have an existing account, healthcare.gov has probably pre-filled a 2016 application for you.

If so, you’ll see this ‘review my application’ button:

If you don’t see the ‘review my application’ button, don’t click ‘start new state application’! That requires you to re-enter all the info you entered last time. You need to create your own pre-filled 2016 application. Click the blue ‘select another application to update’ button at the bottom. On the next page near the top you’ll see ‘Get coverage for 2016’. Just under those words, select 2016 for the year, and Oregon for the state, and click the big green ‘apply or renew’ button. See here:

Now you’ll see a page with a green ‘next’ button. Click it to move forward. Keep clicking ‘next’, read the privacy info and if it sounds OK click the button. Then click ‘save and continue’.

If you’re new, then you’ll next enter all your basic info. If you’re renewing, it will be pre-filled. If you’re new you’ll eventually arrive at a ‘verify your identity’ page. Sure, YOU know who your are, but healthcare.gov is asking you to prove to THEM who you are. They do it via pulling your credit report and asking you to verify a few questions about your history. If your credit is frozen, the site won’t be able to pull your credit info. Either unfreeze your Experian credit report and try again, or follow the message explaining a different way to verify your identity.

If you’re frustrated at this point, I’m going to ask that you please consider adding me as your agent. It doesn’t cost you anything—the insurance companies pay me. I will then be able to help you with your healthcare.gov account, insurance questions, problems with billings or claims, etc. Even if you feel confident in the process, using this (hopefully) helpful walkthrough, I hope that you will consider adding me as your agent. Below you’ll see how to add me for both new and renewal accounts.

After you review all of your basic contact info, and if this is a new application, you’ll see this (below) at the bottom. First, click the ‘Agent or broker’ button. Then the lower area will appear on the page, allowing you to fill in my info: Jeff Tomlin, NPR 92063.

You also might see something like below. The left hand column shows your progress in the application process. See the blue box on the left that says ‘help applying for coverage’? If you click this and then click ‘agent or broker’, a box will appear, allowing you to enter my information. First name ‘Jeffrey’ last name ‘Tomlin’. Skip the next few boxes, but be sure to enter 92063 in the NPN number area, just under the NPN text. The NPN number is the specific piece of data which assigns me as your agent. When done it should look like this:

If you’re renewing, you’ll see this (below), when you get to the ‘review your household information’ area:

Please click the box ‘a person is helping me complete my application’ and enter my info as shown above. Thanks!

The most difficult parts of this application are the beginning and the end. Getting started is tricky, but I’ve walked you through that portion. I’m going to skip the middle. The middle is where you enter information about your household, income, etc. For most people, this part is fairly straightforward, but here are a few notes to help:

  • If one spouse is on Medicare, tell the system they are not applying for coverage. (Same thing goes for spouses or dependents on OHP or those who have employer-based coverage.) However, social security income must be added in the household income section, even though that spouse isn’t seeking coverage. In other words, the income is added to the other spouse’s income and the system will consider you to be a 1-person household but will attribute both incomes to the one person who needs the coverage. This makes it harder to qualify for a tax credit.
  • As I said, the same thing is true if the children are on OHP. Say you’re a family of 4. If the kids get OHP, all family income will be attributed to the parents and they will only get a subsidy if they fall under the 2-person household income limit. See here: Income Table and here: Which Income and Deductions are Counted?
  • Immigrants and people on visas may have a hard time with the middle section. There is one person in our office with expertise in this area. Her name is Shonna Butler and you can reach her at shonna@tbplan.com or 541-343-1999. If she helps you, please add her as your agent. Her NPN is 16458731.
  • If you’re married, you must file a joint tax return in order to seek a tax credit/subsidy. Note that same-sex marriage may be legal in your state but healthcare.gov requires you to complete separate enrollments. This is because you can’t file a joint tax return.

Eventually you’ll get to this page:

Click ‘next’. A summary page will appear. This is your chance to carefully review your application data entry. This information is accessible when you log in to your account, but to see it you have to painstakingly go through each page again. So I typically print this page to a PDF file and save it somewhere safe. If it looks OK, scroll to the bottom and click the green ‘save & continue’ button.

The next page is very important!

This is what you’ll see at first:

I recommend marking ‘agree’ to all three. The middle one is the tricky one. You can disagree and you’ll still be able to move ahead. But the site will not be happy. A box will pop up asking you (again) to agree. They really, really, really want you to give permission to allow healthcare.gov to talk to the IRS to verify your income. If you don’t agree, the consequences can be pretty grim. This is what you’ll see if you disagree:

Important If you don’t attest to this item, it may impact your eligibility.’

If you don’t agree, it is likely to create problems such as:

  • Requiring extra documentation to verify your income.
  • Losing your tax credit part way through the year, because they’ll send you mail asking for documentation and it’s easy to forget or it may not seem important at the time. I’m not accusing you of ignoring the mail! I’m just sayin’… it’s happened to several of my clients.
  • Losing coverage because healthcare.gov asked for citizenship documentation. This has happened when the system hit a glitch and couldn’t verify the social security number that the person has had their entire life.

These things have all happened to quite a few of my clients, and they stem from marking ‘disagree’ to the middle question.

After you’ve answered those three questions, click the green ‘save & continue’, then click ‘agree’ (if applicable) that you’re being honest and truthful in your answers.

The next step is to e-sign your name and click ‘submit application’. Wait for the spinning wheel to stop spinning. Click the big green ‘view eligibility results’ button. Congratulations! You’ve completed your application, and now you find out if you qualify for tax credits. KEEP THIS DOCUMENT. It should download to your downloads folder, or open up in your PDF viewer or a new tab in your browser. Print at least the first five pages in hard copy. In these pages it will tell you:

  • If you qualified for a subsidy or OHP.
  • If dependents qualified for a subsidy or OHP
  • The amount of the subsidy/tax credit
  • If the government requires any documentation verifying your income. (IMPORTANT! If they want documentation, uploading it into your account is far, far, far better than mailing it. I’ve had clients who have mailed the documentation 3 times. Each time, healthcare.gov lost it and re-requested it. In the end the client lost their tax credit due to the errors of healthcare.gov.)

A little later I will give instructions on how to upload documents within your account (assuming you can get them into electronic form). I will also cover how you can make changes to a completed application or delete an application and start over.

After review, you can ‘continue to enrollment’

After you read a pop up box and close it, you’ll see this:

If you qualify for a tax credit, click ‘set tax credit’. At this point you can decide whether to use the entire tax credit against your monthly premium, or to use only part of the credit, or to defer it. Remember that whatever you decide here, the final accounting happens when you file your 2016 tax return. The government may giveth or taketh away a portion, depending on the accuracy of your income estimate. Having said that, most people need all the help they can get to pay for their insurance, and they use the entire amount as a monthly credit against their premium. The site will walk you through this process. There are 8-10 screens to work through.

Next you’ll get to the page with a green button: ‘Answer Questions’. Here, they want to know if you use tobacco. Some insurers charge more premium if you use tobacco, other than for religious or ceremonial use.

The next step is to choose a plan. I’ll walk you through that process here or if you need a break, you can come back to the ‘Choose a Plan and Finish Your Application’ step on the previous page.