It can be done.
Yes, healthcare.gov requires the patience of, say, Buddha on a mountain, but at least 110 Nebraskans and Iowans have successfully signed up for health insurance via the Affordable Care Act's online marketplace in its first three weeks.
Based on discussions with industry officials, here are some tips to make enrollment easier, or at least more likely:
» Have this information on hand when you start: Social Security numbers of everyone being covered, including children; W-2 forms, pay stubs or other wage information for everyone needing coverage; an Employer Coverage Tool if someone in the household is offered a job-based insurance plan.
» Don't open the website and then shut it down if it doesn't respond immediately. It may take some time to go to the next screen.
» Occasionally hit the “refresh” button to avoid being timed out.
» Paper applications also work and can be downloaded from the Medicare center's website, marketplace.cms.gov.
» People can enroll by calling 800-318-2596 or by getting help from trained people, including qualified insurance agents.
To reach a Nebraska navigator, call Community Action at 402-471-3714 or the Ponca Tribe at 402-738-3158, or find a local office at www.canhelp.org/map.
The Iowa navigators are from Planned Parenthood, 800-318-2596, and the Visiting Nurse Services, 515-558-9946.
Some of them have qualified for tax credits that will reduce their monthly premiums — in some cases to zero — for coverage that will start Jan. 1.
That's only a smidgen of the hundreds of thousands of people in the two states who are expected to buy insurance on the marketplace set up under the new law, also known as Obamacare.
And the official “navigators,” local individuals trained to guide people through the process, say they can't be sure that any of their clients have successfully enrolled in an insurance plan.
It's better than when the website went live Oct. 1. Now the navigators can create client accounts and help them submit subsidy-qualifying information, partway to enrolling, said Roger Furrer, executive director of Community Action of Nebraska, an agency that received a grant to create a statewide network of navigators for the marketplace.
“It appears things are starting to move,” he said.
“It isn't as dire or as horrible as some people have experienced,” said Leigh McGivern, a spokeswoman for CoOportunity Health of Des Moines. “You have to be patient and persistent.”
“It still is a bit slow, but it appears that the pace is picking up,” said Tom Gilsdorf, director of product development for Blue Cross Blue Shield of Nebraska.
That pace of enrollment must pick up substantially if the law is to succeed in signing up everyone who wants to or should buy insurance under the health care law. People must apply by Dec. 15 for coverage to start Jan. 1, or apply by March 31 to get coverage later in the year.
CoOportunity has enrolled 58 people and Blue Cross about 50 through the federal website.
Blue Cross has signed up several hundred others on its own website for identical plans, although the federal tax credits aren't available that way. And CoOportunity has signed up 90 on its website, a step toward the new company's goal of at least 11,000 clients by the end of 2014.
Two other companies — Coventry Health and Health Alliance Midwest — are selling policies in Nebraska that meet the Obamacare standards, but they weren't reporting numbers Friday. In Iowa, insurers are Coventry, CoOportunity, Gunderson Health Plan, Avera Health Plans and, for small businesses only, Health Alliance and Sanford Health.
Buying a health plan is easier on the company websites, but only at healthcare.gov can people get tax credits to help pay premiums. And that site shows side-by-side comparisons of the competitors' plans, listing features such as deductibles, premiums, co-payments, health provider networks and other details.
Jean Wendl of Omaha, a self-employed 59-year-old, was one of about 45,000 Nebraskans, mostly individual policyholders, who got letters from Blue Cross telling them their existing policies would end and offering new policies that comply with the Affordable Care Act.
The letter suggested that her $335-a-month policy could be replaced by an Obamacare-compliant policy through the company that would cost $519.
The policies listed in the letter are different from the clients' existing policies, so it's not a direct comparison. For example, the new policies must include a list of health needs, some of which aren't covered in existing policies.
Also, the $519 policy Blue Cross offered isn't Wendl's only option. She could buy another Blue Cross policy, or a policy from another company directly or on the federal marketplace, though Wendl said she doubts she would qualify for the tax credits offered there.
“Over time this will smooth out, and it will be a good thing,” Wendl said Friday. “My feeling is that you shouldn't be wiped out just because you get sick.
“It will be more expensive, but in general, you kind of have a moral contract with other people that it will be a good thing in the long run. I think people will quit pulling their hair out eventually, I hope, and get onboard.
“When I can eventually get online and see what other companies are offering, that's what I'm going to do.”
The law requires nearly everyone to have health insurance of some kind.
You don't need to buy insurance through the Affordable Care Act's marketplace if you have group insurance through your employer; if you have Medicare for people age 65 and older or for younger people who have disabilities; if you have Medicaid for low-income citizens; or if you have military coverage such as Tricare.
The federal Centers for Medicare and Medicaid Services said the enrollment process is improving, “but we are not satisfied with the website's performance and will not stop addressing issues and improving the system until the doors to healthcare.gov are wide open.”
The newness of the system prompted Blue Cross to hold a series of meetings in Lincoln, Norfolk and Omaha to give out basic information, answer questions and sell policies.
The company website is supposed to have a direct link to the federal marketplace so applicants can find out if they qualify for tax credits. Matt Leonard, manager of sales, said Blue Cross is still testing that link. “We don't want to put something up that is a little buggy or glitchy.”
Blue Cross executive Gilsdorf said people are sometimes surprised when the federal website's “identity proofing” page asks detailed questions designed to confirm an applicant's identity. The site may ask you to confirm a previous address, cars you may have owned or mortgages held in the past.
The information, which is publicly available, apparently comes from a credit rating company. Gilsdorf said answers to the questions do not affect the insurance coverage once someone's identity is verified.
Leonard said there's still confusion among consumers. Some think incorrectly there is a federal insurance policy called “Obamacare.”
Actually, private insurance companies are offering to sell policies that comply with the Affordable Care Act, the federal law that has been nicknamed Obamacare.
“Our intent is to help Nebraskans get through this and understand it,” Leonard said, as well as to sign up customers. “We think we've got a competitive portfolio. It's good for our market that there are three other carriers out there.”
Gilsdorf said some of the applications that come in through healthcare.gov have errors, such as children listed in the spouse category, or spouses listed under children. The company calls those applicants to fix the mistakes.
“We do expect the volume to pick up significantly,” Leonard said. “We're telling people to take a break (from trying healthcare.gov) and come back later.”
World-Herald staff writer Martha Stoddard contributed to this report.
Watch out for fraud
Recommendations from the health insurance marketplace on protecting against fraud:
Be informed about your health care choices
Learn the basics, and call 800-318-2596 if you have questions. Look for official government seals, logos and Web addresses you see in print or online, especially the marketplace address healthcare.gov.
Protect your private health care and financial information
Nobody should be asking about your health history, treatments or other medical information. Keep personal and account numbers private, including your Social Security number, credit card numbers and bank accounts. Don't give information to someone who calls or comes to your home uninvited.
Ask questions and verify the answers
The marketplace has trained people to help. You should never be asked to pay for services or for help to apply for coverage through the marketplace. Write down names and numbers of people who may assist you. Don't sign anything you don't fully understand.
Report suspected fraud
Take action if someone you don't know contacts you about getting health insurance and asks you to pay, or asks for personal financial or health information or to pay for an Obamacare “insurance card,” or if you give information to the wrong person. Go to www.ftc.gov/idtheft or call 800-318-2596 or call the local police.