insurance advice with pre-existing condition after election

[Global1]

Is your nestegg in 401k accounts that are governed by ERISA? If so then they are likely off limits to nearly all creditors (under current Federal law). An Asset Protection attorney could give you further details.

-gauss

gauss - Most of my next egg is in after tax accounts so, I believe, that my assets would not be protected.

Bamsphd, I stand corrected. I went back to my old emails I was not declined because of pre-existing condition a year ago - It was late 2013 (we have been dealing with health issue for a long time, unfortunately).

 

[mpeirce]

What he said during one of the debates (CNN one in Texas):

TRUMP: I agree with that 100% [repeal and replace Obamacare, which Rubio had just said], except pre-existing conditions, I would absolutely get rid of ObamaCare. I want to keep pre-existing conditions. It's a modern age, and I think we have to have it.

So yes, expect Obamacare to be repealed and replaced with new legislation. And that something will certainly include some provision for pre-existing conditions. Details to follow.

 

[ziggy29]

Perhaps ACA individual policies are required to be issued only if you don't have access to employer sponsored health insurance (such as Cobra)?

I'm virtually certain anyone can purchase an individual plan on the exchange. BUT if you have access to employer group coverage that costs you less than 9.5% of your income, you are not eligible for subsidies.

 

[Another Reader]

There is a thread here for a more general discussion on healthcare insurance. Once again, please limit comments here to the OP specific issue.

The OP is almost certainly safe through the end of 2017. In the OP's shoes, I would assume that in making my decision. I would also assume that some significant changes might occur for 2018 but I would know about them by Fall 2017 and could react at that time.

 

[pb4uski]

....My assumption is that this would eliminate my ability to get insurance given the pre-existing condition. ...

I would re-examine that assumption. Speaker Ryan's proposal, which any Trump repeal and replace action would likely be based on since it needs to clear both the House and the Senate, allows pre-existing conditions, which are very popular so are likely to be retained.

No American should ever be denied coverage or face a coverage exclusion on the basis of a pre-existing condition. Our plan ensures every American, healthy or sick, will have the comfort of knowing they can never
be denied a plan from a health insurer.

Our plan also proposes a new patient protection for those Americans who maintain continuous coverage. Already in place for the employer market, this protection would apply to those in the individual market as well.
This is how it works: If an individual experiences a qualifying life event, he or she would not be charged more than standard rates – even if he or she is dealing with a serious medical issue.

This new safeguard applies to everyone who remains enrolled in a health insurance plan, whether the individual is switching from employer-based health care to the individual market, or within the individual market.

This provision is modeled after a 1996 law – the Health Insurance Portability and Accountability Act, commonly known as HIPAA – that offers pre-existing condition protections when patients move from one job to another. In other words, without this protection even those individuals who maintained continuous coverage in the group market were not rewarded and were rated by insurers each time they enrolled in a new plan. This often resulted in an increase in premium costs for individuals and families. Extending these protections to the individual market is a simple but important reform that will encourage Americans to enroll in coverage and stay enrolled.

http://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf

 

[MichaelB]

All this speculation on the ACA is unhelpful to the OP, who is asking about a decision to extend cobra through 5/17 or sign up for an exchange plan on 1/17.

I have no crystal ball, but it seems pretty unlikely to me that the 2017 individual policies will be cancelled mid year. I would also be concerned about having to meet two different deductibles - first the cobra, then the individual policy, which might happen with a 5/17 change. Unless the cobra policy has a much lower price, I'd go with an individual policy 1/1/17. Open enrollment has begun, so you cannot be denied.

 

[pb4uski]

... BUT if you have access to employer group coverage that costs you less than 9.5% of your income, you are not eligible for subsidies.

I think this is true only if you are an active employee... but not if you are a former employee but can buy coverage under COBRA. IOW, a former employee who is eligible for COBRA coverage can opt for ACA and still get subsidies if they otherwise qualify for subsidies even if their COBRA cost is less than 9.5% of their income.

 

[bmcgonig]

No, you just negotiate a payment plan. Or declare bankruptcy. I understand you do not want to risk your nest egg, no one does. (skip political banter).

No one was ever denied healthcare pre ACA, or during ACA, and no one will after ACA. It may look different. It may cost different. It may be more complex, or more simple. Maybe we will all be able to get on the federal healthcare plan.

Rest assured, there are more important things to worry about, like preparing for zombies..

I don't think that's correct. Maybe not denied emergency care but the ER is not obliged to help you with chemotherapy. Just last month I had a small surgery for a cancer spot and they demanded my coinsurance up front. I'm sure any doctor or hospital can do the same for any non emergency procedure.

 

[ziggy29]

I think this is true only if you are an active employee... but not if you are a former employee but can buy coverage under COBRA. IOW, a former employee who is eligible for COBRA coverage can opt for ACA and still get subsidies if they otherwise qualify for subsidies even if their COBRA cost is less than 9.5% of their income.

But the real point is that they can *get* an individual plan which can not have preexisting condition exclusions. Access to COBRA doesn't change that. Even access to employer group health insurance doesn't change that.

 

[pullmyfinger]

I have no crystal ball, but it seems pretty unlikely to me that the 2017 individual policies will be cancelled mid year. I would also be concerned about having to meet two different deductibles - first the cobra, then the individual policy, which might happen with a 5/17 change. Unless the cobra policy has a much lower price, I'd go with an individual policy 1/1/17. Open enrollment has begun, so you cannot be denied.

I would recommend this plan as well. I would also try to get any needed care before the end of the year while on the cobra plan because it will likely have better coverage. So stockpile meds, if appropriate.

 

[ziggy29]

I have no crystal ball, but it seems pretty unlikely to me that the 2017 individual policies will be cancelled mid year. I would also be concerned about having to meet two different deductibles - first the cobra, then the individual policy, which might happen with a 5/17 change. Unless the cobra policy has a much lower price, I'd go with an individual policy 1/1/17. Open enrollment has begun, so you cannot be denied.

Agreed. I find it *extremely* unlikely that any significant health care legislation to modify (or repeal/replace) the ACA would take effect before 1/1/2018. You never say never, but the new government won't even be in place until after 2017 has started and changing the rules midyear would be a headache for everyone.

 

[Global1]

All this speculation on the ACA is unhelpful to the OP, who is asking about a decision to extend cobra through 5/17 or sign up for an exchange plan on 1/17.

I have no crystal ball, but it seems pretty unlikely to me that the 2017 individual policies will be cancelled mid year. I would also be concerned about having to meet two different deductibles - first the cobra, then the individual policy, which might happen with a 5/17 change. Unless the cobra policy has a much lower price, I'd go with an individual policy 1/1/17. Open enrollment has begun, so you cannot be denied.

That is a great point. Insurance under cobra will cost me about $700 less per month so it may make sense to use cobra through the end (4/2017) and then start up the more expensive ACA insurance in 5/2017. This brings up 2 risks:

1. There will be a major health issue in the first 4 months meaning I have to pay a large deductible. At this point I do not think that is likely.

2. There will be some change in ACA that makes insurance hard for me to get. Again, given the discussions in this thread, this is also unlikely.

So do you agree that the best path forward would be to keep on cobra until is ends in 4/2017 and then switch to ACA insurance? Thanks again for all the advice!

 

[broadway]

So do you agree that the best path forward would be to keep on cobra until is ends in 4/2017 and then switch to ACA insurance? Thanks again for all the advice!

It depends on the deductible.

$700 x 4 = $2800 in savings.

What is your new deductible once you go on ACA insurance?

 

[John Galt III]

I would be uninsurable at any reasonable price due to pre existing conditions. This situation is very unsettling.

Jim, aren't you on Medicaid? Even if they repeal Obamacare, wouldn't you still be able to use Medicaid? Is there an Obamacare version of Medicaid that has different eligibility rules from your state's version of Medicaid?

 

[Bamaman]

What he said during one of the debates (CNN one in Texas):

So yes, expect Obamacare to be repealed and replaced with new legislation. And that something will certainly include some provision for pre-existing conditions. Details to follow.

The ACA and healthcare in general is a very, very complicated issue. There may be something coming down the line, but coming up with the cure for the programs is going to take quite sometime.

Go with your Option #1 and take a Gold Plan.

 

[Droo]

There are rules about signing up on the ACA exchanges mid-year, you have to have a qualifying life event. You should check to make sure that COBRA expiring counts, I don't remember ever reading exactly that (although it might just fall under losing workplace coverage).

If I were in your shoes I would probably switch over to a new full year plan in January, and maybe start poking around the job market just in case I came across a less-than-full-time dream job that offered family insurance as a benefit.

I am surprised people are so confident that the pre-existing condition exemption will stay. It makes for a very complicated market because of the ability to game the system, and the political party that has been voting, stumping, and essentially turned into one giant blinking neon sign to repeal the ACA for the last 4 years just took over the entire government. I would be very worried if I relied on it for health insurance.

 

[donheff]

All this speculation on the ACA is unhelpful to the OP, who is asking about a decision to extend cobra through 5/17 or sign up for an exchange plan on 1/17.

I have no crystal ball, but it seems pretty unlikely to me that the 2017 individual policies will be cancelled mid year. I would also be concerned about having to meet two different deductibles - first the cobra, then the individual policy, which might happen with a 5/17 change. Unless the cobra policy has a much lower price, I'd go with an individual policy 1/1/17. Open enrollment has begun, so you cannot be denied.

This is what I would do also. It seems like the worst a replacement system would do re pre-existing conditions is penalize people who let their insurance lapse. As long as you hold a policy you will likely be able to keep it or be able to move to another if your current policy gets changed/cancelled.

 

[eytonxav]

I can't imagine a flash cut away from ACA during the plan year. I also suspect that any ACA replacement scheme may have to include a solution for pre-existing conditions.

 

[ratface]

Unsettling times for sure

I feel as many of you do here. Having a pre-existing cancer diagnosis from 2009 and relying on ACA for my family's health insurance. I also dread the idea of going back to work in any capacity. I bought a policy yesterday on the exchange for myself, wife and daughter for 2017. Many of the comments here are reassuring and I appreciate the perspectives offered and always learn so much here. I agree that you must insure for 2017 and postpone any decisions until the year unfolds. Just wanted to let you know that you are not alone and many here will be waiting and watching. All the best to you in 2017.

 

[Global1]

Thanks to everyone for all of the comments and support. It is much appreciated. After all of the input I will likely just switch at the end of this year to ACA insurance. Waiting until 5/2017 may save me a few dollars but I'd rather avoid the stress of the unknown.

 

[Walt34]

It seems that the OP has his questions answered. Thanks to all for the interesting discussion.