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Old 09-19-2019, 08:02 PM
dalej42 is online now
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How do I get on Obamacare?


This may not stay in GQ, but please donít turn this into a debate over Obamacare.

I got laid off and I only have my previous companyís healthcare plan for two months. They gave me a severance package which includes a health care supplement.

I can use COBRA but I think Iíd like to see whatís available though the ACA as well. I live in Illinois.
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  #2  
Old 09-19-2019, 08:08 PM
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  #3  
Old 09-19-2019, 08:12 PM
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https://www.healthcare.gov/

Although it's not open enrollment season yet, getting laid off is a qualifying life event that makes you eligible to enroll.

Be careful, however. A lot of the cheap plans have very tiny networks. And if you have a medical emergency, an ambulance driver is not going to ask you what hospital you want to go to or even know which hospital is in network. And a lot of the cheaper plans will have no in-network providers out-of-state or even out-of-county in case you ever need medical assistance away from home. And they will provide no coverage for out-of-network services. The plans that provide even token out-of-network coverage are few and far between.
  #4  
Old 09-19-2019, 09:31 PM
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Originally Posted by Alley Dweller View Post
Although it's not open enrollment season yet, getting laid off is a qualifying life event that makes you eligible to enroll.
Exactly so. Here's a link to the info on Special Enrollment Periods on Healthcare.gov, and losing job-based health coverage is one of the "qualifying life events."

https://www.healthcare.gov/coverage-...llment-period/

As you'll see, your window for buying an ACA plan runs from 60 days from the point that you lose that coverage.

In addition, the Open Enrollment Period will be running from November 1st until December 15th -- if you don't buy a policy during your Special Enrollment Period window, you have until December 15th to buy a policy during Open Enrollment. However, in that case, the coverage won't go into effect until January 1st.

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Originally Posted by Alley Dweller View Post
Be careful, however. A lot of the cheap plans have very tiny networks. And if you have a medical emergency, an ambulance driver is not going to ask you what hospital you want to go to or even know which hospital is in network. And a lot of the cheaper plans will have no in-network providers out-of-state or even out-of-county in case you ever need medical assistance away from home. And they will provide no coverage for out-of-network services. The plans that provide even token out-of-network coverage are few and far between.
This is good advice. I was on an ACA plan (in Illinois, as a matter of fact) during 2016 and early 2017. At that point, there were several companies I had never heard of offering inexpensive policies, but they had weak networks -- and I know that some of them are no longer offering ACA plans at all.

I wound up buying a plan from Blue Cross and Blue Shield of Illinois -- it wasn't an ideal plan (it was a high-deductible plan, which is what made it at least moderately affordable), but it did give me access to BCBSIL's network, which is throughout Illinois, and nationwide through the BCBS network.

As it turned out, the price for the policy I bought was fairly comparable to what I was having to pay for my COBRA coverage from my old employer -- after I'd gotten laid off, I wound up freelancing for almost two years, and thus, had to buy my own insurance. I finally was able to drop my ACA plan when I got a full-time gig, with insurance.
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Old 09-19-2019, 09:48 PM
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You can look into meeting with a navigator.

https://www.healthcare.gov/glossary/navigator/

Word of warning, I tried applying for Obamacare in 2018. I got laid off at the end of Dec 2017 and my only income in 2018 at the time was UI.

When I went in to apply, they looked at my UI income (about 1300/month) and said it was too high for me to get medicaid. But then they said my annual income (UI is only for 6 months) was too low to qualify for a subsidized ACA plan.

So I was disqualified from both plans. My income was too high on a monthly basis and too low on an annual basis. Its a major loophole.
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Last edited by Wesley Clark; 09-19-2019 at 09:49 PM.
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Old 09-19-2019, 09:56 PM
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Word of warning, I tried applying for Obamacare in 2018. I got laid off at the end of Dec 2017 and my only income in 2018 at the time was UI.

When I went in to apply, they looked at my UI income (about 1300/month) and said it was too high for me to get medicaid. But then they said my annual income (UI is only for 6 months) was too low to qualify for a subsidized ACA plan.

So I was disqualified from both plans. My income was too high on a monthly basis and too low on an annual basis. Its a major loophole.
I have a question -- you were told that your income was too low for a subsidy (which I understand -- I know that there is an income "floor" for subsidies for ACA plans). But, while it meant you wouldn't be able to get a subsidy for an ACA plan, it didn't mean that you were prohibited from buying an ACA plan *at all*, correct?

That said, even if you could, legally, have bought an ACA plan without a subsidy, the monthly premiums may have been more than you could have afforded, so you may still have been "prevented" from getting an ACA plan -- but due to the cost, and the ineligibility for a subsidy, but not due to ineligibility for a plan.

Last edited by kenobi 65; 09-19-2019 at 09:56 PM.
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Old 09-19-2019, 10:05 PM
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Originally Posted by kenobi 65 View Post
I have a question -- you were told that your income was too low for a subsidy (which I understand -- I know that there is an income "floor" for subsidies for ACA plans). But, while it meant you wouldn't be able to get a subsidy for an ACA plan, it didn't mean that you were prohibited from buying an ACA plan *at all*, correct?

That said, even if you could, legally, have bought an ACA plan without a subsidy, the monthly premiums may have been more than you could have afforded, so you may still have been "prevented" from getting an ACA plan -- but due to the cost, and the ineligibility for a subsidy, but not due to ineligibility for a plan.
Yes. But this is only theoretical - if you are making under ~13,500 a year it's going to be really hard to come up with ~$500 a month for the un-subsidized premium. In practice, it's a loophole, as you are too poor to be considered eligible for ACA (you were supposed to get medicaid) but too rich for medicaid in conservative Southern states.
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Old 09-19-2019, 10:14 PM
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Originally Posted by SamuelA View Post
Yes. But this is only theoretical - if you are making under ~13,500 a year it's going to be really hard to come up with ~$500 a month for the un-subsidized premium. In practice, it's a loophole, as you are too poor to be considered eligible for ACA (you were supposed to get medicaid) but too rich for medicaid in conservative Southern states.
Oh, I completely agree -- but my point is that, as I understand how the laws and the policies work (and I've worked on these sorts of policies for four years as part of my job), I suspect that it wasn't that Wesley Clark was prohibited from buying a policy due to his income level, it was that he was prohibited from qualifying for a subsidy to help him pay for a policy. Eligibility for an ACA policy, and eligibility for a subsidy, are two different things.

You're right, it ends up being a de facto "you can't buy a policy," but, to be clear, as long as you aren't on Medicaid, there are, as I understand it, no income restrictions on your legal eligibility to buy an ACA policy.

Last edited by kenobi 65; 09-19-2019 at 10:18 PM.
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Old 09-19-2019, 10:22 PM
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Oh, I completely agree -- but my point is that, as I understand how the laws and the policies work (and I've worked on these sorts of policies for four years as part of my job), I suspect that it wasn't that Wesley Clark was prohibited from buying a policy due to his income level, it was that he was prohibited from qualifying for a subsidy to help him pay for a policy. Eligibility for an ACA policy, and eligibility for a subsidy, are two different things.

You're right, it ends up being a de facto "you can't buy a policy," but, to be clear, as long as you aren't on Medicaid, there are, as I understand it, no income restrictions on your legal eligibility to buy an ACA policy.
Ok sure. And then I think about how these policies screw over millions of citizens in these red states where they were instituted.

The problem with Conservatism - and the Republican party - isn't the people who are voting conservative because it's in their own best interests. The richest 1% don't need any help from the government and never will, they have more money than almost anyone else anywhere in the world.

But millions of poor people who do not benefit from conservative governance are taught through false information that they do. And so they become "useful idiots", voting against their own interests.
  #10  
Old 09-19-2019, 10:33 PM
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Originally Posted by SamuelA View Post
Ok sure. And then I think about how these policies screw over millions of citizens in these red states where they were instituted.

The problem with Conservatism - and the Republican party - isn't the people who are voting conservative because it's in their own best interests. The richest 1% don't need any help from the government and never will, they have more money than almost anyone else anywhere in the world.

But millions of poor people who do not benefit from conservative governance are taught through false information that they do. And so they become "useful idiots", voting against their own interests.
I don't disagree with any of this (and the state where my client operates is a deeply red state, which does, in fact, have the "Medicaid gap" due to the decisions of its Republican government). But, this sidetrack has pulled the thread away from the OP's question.
  #11  
Old 09-19-2019, 11:39 PM
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Quote:
Originally Posted by SamuelA View Post
Ok sure. And then I think about how these policies screw over millions of citizens in these red states where they were instituted.

The problem with Conservatism - and the Republican party - isn't the people who are voting conservative because it's in their own best interests. The richest 1% don't need any help from the government and never will, they have more money than almost anyone else anywhere in the world.

But millions of poor people who do not benefit from conservative governance are taught through false information that they do. And so they become "useful idiots", voting against their own interests.
The OP is specifically looking for factual answers regarding what is available through the ACA. They are not looking for a debate on Obamacare.

Feel free to debate Obamacare, just not in this thread, or this forum. Great Debates would be the appropriate forum.

Last edited by engineer_comp_geek; 09-19-2019 at 11:39 PM.
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Old 09-19-2019, 11:57 PM
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Originally Posted by engineer_comp_geek View Post
Moderator Note



The OP is specifically looking for factual answers regarding what is available through the ACA. They are not looking for a debate on Obamacare.

Feel free to debate Obamacare, just not in this thread, or this forum. Great Debates would be the appropriate forum.
Sorry. Though I think my post is completely factual and supported by all documented evidence. But yes, it's off topic.
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