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Are You Still Waiting to Apply to PPACA ?
Old 11-19-2013, 07:49 AM   #1
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Are You Still Waiting to Apply to PPACA ?

I'm still waiting. I found an insurance company that was able to tell me over the phone what my cost sharing (deductible, copays, coinsurance) would be, given my subsidy percentage, for each of their silver plans, which was a big help.

I'm still waiting, so that more bugs can be fixed on healthcare.gov. But the December 15, 2013 deadline is approaching. I might apply this week.

Anyone else still waiting?
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Old 11-19-2013, 08:39 AM   #2
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I tried filling out an application on healthcare.gov so I could see that various plans available for my family.

Currently healthcare.gov still shows as "in progress". I've resubmitted the info a couple of times, but that doesn't seem to help.

ehealthinsurance.com did work for showing me some available plans for my family. It also had a nice feature showing pre/post ACA plans for comparison. Something healthcare.gov certainly doesn't provide. This was quite an eye opener.

Luckily, here in Ohio Anthem/BCBS extended an offered to folks to "extend" their existing plans through next year by restarting the plan clock in December so that the plans remain legal through next November. This was before the President's press conference.

We did this and already have our new insurance cards. Everything is in place, And we don't have to worry about not being covered by health insurance because of the ACA.

So now I don't really care so much about getting healthcare.gov to work for me, at least not until the end of next year.
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Old 11-19-2013, 09:06 AM   #3
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I don't need the PPACA, but Frank does and he is still waiting. We are not married and he has insurance from his former employer but at a very high cost. He was hoping to get a PPACA policy, which with the subsidy would be less expensive for him.

Since healthcare.gov is not fixed yet to his satisfaction, he may just stay with his present policy for 2014. He is especially appalled by the website's potential security problems.
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Old 11-19-2013, 10:04 AM   #4
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I'm still waiting. I expect to sign up during the next 2 weeks on my state exchange. I haven't fully decided which plan I want.
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Old 11-19-2013, 11:38 AM   #5
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I'm waiting for the feds to release the form to apply for an exemption from the penalty (aka the individual shared responsibility payment) based on coverage being unaffordable (premiums of the lowest plan available exceeding 8% of O-MAGI).

Once I have the exemption in hand I can then buy catastrophic coverage for 2014 which will save us $250 a month compared to the cheapest plan available. Our net cost will be ~$50/month more than if we reduced our income to just below 400% FPL to qualify for subsidies but we will have much more latitude to do 0% LTCG and Roth conversions.

Meanwhile, my current plan at its current premium will extend to the end of March.
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Old 11-19-2013, 11:53 AM   #6
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I'm waiting for the feds to release the form to apply for an exemption from the penalty (aka the individual shared responsibility payment) based on coverage being unaffordable (premiums of the lowest plan available exceeding 8% of O-MAGI).

Once I have the exemption in hand I can then buy catastrophic coverage for 2014 which will save us $250 a month compared to the cheapest plan available. Our net cost will be ~$50/month more than if we reduced our income to just below 400% FPL to qualify for subsidies but we will have much more latitude to do 0% LTCG and Roth conversions.

Meanwhile, my current plan at its current premium will extend to the end of March.
What is 8% of your lowest Bronze in terms of FPL? Mine would be far under 400%, I think. I thought that you had to be less than 250% FPL to qualify for that catastrophic plan.

I'm waiting until January or maybe February, depending on when I part ways. Maybe by then the path will be trod enough to make it easy for me to pass.
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Old 11-19-2013, 01:21 PM   #7
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The lowest bronze plan for a couple in my state is ~$675/month.

($675 * 12)/8% = 101,250 which ~ 650% FPL I think

I plan to manage my income to ~$90k so the lowest bronze plan would be ~9% of our O-MAGI
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Old 11-19-2013, 01:29 PM   #8
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SO, is anyone worried about this program folding?? We were set to register (we are in mid-50's and on DH retirement medical plan) but once we leave that, we cannot come back. So if this federal plan would fail, then we fear costs could skyrocket with DH preexisting conditions. His current plan costs us more than the 9.5% for his premium, so we do qualify to switch, and even without the subsidy would save several thousand a year.... what to do, what to do....
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Old 11-19-2013, 01:40 PM   #9
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SO, is anyone worried about this program folding?? We were set to register (we are in mid-50's and on DH retirement medical plan) but once we leave that, we cannot come back. So if this federal plan would fail, then we fear costs could skyrocket with DH preexisting conditions. His current plan costs us more than the 9.5% for his premium, so we do qualify to switch, and even without the subsidy would save several thousand a year.... what to do, what to do....
I could be wrong, but I strongly doubt underwriting and preexisting condition exclusions are going to make a comeback. Things may change in the future about PPACA, but I doubt these will be among them.
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Old 11-19-2013, 01:47 PM   #10
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I'm waiting for the feds to release the form to apply for an exemption from the penalty (aka the individual shared responsibility payment) based on coverage being unaffordable (premiums of the lowest plan available exceeding 8% of O-MAGI).
I don't think there is a form for it. There should be an application for it on the exchange when you input your info or claim it at tax time, per this FAQ

https://www.healthcare.gov/exemptions/
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Old 11-19-2013, 02:35 PM   #11
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Originally Posted by bizlady View Post
SO, is anyone worried about this program folding?? We were set to register (we are in mid-50's and on DH retirement medical plan) but once we leave that, we cannot come back. So if this federal plan would fail, then we fear costs could skyrocket with DH preexisting conditions. His current plan costs us more than the 9.5% for his premium, so we do qualify to switch, and even without the subsidy would save several thousand a year.... what to do, what to do....
I don't see how it can retroactively switch back to underwriting if you are already on a plan. And even if you are not - I doubt underwriting can come back into the picture.

Insurance prices may continue to go up..........

Insurance companies could choose to limit networks for individual insurance plans.

But these last two - probably would happen whether or not you signed up for an ACA compliant plan or kept your old, grandfathered non-compliant plan.

I have no choice - I had to start a new plan. DH is switching because it's cheaper. We're not sticking with his old plan, because I don't see how he is somehow still "covered for pre-existing conditions" by sticking with his old plan.
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Old 11-19-2013, 02:47 PM   #12
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Other components of health insurance reform already implemented and fully functional, difficult to walk back.

Essential health benefits
Coverage of preventive services and wellness programs for Medicare
Elimination of lifetime limits
Expanded dependent coverage
Expanded coverage for Medicaid
Benefit tiers
Medical Loss ratio requirement
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Old 11-19-2013, 03:33 PM   #13
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I don't see how it can retroactively switch back to underwriting if you are already on a plan. And even if you are not - I doubt underwriting can come back into the picture.

Insurance prices may continue to go up..........

Insurance companies could choose to limit networks for individual insurance plans.

But these last two - probably would happen whether or not you signed up for an ACA compliant plan or kept your old, grandfathered non-compliant plan.

I have no choice - I had to start a new plan. DH is switching because it's cheaper. We're not sticking with his old plan, because I don't see how he is somehow still "covered for pre-existing conditions" by sticking with his old plan.
Note that limited networks are also coming in part to some employeer plans such as CalPers for some proceedures. They discovered that the price for joint replacement varies by a factor of three depending on where it is done. So they decided that they would pay no more than an amount that would cover about 60% of the places. You may go elsewhere but you pay the difference, this is called reference pricing. Also Wal-Mart has contracted with a few hospitals for some non-emergency proceedures, and pays the contracted amount. In the case of CalPers, they pay travel for the patient and a companion as well. Kroger is doing the same thing to pick imaging centers.
I do expect this to continue with the high cost places being eased out of networks, in particular when their quality measures are no better than lower cost places.
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Old 11-19-2013, 03:41 PM   #14
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I don't think there is a form for it. There should be an application for it on the exchange when you input your info or claim it at tax time, per this FAQ

https://www.healthcare.gov/exemptions/
I'm told there is going to be a form. The rub for me is that my state has its own website and is not part of the federal site, so if I try to input my info the first question it asks me is what state I am from and once I put that in the federal website refers me to my state's website. OTOH, my state's website wants me to have the federal exemption before they will sell me a catastrophic policy (even though I clearly will qualify).

I have been corresponding by email with a nice woman at the state website who understands the situation and has been helpful.

I think my situation is a nuance that for some stupid reason they did not consider.

IMO both the state and federal systems would have been much better if they had been designed as dumb systems (like the way we do tax returns) rather than trying to verify everything on the fly. IOW have people apply and provide their info under penalties or perjury and then verify the information once it has been received and slam those who provide false information. While verification on the fly would have been nice, sometime you need to walk before you run.
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Old 11-20-2013, 02:48 PM   #15
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I applied today and got my eligibility statement telling me my tax credit amount, and also that my number for the cost sharing subsidy is "06" which I believe means I will be getting a considerable cost sharing subsidy.
There were a lot of questions about my 2013 income I thought could derail me in many ways, but it appears they only used my 2014 income estimate to calculate my tax credits and cost sharing.
Woo Hoo! Time for a break. Enrollment later.
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Old 11-27-2013, 11:18 AM   #16
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I just signed up for a "pre-ACA" underwritten policy that is effective on December 1, 2013 for a one year period. I don't actually leave service until the 20th of December, so I have to pay for a little overlap with my employer provided insurance, but I am OK with that. I think the monthly premium will save me a couple of hundred per month from what I was looking at under the bronzest ACA plan.

To be honest, I was surprised I could still get a policy like this, but apparently I just snuck in under the wire.
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Old 11-27-2013, 12:16 PM   #17
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We signed up this weekend. We aren't eligible for a subsidy, but we will still save about $5K per year on the bronze plan. The deductible is $5K higher, but barring some calamity, we are unlikely to meet that at this point. I can think of a lot of fun things to do with $5K. I tried to talk DH into the bronze-HSA plan, but he was concerned about the management fees since we are dedicated Vanguard indexers.

We've been able to shop since July and the choices were a little confusing, it sure is easier when HR just tells you what you get! Our doctors, whom we don't particularly care about keeping, were on every plan but the one we were dropping. Go figure.
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Old 11-27-2013, 12:43 PM   #18
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We signed up this weekend. We aren't eligible for a subsidy, but we will still save about $5K per year on the bronze plan. The deductible is $5K higher, but barring some calamity, we are unlikely to meet that at this point. I can think of a lot of fun things to do with $5K. I tried to talk DH into the bronze-HSA plan, but he was concerned about the management fees since we are dedicated Vanguard indexers.

We've been able to shop since July and the choices were a little confusing, it sure is easier when HR just tells you what you get! Our doctors, whom we don't particularly care about keeping, were on every plan but the one we were dropping. Go figure.
If your plan qualifies you for an HSA, you aren't obligated to use the HSA provided by the company. You can open one on your own if it's better in terms of expenses. Sometimes companies cover some of those account expenses.

And in future, HSA account funds can be moved to another account. You aren't stuck with one HSA administrator forever.

The tax savings probably way exceed any management fees, so don't let that discourage you.
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