ACA question due to likely job loss

[bltkmt]

Unfortunately, it seems pretty likely that I am going to be out of work in the next few months and have not gone through this previously. Age 57, married with one son still in college and on our health insurance. Living in CT. I know that I will have COBRA as an option for 18 months. However, in looking on HealthSherpa.com, it seems that all of the plans available in CT are very much inferior to our current plan and not dramatically cheaper. Is that everyone's experience?

Also, I know the ACA signup deadline recently passed. However, if you lose coverage can you still sign up?

Sorry in advance for likely basic questions. I have been lucky to only have had three jobs in my career and have not been unemployed previously. This will be an adjustment.

 

[cathy63]

...However, in looking on HealthSherpa.com, it seems that all of the plans available in CT are very much inferior to our current plan and not dramatically cheaper. Is that everyone's experience?

No, everyone's experience is different. It depends heavily on the state you live in, your age, and the quality of your employer's health plan.

Also, I know the ACA signup deadline recently passed. However, if you lose coverage can you still sign up?

Yes, losing coverage is a qualifying event and you can sign up for ACA mid-year in that case. However, if you have already incurred medical expenses for the year under you employer's plan, it may be better to go with COBRA for the rest of the current year and reevaluate that decision when ACA open enrollment comes around again in the fall.

 

[Dtail]

No, everyone's experience is different. It depends heavily on the state you live in, your age, and the quality of your employer's health plan.



Yes, losing coverage is a qualifying event and you can sign up for ACA mid-year in that case. However, if you have already incurred medical expenses for the year under you employer's plan, it may be better to go with COBRA for the rest of the current year and reevaluate that decision when ACA open enrollment comes around again in the fall.

+1 on both.
Florida in general has great ACA plans in terms of doctor acceptance and low premiums.

 

[PJHawk]

For your son take a look at the College's Healthcare Plan. We may be retiring while my son is in college and between COBRA and ACA I think his college plan will be cheaper for him/us. I'm not sure if college plans support qualifying events, but you would think they would.

 

[agh1]

In my state there is nothing available on ACA that is even remotely like an employer plan. I have no PPO option. I am 61 and the ACA HMO Bronze options start at 3 times the cost of my Cobra PPO from a previous employer. The Cobra PPO was accepted everywhere and the ACA HMO has a very limited network and extreme requirements for referrals. If you state is like mine I would keep your Cobra as long as possible.

Losing your job is a qualifying event. If you decide to take Cobra you can elect to change to ACA at the next open enrollment of when your Cobra runs out.

 

[4legsgood]

If you can, accelerate tax advantaged deductions to reduce your income to qualify for a better ACA subsidy. For instance, during the partial last year I worked I had my standard deferred comp deduction increased (but of course keep below max), and it was very beneficial.

 

[jim584672]

When I quit the only plans close to coverage I had at work was the Platinum plans at very close to the price of COBRA, which wasn't cheap.

 

[orchid55]

We had a layoff at age 60 and found that indeed Cobra was both cheaper and a more comprehensive insurance plan. My husband was laid off in November so our income was already too high for a subsidy at that point. We stayed on COBRA for the full 18 months and then went to the ACA. The unsubsidized premiums are significantly more than COBRA and the coverage is much weaker (narrow network HMO versus nationwide PPO, $6500 deductible versus $500).

 

[bltkmt]

Thanks all. I guess I am screwed. Will look into getting my son onto his own plan via college.

 

[jollystomper]

...The Cobra PPO was accepted everywhere and the ACA HMO has a very limited network and extreme requirements for referrals. If you state is like mine I would keep your Cobra as long as possible...

Totally agree with this, as our youngest son had this experience. He is in college and was on our COBRA through the end of last year before COBRA retired (it was a better deal and network than college plans) Our non-COBRA retiree plan in 2020 does not cover children. He started checking with doctors in our area and his college area for ACA coverage back in September. 75% of them did not accept ACA, even if they accepted the same health carrier from private insurance (.eg. "we accept Carefirst coverage from employer or private plans but not from the ACA"). We also learned not to trust our state website, they would list doctors who would accept a policy but the doctor would say we do not, and all the state would say is "we verify they accept insurance but not specific ACA polices, who they accept is subject to change and we don't track." .

Fortunately he is young and has minimal medical needs now. But it was an eye opener that taught us that if you like your current doctors and network, try to stay on COBRA for as long as you can.

 

[ratface]

COBRA will probably be better

I am on COBRA now and it's slightly cheaper than ACA plans in Illinois but it has much lower deductibles and better access to doctors and networks. You will probably want to stay on COBRA as long as possible. The college plans for your son are a good idea, I checked into it while my daughter was in college and the coverage seemed adequate. Wish you the BEST during this difficult period for you and your family.

 

[EastWest Gal]

Totally agree with this, as our youngest son had this experience. He is in college and was on our COBRA through the end of last year before COBRA retired (it was a better deal and network than college plans) Our non-COBRA retiree plan in 2020 does not cover children. He started checking with doctors in our area and his college area for ACA coverage back in September. 75% of them did not accept ACA, even if they accepted the same health carrier from private insurance (.eg. "we accept Carefirst coverage from employer or private plans but not from the ACA"). We also learned not to trust our state website, they would list doctors who would accept a policy but the doctor would say we do not, and all the state would say is "we verify they accept insurance but not specific ACA polices, who they accept is subject to change and we don't track." .

Fortunately he is young and has minimal medical needs now. But it was an eye opener that taught us that if you like your current doctors and network, try to stay on COBRA for as long as you can.

Doctor’s who say they don’t accept the ACA plans but accept the same plan through an employer disgust me. It’s the same plan, the same company! It seems purely discriminatory to me and judge mental about the “type” of people on ACA insurance. You know, self-employed, or wealthy early retirees like us.

A couple of years ago when I was working part time, I was chatting with the mother of a patient who was worried her insurance wouldn’t cover a medication. She acted all embarrassed because she had insurance through the ACA since her job didn’t offer insurance. Through the EMR I saw that she and I were on the same plan, and I told her that. She was surprised.

 

[GTFan]

It's not the same plan strictly speaking because the ACA reimbursement rates are likely a lot lower than with group plans. Same insurance company, not the same plan IOW.

 

[athena53]

Doctors who say they don’t accept the ACA plans but accept the same plan through an employer disgust me. It’s the same plan, the same company! It seems purely discriminatory to me and judgemental about the “type” of people on ACA insurance. You know, self-employed, or wealthy early retirees like us.

Are you sure they're the same, and not plans with the same insurance company but different reimbursement rates or different networks?

 

[Bir48die]

Yes you have an option between Cobra and ACA in which a change in employment status is a qualifying event so can do at any time during the year.

In regards to your son he has the option of adding to your plan or joining a plan through the college. He certainly has all the qualifications to be on your plan at under 24 years old and full time student. You have three good options

 

[arch57]

Hi I also live in CT retired in mid-2015 and rode the Cobra ($700/month for DW and I) for 18 months so I signed up for ACA on 1/1/2017. That was $1000/month for Bronze with HSA and $5500 deductible from Connecticare. It has gone up quite a bit each year.
2018 - $1230
2019 - $1432
2020 - $1660

However for 2019 we kept our MAGI below the ACA subsidy amount ($54K) and we are getting the full premium $17,000 back on our taxes!!!
We were able to maintain our "high cost of living" by borrowing against a Home Equity Line of Credit, that resulted in interest of $1400 for 2019 and I then paid down the line in 2020 so the plan is to do that again in 2021 if ACA is still around of course.
My wife was nervous but paying $1400 in interest to get $17,000 back was quite an awesome return.

 

[FIRE'd@51]

Thanks all. I guess I am screwed. Will look into getting my son onto his own plan via college.

Will your employer allow you to switch to a high-deductible plan when/if you go on COBRA? This could allow you to keep the same doctors and give you catastrophe coverage at a significantly lower premium.

 

[Bamaman]

Thanks all. I guess I am screwed. Will look into getting my son onto his own plan via college.

It's almost enough to make a ER person enroll in a public college--in order to buy the college's healthcare insurance.

When I was in college, we often saw older students.

 

[ERhoosier]

It's not the same plan strictly speaking because the ACA reimbursement rates are likely a lot lower than with group plans. Same insurance company, not the same plan IOW.

That has been my experience.