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Old 09-10-2015, 05:31 PM   #21
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What I would do is start the process on the website and see what comes up.... you can start looking at the current plans and do more research on which ones you might like...

You can also see how long it would take to get insurance... I do think they tell you when insurance would start....


But, to me picking the plan was the harder issue with all the various deductibles and even the price of the plans... last year I was on a PPO, but the rate increased SO much I dropped to an HMO and even then my rate went up over 30%.... and I have read where the PPO is being dropped because it lost so much... almost all of the other plans are price so high I just do not want to touch them....


Also if you start now you can make sure there are no hitches in your app... I signed up back where there were many problems and it took me a good while to get through them all... I had to provide docs that they seemed not to get and would ask for them again... when I resigned to the ACA it was easy-peasy..... just did not have a good plan at a price I liked... but that is not the website causing that problem....
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Old 09-10-2015, 06:10 PM   #22
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Be mindful of the coverage deadlines. For December coverage be sure to sign up no later than November 15th.

"Coverage purchased after the 15th starts on the 1st of the month after the next month. So coverage purchased on December 16 starts February 1st."
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Old 09-10-2015, 07:11 PM   #23
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Be mindful of the coverage deadlines. For December coverage be sure to sign up no later than November 15th.

"Coverage purchased after the 15th starts on the 1st of the month after the next month. So coverage purchased on December 16 starts February 1st."

Oh wow!!! that is 45 days... I only thought it was 30....


This is a big deal.... you can only start at the beginning of a month so if you miss it you are out of luck....

Or, just buy temp insurance as they can start same day (IIRC)....
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Old 09-10-2015, 08:23 PM   #24
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Thanks again. If it were you, would you wait until November to try and get insurance for December? I'm a worrier and I have visions of ending up not getting covered. I have no experience with ACA, so maybe all my worrying is unfounded.

Thanks, Murf
No reason to wait, do it now. First part of the process is identity verification. After the account is created and verified then you can start an application. Doesn't have to be completed at once, you can save and come back when you need to look something up.

Also ACA uses it's own MAGI formula for income, slightly different than 1040 reported.

For big income income changes I think most people have included an explanatory note when uploading the income documents.
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Old 09-11-2015, 06:51 AM   #25
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Be mindful of the coverage deadlines. For December coverage be sure to sign up no later than November 15th.

"Coverage purchased after the 15th starts on the 1st of the month after the next month. So coverage purchased on December 16 starts February 1st."
+1
The ACA Special Enrollment Period for loss of coverage begins 60 days before your current coverage is terminated but you can research plans and create an account before then.

Reference: https://www.law.cornell.edu/cfr/text/45/155.420
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Old 09-12-2015, 10:23 AM   #26
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Well, I got my ACA account set up with no problems. A big thank you to all! It was far easier than some other people made it sound. I'm glad I posted here. It is a very helpful forum.

I do have another question, mostly out of curiosity. How does the enrollment and payment phase of this work? Are the payments set up on the site or do you go to the insurer for that?

Thanks again, Murf
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Old 09-12-2015, 11:40 AM   #27
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My insurance company billed me.


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Old 09-12-2015, 12:33 PM   #28
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Thanks bp, So at they time you enrolled online there was no real transaction and the insurance co. sent a bill directly to you? Was your tax break already figured into the insurance co. bill? I guess I'm having a hard time believing it go so well after all the negative talk I've heard.

Thanks, Murf
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Old 09-12-2015, 12:59 PM   #29
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Thanks bp, So at they time you enrolled online there was no real transaction and the insurance co. sent a bill directly to you? Was your tax break already figured into the insurance co. bill? I guess I'm having a hard time believing it go so well after all the negative talk I've heard.

Thanks, Murf

It makes a difference how you signed up.... I did not put in any income info so got a full cost of insurance and I have to pay the full amount... will get my money when I file tax return....

If you put in income, they should have told you your credit amount and quoted your net amount which you will pay... any difference to that you pay at tax time...
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Old 09-12-2015, 01:18 PM   #30
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Thanks bp, So at they time you enrolled online there was no real transaction and the insurance co. sent a bill directly to you? Was your tax break already figured into the insurance co. bill? I guess I'm having a hard time believing it go so well after all the negative talk I've heard.

Thanks, Murf

I found it easy too. I made a mistake with initial enrollment stating my coverage ended 2/1/15 when I should have stated 1/31/15, so my insurance start date was 3/1/15. I worked the very nice and helpful folks at the ACA help center and they helped me fix it.

I think you need to pay your first premium in November to insure your coverage starting December 1st. I paid my first premium through the ACA website and afterward set up autopay directly with the insurance company. It was a very smooth process. And even my bronze plan is costing us less out of pocket than our old insurance coverage, even though it is with the same insurance company as my old employer used!

I've been convinced from Day 1 that the negative talk is political rather than real life experience, unfortunately.


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Old 09-12-2015, 02:17 PM   #31
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My enrollment process was also smooth. When I submitted the application on the federal exchange, I got a screen asking if I wanted to make the first month's payment. I chose 'yes' but the next screen said my insurer had not set up that option and they would contact me. I received a welcome package about a week later. I receive a bill around the 20th of each month, due by the 1st of the following month.

Premium: $300
Credit: $100 (subsidy)
Amount due by 1st of month: $200
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Old 09-12-2015, 04:12 PM   #32
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You can only voluntarily end COBRA during the annual ACA open enrollment period. Voluntarily ending COBRA any other time of the year is not a qualifying life event so it will not create an ACA special enrollment period.

Source: Health Reform FAQs | The Henry J. Kaiser Family Foundation
Useful information, thanks. I'm just figuring out that I should look into this earlier than I had planned. COBRA runs out in April, but since we're on a high deductible plan, making a transition in mid-year would make us have to satisfy the high deductible twice for 2016 for the different plans. That could make for an expensive year, so I might be better off switching in January.

We also have the option of a state teacher's retirement plan, so there's some tedious comparison research to do. Not planning to manage my income for ACA subsidy - rather use up the 15% tax bracket to flush out capital gains for 0% income tax and then Roth conversions.
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Old 09-12-2015, 04:33 PM   #33
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Thanks bp, So at they time you enrolled online there was no real transaction and the insurance co. sent a bill directly to you? Was your tax break already figured into the insurance co. bill? I guess I'm having a hard time believing it go so well after all the negative talk I've heard.

Thanks, Murf

That's right. I put my estimated MAGI for the year in and my payments were figured accordingly. As others have noted, you can also leave that part alone and instead take care of it at tax time. Now, 6 months into it, I went back to work. I called ACA and the insurance company to cancel the policy. At tax time, because I made too much for the second half of the year, I had to pay back the 6 months of subsidies. But since I already knew that, I figured that into my withholdings once I went back to work.

Really the biggest problem was right at the very beginning of ACA because of website malfunctions. After that the only issue I had was with the insurance company for a medication for my daughter that was clearly in the formulary. So every month it was go to the pharmacy, be told it was $165, then go home and call the insurance company and after 30 minutes it was fixed and was $10. Go back to the pharmacy and pay $10 and pick it up. It seems it was always handled as an exception by the insurance company instead of the insurance company fixing it permanently.


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Old 09-14-2015, 02:34 PM   #34
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One more?. Are you only covered in your state if you don't buy a national network plan? Seems like a bad deal. What happens if your traveling and get sick?
Seems like a big step backwards from private insurance.

Murf
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Old 09-14-2015, 03:08 PM   #35
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I think they cover emergency and urgent care only for out of state.
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Old 09-14-2015, 03:36 PM   #36
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One more?. Are you only covered in your state if you don't buy a national network plan? Seems like a bad deal. What happens if your traveling and get sick?
How sick? If you aren't on a "multistate" plan, as far as I can tell, you're only covered for emergency and urgent care.
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Old 09-14-2015, 06:06 PM   #37
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One more?. Are you only covered in your state if you don't buy a national network plan? Seems like a bad deal. What happens if your traveling and get sick?
Seems like a big step backwards from private insurance.
All ACA compliant plans cover emergency services (heart attack, stroke, car accident, etc.) that occur within the U.S. You may be interested in this E-R post.

Healthcare.gov link: https://www.healthcare.gov/blog/know...o-go-for-care/

PPO plans offer broader coverage but their premiums are higher. HMO/EPO plans have more restrictive provider networks for non-emergency care. Not all providers within the state will participate in the network. Most Blue Cross Blue Shield plans participate in the BlueCard Program. This expands your home state's BCBS provider network to other states.

Be careful when you see the term "multi-state plan" on the ACA exchange as it can be misleading. It actually means the same plan benefits can be purchased by residents of different states but each state may have its own separate provider network. It's very important to review the provider network directory before you purchase any plan.
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Old 09-15-2015, 06:44 AM   #38
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Hi, I was speaking of "National Provider Networks" not "multi-state" plans. The wording is very tricky on those isn't it? So if we were traveling and had a problem, we'd have to got to the emergency room. Just like all the uninsured do now?

Murf
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Old 09-15-2015, 07:21 AM   #39
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Hi, I was speaking of "National Provider Networks" not "multi-state" plans. The wording is very tricky on those isn't it? So if we were traveling and had a problem, we'd have to got to the emergency room. Just like all the uninsured do now?

Murf
Just like other private insurance, each policy offers its own coverage network plan. You need to research the offerings and judge the network. All insurers have a search tool in their website to allow members and prospective clients to browse their provider network.

There is now little difference in coverage among ACA compliant plans. The differences are to be found in cost sharing and network coverage.
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Old 09-15-2015, 09:12 AM   #40
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So if we were traveling and had a problem, we'd have to go to the emergency room. Just like all the uninsured do now?
Some plans also allow you to go to an urgent care facility but the problem still has to meet the prudent layperson definition of emergency to be covered out of network.
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