Reply
 
Thread Tools Display Modes
  #1  
Old 05-08-2019, 03:31 PM
zwede is offline
Guest
 
Join Date: Mar 2001
Location: Plano, TX USA
Posts: 708

Confused re if I can use ACA "Obamacare" or not


Last year I got a severance package from my now ex-employer that included them paying for COBRA for 12 months. The pre-paid COBRA ends June 30th this year. I have semi-retired and figured I'd try to get a plan under ACA, via healthcare.gov. I filled out the application and said my current coverage ends 6/30. They approved it pending I send proof my coverage ends 6/30.

So here is where my confusion is: When I check my COBRA status it looks like it can continue until 2020 (18 months from that I left the company), with 12 months paid by the employer. Does this mean I can't apply for an ACA plan until 2020 and I have to pay the last 6 months of 2019 myself? I really don't want to do that as it's over $600 a month. COBRA also says I can cancel coverage, but is that acceptable for special enrollment?

Last edited by zwede; 05-08-2019 at 03:32 PM.
  #2  
Old 05-08-2019, 03:38 PM
Folly's Avatar
Folly is online now
Guest
 
Join Date: Aug 2004
Location: Chicago! (no more burbs)
Posts: 2,194
I'm pretty sure that canceling COBRA does not count as a qualifying event.
  #3  
Old 05-08-2019, 03:43 PM
kenobi 65's Avatar
kenobi 65 is offline
Corellian Nerfherder
 
Join Date: May 2000
Location: Brookfield, IL
Posts: 14,640
Disclaimer: I work in advertising, but my primary client is a health insurance company, and I've worked on ACA policies in the past.

Based on what I see on this "do I qualify for a Special Enrollment" screener on Healthcare.gov, it looks like the answer is "no." The first question that it asks is: "Did you or anyone in your household lose qualifying health coverage in the past 60 days OR do you expect anyone in your household to lose coverage in the next 60 days?"

Next to the end of that question, there's a question mark; if you click on that, it opens a pop-up window which says this:

"Note: Voluntarily giving up coverage or losing it because you didn't pay your premium doesn't qualify you for an SEP. You also don't qualify if you drop COBRA outside Open Enrollment before the COBRA coverage runs out."

So, as I read it, since you are currently on COBRA, and do have COBRA available to you through the end of this year, cancelling it doesn't open up a special enrollment period for you. You're stuck with the COBRA until the next Open Enrollment, and you can't start an ACA policy until 1/1/20.
  #4  
Old 05-08-2019, 04:07 PM
zwede is offline
Guest
 
Join Date: Mar 2001
Location: Plano, TX USA
Posts: 708
Ouch. Thanks for the info. I guess my options then are either to continue COBRA at $600/month or get some plan outside of ACA for the last 6 months this year.

Follow-up Q: If I cancel COBRA as of 7/1 this year and get some other plan, does it matter if that plan is not ACA compliant? Used to be that there was a tax penalty for not having an ACA compliant plan but I think that's gone? I have savings so a plan with very high deductibles would be my choice to keep the premium low.
  #5  
Old 05-08-2019, 05:40 PM
dougrb is offline
Guest
 
Join Date: Apr 2003
Posts: 151
Quote:
Originally Posted by zwede View Post
I guess my options then are either to continue COBRA at $600/month
The last time I looked (last year), a Bronze ACA plan was $590/month and had a $6500 deductible.
  #6  
Old 05-08-2019, 05:47 PM
Iggy is offline
Guest
 
Join Date: Jun 2012
Location: somewhere else
Posts: 5,336
Quote:
Originally Posted by zwede View Post
...

Follow-up Q: If I cancel COBRA as of 7/1 this year and get some other plan, does it matter if that plan is not ACA compliant? Used to be that there was a tax penalty for not having an ACA compliant plan but I think that's gone? I have savings so a plan with very high deductibles would be my choice to keep the premium low.
At present the tax penalty (a.k.a "shared responsibility payment") is $0 if you do not have ACA compliant coverage for the 2019 tax year (filing deadline April 15, 2020).
  #7  
Old 05-08-2019, 06:34 PM
zwede is offline
Guest
 
Join Date: Mar 2001
Location: Plano, TX USA
Posts: 708
Quote:
Originally Posted by dougrb View Post
The last time I looked (last year), a Bronze ACA plan was $590/month and had a $6500 deductible.
Bronze ACA plan is $350/month when I checked today. Guess it depends on location.
  #8  
Old 05-08-2019, 06:37 PM
zwede is offline
Guest
 
Join Date: Mar 2001
Location: Plano, TX USA
Posts: 708
Quote:
Originally Posted by Iggy View Post
At present the tax penalty (a.k.a "shared responsibility payment") is $0 if you do not have ACA compliant coverage for the 2019 tax year (filing deadline April 15, 2020).
Thanks. I'll have to do some math, but a short term plan may make sense since I'm healthy and it's only 6 months. My COBRA plan has a high deductible too.

And just to be clear: As soon as I can I'll get an ACA plan. I'm aware of the pitfalls of non-ACA plans (lifetime caps, limited network, usually no prescription coverage etc).
  #9  
Old 05-08-2019, 09:46 PM
glowacks is offline
Guest
 
Join Date: Aug 2008
Posts: 2,090
Quote:
Originally Posted by zwede View Post
Bronze ACA plan is $350/month when I checked today. Guess it depends on location.
It depends on state at very least (and possibly within the state) as well as age. There's no reason to believe that people at different ages will pay the same premium. I think it also depends on tobacco use.
  #10  
Old 05-08-2019, 11:35 PM
kenobi 65's Avatar
kenobi 65 is offline
Corellian Nerfherder
 
Join Date: May 2000
Location: Brookfield, IL
Posts: 14,640
Quote:
Originally Posted by zwede View Post
Thanks. I'll have to do some math, but a short term plan may make sense since I'm healthy and it's only 6 months. My COBRA plan has a high deductible too.

And just to be clear: As soon as I can I'll get an ACA plan. I'm aware of the pitfalls of non-ACA plans (lifetime caps, limited network, usually no prescription coverage etc).
Good, since that was what I was going to warn about short-term plans; they're about the only other option other than ACA-compliant plans if you need individual coverage, and you're not eligible for Medicare.

And, yes, costs for ACA plans (even at the same "metal" level) vary a lot by state, and by insurance provider (if you have more than one company even offering ACA policies in your state at this point; a number of states are down to one carrier).
  #11  
Old 05-11-2019, 09:59 PM
zwede is offline
Guest
 
Join Date: Mar 2001
Location: Plano, TX USA
Posts: 708
Update: Back when I was still with my old job they switched us to a high deductible plan and to make it up to us they gave us $1,100 in an HSA (health savings account). I haven't used any of that money. I read up on it today and found out that although it usually can't be used for insurance premiums, there's an exception for COBRA. So I can use the HSA money to pay for 2 months of COBRA. Considering that, I'm thinking I might as well stay on COBRA the last 4 months instead of messing around with short term plans that are well known for ruining peoples lives when they refuse to cover anything.
  #12  
Old 05-11-2019, 11:34 PM
Colibri's Avatar
Colibri is online now
SD Curator of Critters
Moderator
 
Join Date: Oct 2000
Location: Panama
Posts: 42,251
Since the OP is looking for advice, let's move this to IMHO.

Colibri
General Questions Moderator
  #13  
Old 05-14-2019, 07:39 PM
zwede is offline
Guest
 
Join Date: Mar 2001
Location: Plano, TX USA
Posts: 708
Looking at the popup at healthcare.gov (see post #3) it does indeed say "Note: Voluntarily giving up coverage or losing it because you didn't pay your premium doesn't qualify you for an SEP. You also don't qualify if you drop COBRA outside Open Enrollment before the COBRA coverage runs out."

However, before that it says "Coverage losses that qualify you for an SEP: COBRA coverage running out (or your former employer stopping contributing to your COBRA coverage, requiring you to pay the full cost)".

Well, that's what's happing July 1st. I will have to pay for COBRA myself. So does that mean I can get on an ACA plan as of July 1st under an SEP?
  #14  
Old 05-14-2019, 09:54 PM
zwede is offline
Guest
 
Join Date: Mar 2001
Location: Plano, TX USA
Posts: 708
I contacted a health advisor who says I indeed qualify for an SEP and he has several existing clients in my position and the ACA accepted them. So this sounds promising.
  #15  
Old 05-15-2019, 12:02 AM
kenobi 65's Avatar
kenobi 65 is offline
Corellian Nerfherder
 
Join Date: May 2000
Location: Brookfield, IL
Posts: 14,640
Quote:
Originally Posted by zwede View Post
I contacted a health advisor who says I indeed qualify for an SEP and he has several existing clients in my position and the ACA accepted them. So this sounds promising.
Excellent!

I had COBRA for a year, back in 2015, when I'd been laid off from my previous job, and wound up having to freelance for a while. My former employer didn't cover any of the cost, so I hadn't even considered the fact that a change in what your former employer was covering as far as COBRA cost would count as a qualifying event (and I clearly missed that verbiage). Fingers crossed that it works out for you!
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 12:28 PM.

Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2019, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@straightdope.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Copyright 2018 STM Reader, LLC.

 
Copyright © 2017