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Old 10-20-2013, 10:50 PM   #401
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Originally Posted by kmt1972 View Post
I was thinking about what sort of people are actually going to the exchanges.

Then I saw this:

Uninsured Americans Still Unfamiliar With Health Exchanges

71% of uninsured unfamiliar with heath exchanges. 34% of uninsured will pay the fine versus 25% in Sept. If these 34% are the young and healthy then the death spiral will be upon Obamacare.

Looking at the interest on this site it seems that a lot of traffic on the health exchanges are people with insurance but are looking to switch into the Health Exchange system rather than those which lack insurance.
Good point. Likely numerous with multiple accounts also since the system is not working. Most spending the frustrating hours trying to get signed up would be either older folks hoping to reduce their costs in retirement or others with pre-existing conditions. I have yet to meet one working 26 year old who has income and plans to buy one of these, unless a health issue. Their folks of course may urge otherwise but...
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Old 10-20-2013, 10:55 PM   #402
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Originally Posted by MichaelB View Post
Not to mention that 26 year-olds are still eligible to continue to receive coverage on their parent's policies.
According to the HHS website it is _until_ age 26.
Young Adult Coverage | HHS.gov/healthcare

I believe that means if they are 26 they are on their own...
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Old 10-21-2013, 12:20 AM   #403
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This is the problem that greatly concerns me. I am not worried as much about this years tremendous premium hike facing me. I am worried about the following years jump. If your above stats bear out, my concern is very valid. There will ultimately be a breaking point somewhere, when I will not pay either and think like OldTrig is. The bottom 50% of Americans consume 2% of healthcare costs. I am one of those and would gamble I stay there. And that 2% penalty...come and get it if you can. Though my opinion may sound on the extreme with posters here, I am very confident it would be the norm with the general population.
Well if we could make it to the end of 2016 after the $675 penalty comes into play, I think we will see at least 95% signed up.

Right now, I think the people rushing to sign up are either:

Pre-retired looking for a price break
People with pre-existing conditons
People whose private insurance policy went up too much.
Subsidy level wage earners
Very few, if any low wage earners who did not carry a policy before.

I hope I'm wrong, but I don't think too many young people will sign up.
They didn't before, and there not going to now, unless it really makes no financial sense for them not to. (hence my end of 2016 prediction)

Something I have observed over the many years as a business owner who employs low wage earners. They would rather turn down insurance where the company pays 1/2 the cost, than have to pay the other 1/2.
There have been exceptions, but not so many. And it was a pretty good policy I was offering with no deductible (at that time)

Also, low wage earners have no interest in high deductible plans, which is 90% of what the insurance policies are offering on the exchange (in my state anyway). It makes no sense to them, and I understand that. They would rather go to a low cost clinic and have to pay cash then have to pay out monthly for something they will probably never get to cash in on.
They don't fret over cancer or a heart attack or even an automobile accident. They would just like to be able to go to the doctor if they or their kids get strep throat.

Wall mart learned the high deductible trick. When they had to offer a policy, they chose one (a while back) with a $2,000 deductible, and offered to pay half of the premium. Well, the average $8.00 an hour employee said, as they expected I'm sure, "Thanks but no thanks."

In fact this is very common with retail stores (there are exceptions of course) When you only make between $8 to $10 or even $12 an hour, you have little use for a high deductible insurance policy, especially if your younger.
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Old 10-21-2013, 11:37 AM   #404
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Well if we could make it to the end of 2016 after the $675 penalty comes into play, I think we will see at least 95% signed up.

Right now, I think the people rushing to sign up are either:

Pre-retired looking for a price break
People with pre-existing conditons
People whose private insurance policy went up too much.
Subsidy level wage earners
Very few, if any low wage earners who did not carry a policy before.

I hope I'm wrong, but I don't think too many young people will sign up.
They didn't before, and there not going to now, unless it really makes no financial sense for them not to. (hence my end of 2016 prediction)

Something I have observed over the many years as a business owner who employs low wage earners. They would rather turn down insurance where the company pays 1/2 the cost, than have to pay the other 1/2.
There have been exceptions, but not so many. And it was a pretty good policy I was offering with no deductible (at that time)

Also, low wage earners have no interest in high deductible plans, which is 90% of what the insurance policies are offering on the exchange (in my state anyway). It makes no sense to them, and I understand that. They would rather go to a low cost clinic and have to pay cash then have to pay out monthly for something they will probably never get to cash in on.
They don't fret over cancer or a heart attack or even an automobile accident. They would just like to be able to go to the doctor if they or their kids get strep throat.

Wall mart learned the high deductible trick. When they had to offer a policy, they chose one (a while back) with a $2,000 deductible, and offered to pay half of the premium. Well, the average $8.00 an hour employee said, as they expected I'm sure, "Thanks but no thanks."

In fact this is very common with retail stores (there are exceptions of course) When you only make between $8 to $10 or even $12 an hour, you have little use for a high deductible insurance policy, especially if your younger.


I know I would not at this point either, although I fall into the semi-retired category you mention. Not only is it a mess but I'm expecting the next hammer to fall. Identity theft. From my experience with IT systems, if there are significant problems with the baseline there are also hidden major security flaws...
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Old 10-21-2013, 12:22 PM   #405
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Fortunately, someone making $8/hr does not have to choose a high deductible policy. Since they make less than 150% of FPL, they qualify for substantial cost-sharing (as well as generous premium subsidy). For example, with a MAGI of $16,000, Coventry shows two Silver plans in Missouri with premiums of $45/mo, and ZERO deductible. No charge PCP OV's, $5 generics, etc.
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Old 10-22-2013, 03:45 PM   #406
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Getting close (in a way). I called to ask why the last application I put in doesn't seem to take my Indian status into account. They claim an "advanced resolution specialist" should get back to me in about two days. In the meantime, I also looked up the older application I put in (before the church decision to cover my wife and put me on the Exchange but which *does* recognize my Indian status -- and where the website wasn't working properly before that meeting), and if I can't get the last application resolved to acknowledge Indian status, we may be better off if our church council can change their election to not provide any insurance at all (even though after the official deadline).

The church is paying about $520 a month to give my wife basic "gold" level coverage ($1000 deductible, $3500 OOP max), including dental for her at no cost to us (I'd still be on my own). IF I can get the exchange to accept that I should be able to get something with no cost sharing while my wife is covered and I'm not offered coverage... I should be able to get a bronze PPO plan (would pay up for that, the HMO plan sucks) for maybe $100 a month with no copays or deductibles at all. That would be best case -- here's the plan I could get:

http://www.bcbstx.com/pdf/sbc/33602TX0420005b.pdf

But here's the thing: If they can't do that on the Exchange, then if we can have the church rescind their offer to provide employee-only Gold coverage and provide no coverage at all, DW should be able to get comparable Gold coverage ($500 deductible, $4000 OOP max) for $277 a month after subsidy. I can get something for $114 with no cost sharing at all -- the lowest-cost Bronze PPO (again, the HMO sucks even if it's only about $50) -- and we can both get dental for about $35 each, or $70 total.

So the church is paying $520 a month or so for just her medical and dental, when in reality we could get everything for *both* of us for $477 (and I would have NO cost sharing). They could just give us pay in lieu of benefits for (say) $450 a month and we'd both come out ahead. Yes, there's loss of subsidy and loss of deductibility of health insurance premium... but I think we're still ahead on this. (Another option would be to have them authorize family coverage and set up her 2014 contract to take $380 less in pay per month to give me their health plan, but that would be stupid since that is a lot more expensive AND I'd lose the cost-sharing exemption.) DW gets similar coverage, I get ridiculously good coverage with no cost sharing even on a Bronze plan, the church pays less.... seems like a win-win-win situation in our particular case. If we can pull it off.

The good news is, if we screwed this up and can't fix it, it's only for one year at worst. (For what it's worth, in our situation the federal exchange website tells us that in our situation if we both need insurance, we should get two separate individual policies with the subsidy split between the two, because I'd need a "special" American Indian plan with no cost sharing that my better half wouldn't have access to. From what I can tell, this clause in the law was put in because of existing treaties between the US government and the recognized Indian tribes, stemming from the federal Indian health care obligations in those treaties.)

I just wish the website was working well enough on the 8th when the council held a special meeting to discuss this so this was very clear. We might not have to go back and ask our church benefits organization to change their election after the deadline. Hopefully if we have to, they will be understanding because of the nightmare that has been healthcare.gov.
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Old 10-22-2013, 04:11 PM   #407
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Getting close (in a way). I called to ask why the last application I put in doesn't seem to take my Indian status into account. They claim an "advanced resolution specialist" should get back to me in about two days. In the meantime, I also looked up the older application I put in (before the church decision to cover my wife and put me on the Exchange but which *does* recognize my Indian status -- and where the website wasn't working properly before that meeting), and if I can't get the last application resolved to acknowledge Indian status, we may be better off if our church council can change their election to not provide any insurance at all (even though after the official deadline).

The church is paying about $520 a month to give my wife basic "gold" level coverage ($1000 deductible, $3500 OOP max), including dental for her at no cost to us (I'd still be on my own). IF I can get the exchange to accept that I should be able to get something with no cost sharing while my wife is covered and I'm not offered coverage... I should be able to get a bronze PPO plan (would pay up for that, the HMO plan sucks) for maybe $100 a month with no copays or deductibles at all. That would be best case -- here's the plan I could get:

http://www.bcbstx.com/pdf/sbc/33602TX0420005b.pdf

But here's the thing: If they can't do that on the Exchange, then if we can have the church rescind their offer to provide employee-only Gold coverage and provide no coverage at all, DW should be able to get comparable Gold coverage ($500 deductible, $4000 OOP max) for $277 a month after subsidy. I can get something for $114 with no cost sharing at all -- the lowest-cost Bronze PPO (again, the HMO sucks even if it's only about $50) -- and we can both get dental for about $35 each, or $70 total.

So the church is paying $520 a month or so for just her medical and dental, when in reality we could get everything for *both* of us for $477 (and I would have NO cost sharing). They could just give us pay in lieu of benefits for (say) $450 a month and we'd both come out ahead. Yes, there's loss of subsidy and loss of deductibility of health insurance premium... but I think we're still ahead on this. (Another option would be to have them authorize family coverage and set up her 2014 contract to take $380 less in pay per month to give me their health plan, but that would be stupid since that is a lot more expensive AND I'd lose the cost-sharing exemption.) DW gets similar coverage, I get ridiculously good coverage with no cost sharing even on a Bronze plan, the church pays less.... seems like a win-win-win situation in our particular case. If we can pull it off.

The good news is, if we screwed this up and can't fix it, it's only for one year at worst. (For what it's worth, in our situation the federal exchange website tells us that in our situation if we both need insurance, we should get two separate individual policies with the subsidy split between the two, because I'd need a "special" American Indian plan with no cost sharing that my better half wouldn't have access to. From what I can tell, this clause in the law was put in because of existing treaties between the US government and the recognized Indian tribes, stemming from the federal Indian health care obligations in those treaties.)

I just wish the website was working well enough on the 8th when the council held a special meeting to discuss this so this was very clear. We might not have to go back and ask our church benefits organization to change their election after the deadline. Hopefully if we have to, they will be understanding because of the nightmare that has been healthcare.gov.
That's a nice policy. Hope you get it. My gut feel is the exchange won't be much help to you even after they get it fixed up, you'll need a senior navigator with level 2 training (or whatever they call it).
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Old 10-22-2013, 04:20 PM   #408
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That's a nice policy. Hope you get it. My gut feel is the exchange won't be much help to you even after they get it fixed up, you'll need a senior navigator with level 2 training (or whatever they call it).
Yeah, I said months ago that ours was a very unusual and complex situation. But worst case I know we can ask the council to not cover us for 2015 and ask for additional compensation in lieu of coverage. I hope they can fix my application and, failing that, that our church treasurer can convince the churchwide benefits organization to let them change their employee benefits election after the deadline.

[Edit to add: I'm actually looking at this more now, and maybe the $48 HMO option covers me as well as the $114 PPO option because there's still no cost-sharing for out-of-network services. Hmm.]
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Old 10-22-2013, 06:00 PM   #409
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Don't worry, everything is going to be OK now.

HHS brings in Verizon to help HealthCare.gov
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Old 10-22-2013, 06:03 PM   #410
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Don't worry, everything is going to be OK now.

HHS brings in Verizon to help HealthCare.gov
Can you hear me now?
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Old 10-22-2013, 06:56 PM   #411
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Am embarrassed to ask this, but... will any of ACA require me to do anything? I admit to ignoring the issue.
Have been on Medicare since 2000, with the same supplement.
Except for a few changes in coverage, I don't see anything to be concerned about. Am I wrong?
My elderly neighbors, in the same boat, are panicked about how the ACA will affect them. Neither the media, nor the government seem to have emphasized what percentage of the population will be directly affected, and the 24/7 panicky, breathless reports now have me wondering if I've missed something.

Yours in abject ignorance and humility.
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Old 10-22-2013, 09:10 PM   #412
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Am embarrassed to ask this, but... will any of ACA require me to do anything? I admit to ignoring the issue.
Have been on Medicare since 2000, with the same supplement.
Except for a few changes in coverage, I don't see anything to be concerned about. Am I wrong?
As far as I can tell, at least for the vast majority of people, this doesn't affect anyone already on Medicare.
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Old 10-22-2013, 09:21 PM   #413
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Well, after uploading a copy of my drivers license to get past the verify identity part, and not getting any response for 5 days, I decided to start over with a new account. It seemed to work better, my identity did get verified first time through. Went through filling out the application but when I clicked submit after signing the digital signature it just hung (spinning green icon). Went through the application process 2 more times but it always hung at the same spot. Received a notice today that I had a document to download, it was the status of my application. What I got was a form letter stating that I don't qualify for a health plan on the marketplace . Didn't give any reason why I don't qualify (I'm positive I should). Chatted with one of their online reps who went through my info. and couldn't understand why I received the letter. Said I might need to file an appeal.
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Old 10-22-2013, 10:20 PM   #414
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Well, after uploading a copy of my drivers license to get past the verify identity part, and not getting any response for 5 days, I decided to start over with a new account. It seemed to work better, my identity did get verified first time through. Went through filling out the application but when I clicked submit after signing the digital signature it just hung (spinning green icon). Went through the application process 2 more times but it always hung at the same spot. Received a notice today that I had a document to download, it was the status of my application. What I got was a form letter stating that I don't qualify for a health plan on the marketplace . Didn't give any reason why I don't qualify (I'm positive I should). Chatted with one of their online reps who went through my info. and couldn't understand why I received the letter. Said I might need to file an appeal.

1. Do you currently have coverage? The correct answer is no. Even if it's not job based, you don't have it.

Check your income levels you reported to make sure they're accurate.
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Old 10-23-2013, 06:39 AM   #415
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Am embarrassed to ask this, but... will any of ACA require me to do anything? I admit to ignoring the issue.
Have been on Medicare since 2000, with the same supplement.
Except for a few changes in coverage, I don't see anything to be concerned about. Am I wrong?


Yours in abject ignorance and humility.
Well, technically the ACA does affect you, but you don't need to do anything. If you use Medicare Advantage, you might want to budget an increase in cost, because that program receives subsidies that are being rolled back. In addition, Medicare D is also being reformed to close the coverage gap, which will benefit people with hefty prescription deductibles. More info here http://www.medicare.gov/Pubs/pdf/11493.pdf

You can find details and a timeline here Summary of the Affordable Care Act | The Henry J. Kaiser Family Foundation
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Old 10-23-2013, 08:08 AM   #416
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Thank you for the quick response and the directions. Most appreciated.
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Old 10-23-2013, 09:27 AM   #417
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Still not signed up cant get verified. I talked with a CS service person. Who was really nice and professional. Now I need to wait on a specialist who will get back to me in 2 business days. This is day 2 now.
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Old 10-23-2013, 09:40 AM   #418
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My daughter called me today and said she got through the ACA application and get a red flag asking her to upload a "document" from her employer to finish the process. Her employer does not provide her with medical insurance since she is technically part time.

She said there is a "drop down list" of documents to choose from under the upload button but does not have a clue where to get the correct one or which one to choose. I asked her to highlight and copy the list and paste it in an e-mail to me and I'll see if I can figure it out.

Well, the list is not selectable and she can't copy it () so she will have to write it out.

I wonder what this is about? Maybe she should call them? I thought this was to be a "seamless process"?
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Old 10-23-2013, 09:55 AM   #419
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Maybe she should call them? I thought this was to be a "seamless process"?
Definitely call, you may even get an answer to that specific question. Seems like how to use or I'm on this screen and don't understand what I'm supposed to enter issues, the front line folks are prepared for. One positive thing is I've never waited more than a couple of minutes to speak with a human.

Seamless process? That has not been my experience. More like 'transparent', as in an airplanes propeller at full throttle is transparent, best not to walk into it!

Good luck,

MRG
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Old 10-23-2013, 10:02 AM   #420
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Definitely call, you may even get an answer to that specific question. Seems like how to use or I'm on this screen and don't understand what I'm supposed to enter issues, the front line folks are prepared for. One positive thing is I've never waited more than a couple of minutes to speak with a human.

Seamless process? That has not been my experience. More like 'transparent', as in an airplanes propeller at full throttle is transparent, best not to walk into it!

Good luck,

MRG
Thanks, I'll have her call. At least they appear to answer the calls.
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