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get an answer. "Some of the operators knew a little more; some a little less but their command of the information was not what it should be," Marilyn observed.
• After about four weeks, she learned her husband and daughter were eligible for a family tax credit of $233 to help buy a policy. Throughout November and into December she checked out the particulars for Blue Cross bronze and silver policies and for similar plans from CoOpportunity. Bronze policies, usually the cheapest, cover 60 percent of the policyholders' medical costs; silver plans cover 70 percent.
• Blue Cross offered a bewildering number of bronze plans---eight to be exact-with different deductibles and amounts of coinsurance and varying out-of-network benefits. CoOpportunity's plans were also confusing.
• In mid-December, Marilyn told me the process was "getting crazier by the day." She had just gotten a call from a government representative in Kentucky who told her to call the 800 number. Marilyn called and learned her family's subsidy would be only $141 because her daughter might not be eligible for an exchange policy. HealthCare.gov was sending her application to Nebraska Medicaid to see if her daughter qualified for Medicaid coverage instead.
• (Many states are requiring exchange applicants to try Medicaid first to see they qualify for that program, which, of course, adds another layer of complexity.)
• Marilyn, who had worked as a mental health therapist, knew the pitfalls of Medicaid. Providers move in and out of the program. Medicaid drops coverage when people are no longer eligible. She doubted whether her family income would qualify anyway. "I was fit to be tied," she said.
• The next day Marilyn and her husband decided that the small tax credit was not worth buying an exchange policy, and they opted for a non-exchange policy to avoid the pain of dealing with Medicaid. A low premium was at the top of their must-have list.
• They could keep their current policy, which was grandfathered under the law, but the premium might go up 16 percent in January to $862, a steep increase. They could get a new Blue Cross plan that complied with the benefit requirements of the health law, or they could find a policy from another company.
• They weighed the pros and cons and looked at the key trade-off---paying more up front and less when they needed medical care or paying a lower premium and more in the form of coinsurance and copays when they got sick.
• They choose a Blue Cross high deductible bronze policy with a premium of $569. There was one more choice to make. Instead of an "aggregate" deductible, which meant the higher family deductible would apply before benefits could be paid, they could pick an "embedded" deductible with each family member paying $6,325 be

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