ACA/Cobra; do I have this correct?

[thedaily]

If I quit my job today, I wouldn't be able to sign up for ACA because I'm past the deadline and because since I quit thus I voluntarily dropped my coverage. So, does this mean I will have to pay Cobra until the next open enrollment becomes available which appears to be November 15th, 2014?

 

[thedaily]

Okay, I went to ehealthinsurance and for kicks I said I wasn't eligible and it gave me some short term health insurance options of 3-12 months.

 

[MichaelB]

A change in employment status is a qualifying event that allows one to enroll in.a new policy outside of the open enrollment period. http://www.hr.mnscu.edu/insurance/documents/Qualifying_Life_Even.pdf

 

[donheff]

Thanks Michael. I thought that was a key feature of the ACA. You beat me to the lookup. It is funny - polls consistently show that the majority of people disapprove of the ACA overall but the same people approve of all of it's key features by large majorities. Begs the question of what a replacement suitable to the public would look like. Probably something even more progressive than the ACA

 

[travelover]

......... Begs the question of what a replacement suitable to the public would look like........

In other news, everyone agrees that our roads need maintenance. No one wants a tax increase.

 

[Jack_Pine]

Just a note, the whole "qualifying event thing" is not new with ACA. It's an insurance thing and has been around for some time. Even at mega/midi corps there have been qualifying events that let you make changes outside of open enrollment...for what it is worth.

 

[38Chevy454]

Just claim you could not get the website to work, there is an extension grace period. it's another change to the law trying to make it look better.

 

[ziggy29]

Thanks Michael. I thought that was a key feature of the ACA. You beat me to the lookup. It is funny - polls consistently show that the majority of people disapprove of the ACA overall but the same people approve of all of it's key features by large majorities. Begs the question of what a replacement suitable to the public would look like. Probably something even more progressive than the ACA

The problem is that "do you approve of the ACA as it is currently written and implemented" is not the inverse question of "Do you want the ACA repealed". Too many opponents of ACA seem to talk as though everyone who doesn't like the law as established wants it entirely repealed.

A considerable majority say they don't like ACA as it is now, but of those, less than half (according to the surveys I've seen) want a full repeal. The most unpopular part of it seems to be the universal mandate, but without that the most popular aspects of it (keeping kids on the policy until 26, no underwriting or preexisting exclusions, no lifetime benefits cap) can *not* be kept affordable.

 

[jim584672]

If you make under 16.1k (single person) you can sign up for Medicaid at any time, no open enrollment period is required.

I have read that insurers are not offering plans, even privately, outside of the open enrollment period, since they are protecting themselves from people who get sick, and then try to get insurance after the fact.

A qualifying life event would be needed to get in after the open enrollment period.

 

[audreyh1]

A change in employment status is a qualifying event that allows one to enroll in.a new policy outside of the open enrollment period. http://www.hr.mnscu.edu/insurance/documents/Qualifying_Life_Even.pdf

It wasn't clear to me - but you aren't required to exhaust COBRA first anymore are you? You used to have to to qualify for risk pool coverage.

 

[MichaelB]

It wasn't clear to me - but you aren't required to exhaust COBRA first anymore are you? You used to have to to qualify for risk pool coverage.

Even if you are eligible for Cobra you are not required to use it. Quitting or losing your job or your coverage makes you eligible to use the exchange for a new policy outside of the open enrollment period.

 

[rbmrtn]

I think that is still the case. One of the annoying things with HI risk pool was having to take COBRA and use it up then you could go right in.

You can drop COBRA during open enrollment and signup. If your COBRA ends outside of open enrollment then you can signup. If you just drop it, you can't enroll. I think if you never start COBRA you can sign up.

https://www.healthcare.gov/what-if-i-currently-have-cobra-coverage/

 

[steelyman]

I did COBRA for (I think) a little over a year after I resigned. Expensive! But they (the retirement system) stressed you needed "continuous creditable coverage" to be eligible for insurance on retiring, so I chose to be safe.

All of the ACA talk (thanks e-r.org for following) reminded me of that. I've been unaffected, but you never know...

Edit: actually it was "credible", not "creditable". Big difference

 

[audreyh1]

Even if you are eligible for Cobra you are not required to use it. Quitting or losing your job or your coverage makes you eligible to use the exchange for a new policy outside of the open enrollment period.

That's a nice change - and logical now that obtaining insurance is guaranteed.

 

[ERhoosier]

Even if you are eligible for Cobra you are not required to use it. Quitting or losing your job or your coverage makes you eligible to use the exchange for a new policy outside of the open enrollment period.

IIRC, being fired for "gross misconduct" seems to be the only job loss circumstance not eligible for COBRA HI continuation.
After job loss (or reduction in hrs to non-HI status), you only have ~60days (after notification?) to sign up for COBRA, then max of 45d to pay HI premiums. You are not required to use COBRA before signing up for ACA Exchange Plan, but once you leave COBRA your eligibility for it ends (even if you would otherwise be within COBRA coverage duration).
http://www.dol.gov/ebsa/pdf/cobraemployee.pdf
http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html

The circumstance of job loss does not seem to affect ACA eligibility (short of incarceration or loss of legal US residency).
https://www.healthcare.gov/am-i-eligible-for-coverage-in-the-marketplace/

 

[EastWest Gal]

I called the healthcare.gov folks last week, since when I go 1/2 time I lose coverage. Losing insurance coverage is a qualifying event, period. The reason doesn't matter. Funny, I work for a publicly traded physician owned company and I lose coverage going part time or RE, I can't even access the group plan, but my dad working for an oil company had

 

[EastWest Gal]

access to his company plan, even for part B Medicare and for medications for his whole life, even with early retirement, working for an oil company.

My largest single expense will be health insurance starting in September. Probably higher than my food budget, LOL.

 

[2B]

I did COBRA for (I think) a little over a year after I resigned. Expensive! But they (the retirement system) stressed you needed "continuous creditable coverage" to be eligible for insurance on retiring, so I chose to be safe.

COBRA typically runs for 18 months (36 mo for widows) but it makes sense to switch policies at the beginning of a calendar year. If you don't do this, anything you've paid toward the deductible is lost and you have to start over with the new policy.

In my case, COBRA is slightly cheaper than an ACA bronze plan but the deductible is much lower with better benefits. My COBRA has a $3,000 family deductible and the ACA bronze has a $6,000 per person deductible (or $12,000/family but there's only two of us). The COBRA has a 20% copay so it could actually exceed the OOP max of the ACA bronze which covers 100% after the deductible.

Most of us here are reasonably supplied with liquid resources so the question of paying the premium or deductibles comes under the topic of "cash management." The ACA gives me a very slightly less costly HI option then the now defunct Texas High Risk Pool. It's another story for people with very limited resources faced with these premiums and deductibles. Even with subsidies most really don't have effective health insurance.

 

[EastWest Gal]

COBRA typically runs for 18 months (36 mo for widows) but it makes sense to switch policies at the beginning of a calendar year. If you don't do this, anything you've paid toward the deductible is lost and you have to start over with the new policy.

Thank you for this comment. I have spent quite a long time on the ACA website pondering plans, then pondering COBRA. I'm done next month, (wow!) then eligible for COBRA, which is more expensive than the plans on the ACA site. But if I wait until open enrollment in October, there may be more choices and the premiums will be locked in for a year.

This makes the most sense to me. Any alternative thoughts?


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[pb4uski]

I think it makes sense to switch at the beginning of the year only where you have used up a substantial part of your deductible and have ongoing health issues. If you are in good health and your health care costs are minimal so far this year, then I would jump sooner rather than later as the premiums savings which are a sure thing would exceed any "lost" deductible which may or may not happen, but you'll need to assess your own situation.

Even if you signed up now due to changes in circumstances you would still have access to buy the same plans and pricing for 2015, so that's not really a good reason.

As I recall, COBRA sort of gives you an option for health insurance in that you have a certain period of time to decide and also a certain period of time to pay the premium. If one wanted to I think you can get essentially "free" coverage by signing up, delaying payment and then putting an individual policy in place prior to the date you need to pay. IOW, if you get sick you write out a check for the premium and have coverage and if you don't get sick you ignore the bill and had an option for coverage for that period. While I don't advocate doing that and didn't do it myself, if I had retired late in the year i might have played the game to avoid the inconvenience of buying an individual policy for just a couple months.

 

[EastWest Gal]

You 're right. I can play that game, sign up for ACA in October effective December, while I'm still eligible for COBRA but don't need to pay right away (60 days to sign up), see next year's plans and sign up starting in December when my COBRA payment would be due. Savings=$3K.

Thanks!


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[scrabbler1]

COBRA may also offer dental coverage if your old group plan also offered it. That was very helpful to me when I went on COBRA in 2007 after reducing my weekly hours worked to 12 hours, making me ineligible for group health. I had some costly dental work in 2008 but my copay was about $25, a trivial amount.

 

[jim584672]

From what I read, you have up to 60 days to elect COBRA, and 45 days to pay the bill. The payment is retroactive to the last day of work, so this window allows one to free ride through the window period. If you don't get sick don't pay the bill. If you get sick you are covered since it is retroactive.

I hope I am right on this, since I will need to get another coverage after my planned 10/1 departure date from Megacorp.

 

[pb4uski]

And just make sure that your spouse or SO or someone knows about it in case you end up in ER and can't send in the payment to lock in coverage.

 

[Corporateburnout]

I think it makes sense to switch at the beginning of the year only where you have used up a substantial part of your deductible and have ongoing health issues. If you are in good health and your health care costs are minimal so far this year, then I would jump sooner rather than later as the premiums savings which are a sure thing would exceed any "lost" deductible which may or may not happen, but you'll need to assess your own situation.

Even if you signed up now due to changes in circumstances you would still have access to buy the same plans and pricing for 2015, so that's not really a good reason.

As I recall, COBRA sort of gives you an option for health insurance in that you have a certain period of time to decide and also a certain period of time to pay the premium. If one wanted to I think you can get essentially "free" coverage by signing up, delaying payment and then putting an individual policy in place prior to the date you need to pay. IOW, if you get sick you write out a check for the premium and have coverage and if you don't get sick you ignore the bill and had an option for coverage for that period. While I don't advocate doing that and didn't do it myself, if I had retired late in the year i might have played the game to avoid the inconvenience of buying an individual policy for just a couple months.

Since my former employer's coverage ends January 31 I was thinking of using the 60 day Cobra grace period then sign up for an ACA plan to start in April thus saving 2 months of Cobra premiums and if we get sick we'll then pay the premium. I still have few months to decide whether or not to take advantage of this....