No job yet, should one go thru Exchange

[eytonxav]

DD is not yet employed and will need coverage next year. How does the exchange handle those situations for new graduates that are unemployed or is it better to just go to the carrier directly?

 

[MichaelB]

DD is not yet employed and will need coverage next year. How does the exchange handle those situations for new graduates that are unemployed or is it better to just go to the carrier directly?

It depends on her state of residence. Is she eligible to be on your policy (age 25 or younger).

If she expects to be working next year and eligible for premium assistance or cost sharing, she should prepare and document an estimate of her expected 2014 income and then contact a navigator that works with the state exchange. They should review the projection, and once accepted and verified, authorize her for a specific policy. The income projection needs to be revisited every 90 days. If her expected 2014 income changes, at that moment is should once again be presented to the exchange navigator to determine if and how it impacts her eligibility.

 

[eytonxav]

Thanks Michael.

No, she was recently removed from my retiree coverage. We are in Texas, so have to use Federal Exchange or buy a plan directly from one of the TX providers, probably BCBS. This whole verification process seems like an administrative burden to me especially with the website issues, as I would think it would be easier if it could be settled at the time one files taxes vs guessing ones income in advance and revisiting every 90 days.

 

[MichaelB]

Just getting a policy and settling for tax credits later may be an option, but keep two things in mind. First, she may be eligible for both premium assistance and cost sharing. The only way to get cost sharing assistance is to apply upfront and verify eligibility. See more details beginning page 13 here http://www.fas.org/sgp/crs/misc/R41137.pdf
Second, to be eligible for premium assistance, even if she doesn't want the credits upfront, she needs to be enrolled in an exchange policy and have her eligibility verified by the marketplace exchange. Some insurers have an interface to the healthcare engine that can ensure verification, most notably BCBS, but not in all states. This she can verify with he insurer.

 

[eytonxav]

Good info, we'll check with BCBS on the interface

 

[donheff]

No, she was recently removed from my retiree coverage. We are in Texas, so have to use Federal Exchange or buy a plan directly from one of the TX providers, probably BCBS. This whole verification process seems like an administrative burden to me especially with the website issues, as I would think it would be easier if it could be settled at the time one files taxes vs guessing ones income in advance and revisiting every 90 days.

You said "we" must go through the exchange. Are you getting a family policy? She would then be eligible for coverage until age 26. Otherwise, I agree with MichaelB that she may be eligible for subsidies. Most new grads are not making a fortune. In any event, I would encourage helping to insure that she gets coverage one way or another - under your policy or her own. Kids feel invincible and are unlikely to incur high medical expenses but s**t happens and the results can be devastating. I paid for DS's and DD's initial policies right out of college (before the 26 coverage deal can online) because I recognized that a health catastrophe would effect my finances as well as hers. There is no way I could sit idly by a watch one of them go down the tubes because of lack of insurance. I would end up blowing my own portfolio to make sure they got good care. Better to pay for the insurance myself since I was ultimately insuring my own pocketbook.

 

[eytonxav]

Don,

No, its just a single policy for DD. I was using the term we, as like you, I would never let either of my kids go without insurance. As for my mega corp coverage, Obamacare provides an exclusion to corporations (re stay on your parents policy until 26) for their retiree coverage, as it only applies to active employees. Some corporations have allowed dependents to stay on their parents policy until age 26 anyway, but not my former megacorp. When I heard about this exclusion from the insurance admin, I double checked it with the DOL to be sure they weren't feeding me a line of BS. I guess their thinking is, if you are a retiree, you can't possibly have kids under age 26.