When can you enroll in ACA due to an upcoming QLE?

[NXR7]

I transitioned to Medicare this year.

My wife is on my previous employer's COBRA group health plan. Her 18 months of COBRA coverage as my dependent ends on Nov. 30, 2020.

She needs ACA coverage as of Dec. 1, 2020 for December 2020 (and, of course, for 2021 but that's a different enrollment period).

When can she actually enroll in ACA for a Dec. 1, 2020 start date?

All of the QLE explanations we saw talk about "losing" or "lost" group health coverage without giving any pre-loss dates.

Thanks,

Ray

 

[PaunchyPirate]

I transitioned to Medicare this year.

My wife is on my previous employer's COBRA group health plan. Her 18 months of COBRA coverage as my dependent ends on Nov. 30, 2020.

She needs ACA coverage as of Dec. 1, 2020 for December 2020 (and, of course, for 2021 but that's a different enrollment period).

When can she actually enroll in ACA for a Dec. 1, 2020 start date?

All of the QLE explanations we saw talk about "losing" or "lost" group health coverage without giving any pre-loss dates.

Thanks,

Ray

She can start the application process NOW on healthcare.gov or your state exchange if it has one. If one loses their coverage in the next 60 days, that qualifies as a Special Enrollment Period.

 

[NXR7]

Great, thanks for the quick reply!

Ray

 

[PaunchyPirate]

Don’t hesitate to call the help line people if you are unsure how to answer questions on the application. I found them very knowledgeable on how the questions needed to be answered for various situations. Good luck.

 

[Aerides]

yes, end of cobra qualifies just like end of employment insurance.

 

[NXR7]

Thanks for the quick replies. folks. We'll be checking it out today. Whew.

Ray

 

[PaunchyPirate]

I also recommend you browse the plans and prices before bothering to create an account and starting the application process. Use this link to do that.

https://www.healthcare.gov/see-plans/#/

Then, assuming you wish to start the application process, return to the healthcare.gov home page and start that process for the plan you have already decided on.

 

[aaronc879]

I would apply now. They will probably require you to send in prove of when insurance ends before your new insurance will be able to be started. I had to send in a letter from my former employer showing the date my insurance ended with them. It can take a while to go back and forth so start now. Then you get to go thru the whole thing again a month later, how fun.

 

[NXR7]

I would apply now. They will probably require you to send in prove of when insurance ends before your new insurance will be able to be started. I had to send in a letter from my former employer showing the date my insurance ended with them. It can take a while to go back and forth so start now. Then you get to go thru the whole thing again a month later, how fun.

Agreed. She has already started looking at plans however she is eligible for a stipend from the state's police and fire pension plan to help pay for pre-Medicare health care so she needs to go through their broker (AON) to get the stipend. That means she cannot apply directly. Same difference in the end.

She already sent in the stipend application form, the letter showing when her COBRA ends, and a copy of my Medicare card using certified mail. They replied with a letter saying she needs to send them a copy of my Medicare card (sigh) and something showing she has ACA coverage, which is what triggered this query.

Ray

 

[bobbyr]

HRA availability

Just wanted to mention that I didn't realize that ACA subsidy is unavailable until you exhaust all HRA resources.

So instead of possibly being subsidized for most or all of the premiums, I would be paying a minimum of $1,340 for spouse and self with very high deductable and max out of pocket. I had made some money moves this year in anticipation of keeping our income down next year so we would qualify for subsidy. Oh well.