Buying health insurance for ER

[Which Roger]

You have it right - your estimated income for ACA next year will be your anticipated income due to ER, not your reported 2013 or 2014 income. So you'll just want to extend with COBRA this year and then go on the exchange, and may have to explain why your income for 2015 is so much lower to get the subsidy.

I may be in that situation in a year or so, where income drops significantly. Assuming one has the money on hand to pay the full premiums, are there any gotchas to just letting the subsidies be denied during enrollment (instead of explaining the expected income drop), then getting a big refund at tax time?

 

[ziggy29]

Ziggy, I don't think that is correct. You can also go directly into an ACA plan for the rest of the year rather than into COBRA if you wish since by losing employer health insurance you have had a change in circumstances that allows you to enroll in ACA even if it is not the open enrollment period.

That is true if you have elected to decline COBRA during the 60 day window. But if you start taking it, my understanding is that you can't stop COBRA until the next open enrollment.

If you declined it and/or never started taking COBRA, then the loss of employer coverage *is* a qualified status change that triggers a special enrollment period. To be more clear, what I should have said was, "... merely deciding COBRA is too expensive does not trigger a special enrollment opportunity outside the open enrollment window if you are already taking it."

 

[sengsational]

Only for children under 16 I believe:
10 Essential Facts About the Affordable Care Act, Dental and Vision Benefits | BenefitsPro

Kids under 18 have free preventive dental coverage on ACA plans, in my experience.

 

[athena53]

That is true if you have elected to decline COBRA during the 60 day window. But if you start taking it, my understanding is that you can't stop COBRA until the next open enrollment.

It's so darn confusing the insurance companies and agents are still trying to work it out. I quit on 5/9, paid COBRA through 6/1 because it was the fastest/easiest thing to do till we got our bearings. Called in the insurance agent and signed up for a private plan effective 7/1. Then she told me I couldn't get coverage because I'd already elected COBRA. Then the insurance company said I COULD get coverage because I'd terminated it within 60 days. They even called the Insurance Commissioner to make sure. That turned out to be the correct answer.

 

[ziggy29]

Then she told me I couldn't get coverage because I'd already elected COBRA. Then the insurance company said I COULD get coverage because I'd terminated it within 60 days. They even called the Insurance Commissioner to make sure. That turned out to be the correct answer.

Very interesting. I knew there was a 60 day window for electing COBRA. I didn't know you could also back out within the first 60 days and have it treated as if you never elected it (i.e. lost employer coverage directly).

 

[2Muchfun]

I am going to meet some family in NY for my retirement party and my brother-in-law wants to take me to a cigar bar with him. When I apply for health insurance with the ACA, are they going to check me for smoking? I don't want to get stuck with a smoker's rate if I only had one cigar.

 

[scrabbler1]

I am glad I kept dental under COBRA when I reduced my weekly hours worked from 20 to 12 back in mid-2007 and became ineligible for my employer's group health program. Reducing my weekly hours worked, even done voluntarily, was a qualifying event which allowed me to enroll in COBRA including dental. In 2008, I had some costly dental work and had a negligible copay. My dental bills since I lost all dental coverage have been much lower thanks to the dental work I had done in 2008.

 

[pb4uski]

I am going to meet some family in NY for my retirement party and my brother-in-law wants to take me to a cigar bar with him. When I apply for health insurance with the ACA, are they going to check me for smoking? I don't want to get stuck with a smoker's rate if I only had one cigar.

To my knowledge it is self reported and they don't actually test. Not even sure if they differentiate between smokers and non-smokers for HI anymore - I know my state doesn't ask about it. Anyway, after a couple days I wouldn't think that one cigar would register even if they did test you. YMMV.

 

[sengsational]

I am going to meet some family in NY for my retirement party and my brother-in-law wants to take me to a cigar bar with him. When I apply for health insurance with the ACA, are they going to check me for smoking? I don't want to get stuck with a smoker's rate if I only had one cigar.

As long as you're "clean" for 5 days, you wouldn't test positive. That is, unless they take a hair sample. In that case, you're looking at 90 days.