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Old 03-27-2015, 07:57 AM   #21
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I think you mane prove that you are "low income", rather than "poor".
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Old 03-27-2015, 10:04 AM   #22
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Originally Posted by Fermion View Post
I hope the "proof" of low income gets easier as years go by.

2014 MAGI $260k
2015 MAGI $50k
2016 and beyond MAGI $22k to $25k

Some time around 2016, 2017 there should be some document to prove we are income poor. Maybe the previous year 1040?
I think once you have a low income return filed with the IRS there would be no need to verify. This process was for clearing up inconsistencies between your last filed return and claimed income for current year.
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Old 03-27-2015, 12:03 PM   #23
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I was asked to upload documentation as a part of my 2015 application. I did it 2 times (each time uploaded the same PDF that contained images of several bits of "proof"). I got the email again (and the phone call), so I printed the dang PDF and mailed it (with signature confirmation), along with the cover sheet thing they provided. That seems to have done it.
I think I spoke too soon. I got the email today. I might just wait for the final threat letter before I do anything more.
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We recently sent you an important notice about your Marketplace coverage. As of March 22, 2015, our records show that we still havenít received the documents we need from one or more people in your household as proof of their expected yearly income, if they have income. If we donít have the needed documents, we may end or adjust the financial help you are getting to pay for your Marketplace health plan on May 1, 2015 for you and/or someone on your application.
What to do next
  • Immediately send any documents the Marketplace still needs.
  • Check your mail or HealthCare.gov online account for the official Marketplace notice ending coverage.
  • Read all notices carefully to understand who is affected and what will change.
  • If your assistance is adjusted and you think we made a mistake and financial help shouldn't end for you or the person(s) named in the notice, follow the directions in the notices to appeal this decision.
If you need help
You can find local help or call the Marketplace Call Center at 1-800-318-2596 and tell them the Marketplace is ending coverage for someone on your application. TTY users should call 1-855-889-4325.
Your health coverage is important to you and your family. Itís important to us too. Weíre here to help you stay covered.
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Old 03-27-2015, 03:54 PM   #24
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I think I spoke too soon. I got the email today. I might just wait for the final threat letter before I do anything more.
I just got the same email telling me as of 3/22/2015 they haven't received the necessary documents..... unbelievable. I snail mailed it to them, then I uploaded it to them. What is their problem? They also gave me until 5/1/2015 to send in the documents. Guess I'll call hc.gov at the 800 number on Monday.
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Old 03-27-2015, 06:07 PM   #25
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I thought about calling, but figured I'd call and get someone who probably knows less about it than I do, then wait for someone who actually knows something to get back to me. And maybe that would never happen. So I figured there would be a path to resolution on the threat letter that I would follow. But let us know what you find out!!
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Old 03-28-2015, 11:32 AM   #26
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I had the same maddening notifications requesting documentation that we already uploaded. I think I sent in my passport several times. I think they just throw away any mail/faxes they receive.

Regarding income, at least on coveredCA, the support person on the regular helpline was able to look at the docs during a call and approve it right then.


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Old 03-28-2015, 12:01 PM   #27
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Originally Posted by Fermion View Post
I predict big problems for us next year when we apply for cost sharing and subsidy.

They just are not going to believe we went from $260k to $26k income.

I better buy the 1000 minute plan on my cell phone as I think my normal usage is going to go way up.

I think there's another thread that described how people submitted documentation for this case.

We also precipitously dropped in income. All we did is submit a letter explaining that we were retired (no employment income) and stated we expected $X from dividends and retirement withdrawals etc. included tax forms backing up our investment income but we had nothing for planned retirement account withdrawals (Roth conversions).

We did burn a huge number of minutes (hours) on the phone for other reasons though.



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Old 03-28-2015, 12:18 PM   #28
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I predict big problems for us next year when we apply for cost sharing and subsidy.

They just are not going to believe we went from $260k to $26k income.

I better buy the 1000 minute plan on my cell phone as I think my normal usage is going to go way up.
In '14 we had half of your drop. I got away with one question; yes our income changed. This year they asked for proof I sent in a letter and projected income for this year. Haven't heard back.
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Old 03-28-2015, 02:59 PM   #29
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I have been asked on three different occasions to send documents to verify my children's income ($0). Each time I call and after a while they say to just ignore the requests.
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Old 03-28-2015, 04:17 PM   #30
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This is one of the reasons I'm paying full freight through the marketplace (in my case, CoveredCA) and will get my "subsidy" back in the form of a refund. My 2014 income was far to high to qualify but now that I'm retired, my 2015 income will qualify. The subsidies are really just tax credits - that you are able to collect in advance if you choose.

My other reason for doing it this way is that CoveredCA has a glitch - if you are receiving subsidies up front then ALL members of the household must be on the same insurance policy... and my husband wanted a different insurer that me and the kids. (This is *not* an issue on the national exchange - it is a software "feature" of CoveredCA and supposed to be fixed for 2016 enrollment.)

Sure I'm giving the government money up front - but I'll get it back and won't have the hassles described here.
The only problem with this approach is that you may be leaving money on the table depending on your income level as the deductible levels are adjusted up or down based upon income (i.e. on same plan lower income gets a lower deductible).

So while you can recapture the premiums paid, you cannot (at least I am not aware you can) get credits if you were eligible for a lower deductible, but paid higher amounts.

At least on my state exchange you were able to play with income levels and it would show you how deductible levels would change.
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Old 03-28-2015, 08:32 PM   #31
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I thought about calling, but figured I'd call and get someone who probably knows less about it than I do, then wait for someone who actually knows something to get back to me. And maybe that would never happen. So I figured there would be a path to resolution on the threat letter that I would follow. But let us know what you find out!!
I logged into my account on HC.gov and discovered I have no new messages, and that there is now no visible reference to uploading. The *verify* button, which had changed to a *submitted* button has now disappeared completely, which I see as possibly a good sign. My application status is *complete* and there is no mention anywhere of my needing to send or upload proof of income anywhere. So from the online system, I look AOK. But why did I get that nasty email telling me they have not received any documents. I suppose the thing to do is to call them and clarify. But I have to wait until my fear and loathing subside somewhat ...............
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Old 03-29-2015, 08:50 AM   #32
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I'm very curious to see what my May Anthem bill looks like. On 3/12 HC.gov told me my subsidy ends 3/31, (because they didn't get the docs that I both uploaded and mailed) but Anthem says my April premium was subsidized too. Both online and over the phone they say I'm fully paid thru April and don't owe the subsidy part.

This stuff scares me, because I can see it coming...I'll have a big claim in April and they'll say I'm not covered because the subsidy part was not actually paid. This is why I'm just paying the full amount from here on and getting it back at tax time. I want to know for sure that things are paid.
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Old 03-29-2015, 09:33 AM   #33
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Originally Posted by ernow View Post
I'm very curious to see what my May Anthem bill looks like. On 3/12 HC.gov told me my subsidy ends 3/31, (because they didn't get the docs that I both uploaded and mailed) but Anthem says my April premium was subsidized too. Both online and over the phone they say I'm fully paid thru April and don't owe the subsidy part.

This stuff scares me, because I can see it coming...I'll have a big claim in April and they'll say I'm not covered because the subsidy part was not actually paid. This is why I'm just paying the full amount from here on and getting it back at tax time. I want to know for sure that things are paid.
This is all too bizarre. It's as though HC.gov doesn't want to give someone a subsidy, for whatever reason, and instead of telling the person what new documents are needed, or why the subsidy is being denied, they simply pretend the documentation was never received. Too bizarre. I still haven't called them. Too afraid they will bollix it up even more if I do.
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Old 03-29-2015, 10:09 AM   #34
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The only problem with this approach is that you may be leaving money on the table depending on your income level as the deductible levels are adjusted up or down based upon income (i.e. on same plan lower income gets a lower deductible).

So while you can recapture the premiums paid, you cannot (at least I am not aware you can) get credits if you were eligible for a lower deductible, but paid higher amounts.

At least on my state exchange you were able to play with income levels and it would show you how deductible levels would change.
No worries there- our planned income is closer to the 400% of poverty level than the 200% of poverty level... no cost sharing benefits for us... Just tax credits/subsidies for the premiums.

I would have fought harder to get the premium subsidy/tax credits up front IF I hadn't run into the CoveredCA exchange problem of requiring all family parties to be on the same carrier. DH decided this was the year to try a different insurer, but I liked my doc and the kids pediatrician, so we stayed on Kaiser Permanente.

Long talks with the help line showed they did not fix that issue in time for 2015 open enrollment last fall. It's "supposed" to be fixed for 2016 open enrollment this fall.

I just made sure I had enough cash set aside to cover the premium difference. We would not have qualified for the cost sharing benefits.
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Old 03-29-2015, 10:23 AM   #35
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I'm very curious to see what my May Anthem bill looks like. On 3/12 HC.gov told me my subsidy ends 3/31, (because they didn't get the docs that I both uploaded and mailed) but Anthem says my April premium was subsidized too. Both online and over the phone they say I'm fully paid thru April and don't owe the subsidy part.

This stuff scares me, because I can see it coming...I'll have a big claim in April and they'll say I'm not covered because the subsidy part was not actually paid. This is why I'm just paying the full amount from here on and getting it back at tax time. I want to know for sure that things are paid.
Health Reform FAQs | The Henry J. Kaiser Family Foundation

Quote:
For people receiving advanced premium tax credits, if a payment due date is missed, insurers must provide a 90-day grace period during which consumers can bring their premium payments up to date and avoid having their coverage terminated. However, the grace period only applies if an individual has paid at least one monthís premium.

If, by the end of the 90-day grace period, the amount owed for all outstanding premium payments is not paid in full, the insurer can terminate coverage.

In addition, during the first 30 days of the grace period, the insurer must continue to pay claims. However, after the first 30 days of the grace period, the insurer can hold off paying any health care claims for care received during the grace period, which means the enrollee may be responsible to cover any health care services they receive during the second and third months if they fail to catch up on the amounts they owe before the end of the grace period. Insurers are supposed to inform health care providers when someoneís claims are being held. This could mean that providers will not provide care until the premiums are paid up so that they know they will be paid.

People not receiving advanced premium tax credits are expected to get a much shorter grace period; currently, the general practice is 31 days but it may vary in each state.
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Old 03-29-2015, 10:41 AM   #36
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One thing I made a point of doing the last time I called was to write down the name of the person I was talking to. I figure the next time I call (like Monday) I'll be able to say, "But So-and-So told me this last week."

I got the A-OK from the helpline person last Monday but I see that the hc.gov website says I still have incomplete documentation of income. Might as well give 'em a call ...
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Old 03-29-2015, 10:48 AM   #37
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I am so glad I have a grandfathered HC plan, and I will be on Medicare in 2016.
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Old 03-29-2015, 10:49 AM   #38
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This is all too bizarre. It's as though HC.gov doesn't want to give someone a subsidy, for whatever reason, and instead of telling the person what new documents are needed, or why the subsidy is being denied, they simply pretend the documentation was never received. Too bizarre. I still haven't called them. Too afraid they will bollix it up even more if I do.
I understand why it seems that way. From other back office clusters I've seen, and w*rked to fix. It's more likely they're not withholding information, but it's simply lost. Yes, for months never resolved. Seems odd I know but if there getting 100,000 pieces of mail daily(guessing) it takes a lot of discipline and well defined processes to handle that volume. They simply don't have well defined processes or discipline.

The proof of that is the lack of consistency with the simplest communication. Last year no one I talked with knew what cost sharing was. This year they can't tell me how to delete the 3 extra accounts I set up last year. Nor can they tell if they've received my documentation. Seldom do I get an answer that's actionable. More like "well maybe try this or that". Well what would you try? "Oh I have no idea sir".

If they can't answer a yes no question, IMHO it's not a rep problem but failed training, processes, documentation and perhaps technology.
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Old 03-29-2015, 11:47 AM   #39
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I called the 800 number at HC.gov today and asked them if they needed any more documentation from me at this time. She put me on hold for about 3 minutes. I imagined the worst. But she came back on and said there was nothing *pending* on my account and all was OK. I then mentioned the email I had received a few days ago threatening the subsidy, and she said the email was a mistake. I then asked her to make a note of the fact that I had called today, and that nothing was pending, and she did.
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Old 03-29-2015, 11:59 AM   #40
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Thanks- this is good to know. Now if I appeal and get the APTC reinstated, I suppose they would cancel and reapply for the same policy again as they did when they stopped my APTC (old ending 3/31, "new" one starting 4/1). Not sure if I want to rock that boat again.
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