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If you are eligible and not signed up, please sign up. E-mail me if you’re getting stuck. I will see if I can help you out.
This is important to both protect yourself against getting hit by a meteor and to create actual facts on the ground instead of alternative facts as the shit show continues.
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Open Thread
Joshua James
What’s your email? I have a specific question. thanks!
David Anderson
@Joshua James: [email protected]
MomSense
We are bumping into a big concern in Maine. People are signing up on the exchange and getting a message saying that their adult and/or college attending children are being referred to Medicaid. The problem is that we are a non-expansion state so these adult children will not be covered under Medicaid. The state seems to be slow walking this process so parents are trying to find out if their kids are covered and now worried that they won’t be able to insure them once the state finally kicks them back.
The other problem is that these adult children are either paying out of pocket for physicals or having to sign up for very costly insurance at their colleges because they are still in limbo.
Ceci n est pas mon nym
I am currently covered by employer health insurance. This will change in June as I plan to restructure my work life. So what are my options? I can’t lock in anything now, can I?
FYI I’m in PA so we don’t have a state exchange, we get directed to healthcare.gov
David Anderson
@Ceci n est pas mon nym: When you lose your insurance through work you will have two options.
1) COBRA where you pay 102% of the premium of your current policy.
2) Special enrollment period on Exchange (assuming the Exchange is still operating)
If you’re under 55 and healthy, Exchange is probably cheaper for you in most circumstances even if you don’t qualify for a subsidy.
Proudgradofcatladyacademy
@Ceci n est pas mon nym: Hi. I work in HCE for UHC so I think I can answer this. For now, because with the regime it may change, You would call the Marketplace and ask for a Special Enrollment Period or SEP as you had a life change or financial change. I recommend calling in May by the 2nd week at latest because billing issues happen.
Proudgradofcatladyacademy
@David Anderson: Slow Typer on my phone! Forgot about COBRA, it’s generally so expensive I just direct people to the exchange. But it is an option that needs to be mentioned.
Proudgradofcatladyacademy
@MomSense: Once this is straightened out the children may be able to file claims for reimbursement.
J Michael Neal
I’m pissed as hell, because I just found out yesterday that the Medicaid expansion has determined that I made too much money to qualify, so I’m now shopping for a plan on the MNSure exchange. Because my employer offers a ridiculously crappy grandfathered product that somehow qualifies as insurance but does not actually act as insurance, I’m not eligible for a subsidy. And I cannot find any plan on the exchange that includes my doctor in its network; I tried calling his office to ask if they are in the network for any of the plans offered on the exchange, and the woman there says she has no idea.
I am angry beyond words.
ProudGradofCatLadyAcademy
@J Michael Neal:
What region are you from in MN? I did some work on MNsure awhile back, let me see if I can help with your network issues. You can email me.
I am home today so whenever is good.
J Michael Neal
I’m in Minneapolis. My doctor is Joseph Ofstedal at the Primary Care Clinic on Fulton St; it’s connected to the University Medical Center.
ProudGradofCatLadyAcademy
@J Michael Neal: Give me 30-45 minutes. Thank you.
ProudGradofCatLadyAcademy
@J Michael Neal: Do you know what plan you were thinking about?
J Michael Neal
No, I haven’t thought about which plan, since my main concern was finding one that my doctor was in. However, it looks like I may just squeak under the limit for Minnesota Care, since I have about $7,000 worth of expenses from publishing my novel that I can use to offset income.
ProudGradofCatLadyAcademy
Well, I plugged in some numbers at MNsure, and came up with some silver plans, and am on the phone with a contact I have in Medica right now you want me to continue?
bertinTX
I am a first-time commenter, long-time lurker, with a question about the ACA signup. I am in Texas, with a 22, soon to be 23, year old son on my employer-provided health plan (I’m a public school teacher). Should he sign up for this open enrollment?
Thoroughly Pizzled
@David Anderson: Now that’s an email address! If any of my friends need assistance, I will assure them of your expertise and helpfulness.
J Michael Neal
@ProudGradofCatLadyAcademy: Thank you, but I don’t think I need the info, since I just signed up for Minnesota Care. The funny thing is that, unless things have changed in the last 12 months, I know my doctor is covered by MNCare, as well as Medical Assistance. It’s only once I go to the private plans that the network narrows beyond him.
ProudGradofCatLadyAcademy
@J Michael Neal</
Wow, I forgot how awful actually finding a live human is on these things!
Okay, so your doctor is not in the UCare network. Sadly, Medica's Inspiration Network he is not listed, but my contact is doing a deep dive in their network and will call me back. I can call Health Partners and BluePlus next for you.
ProudGradofCatLadyAcademy
@ J Michael Neal it’s no problem, I do this a lot for people I like. Those networks can be so tricky, when I worked Behavioral, people would say “But it’s UHC insurance, why is my doctor suddenly not in Network now that we are covered by my plan at Raytheon when she was in network when we were under my husband’s awesome railroad union sponsored plan?”
It’s a tough conversation to have when the substance abuse facility just charged them OON rates and their son is getting kicked out because they can’t come up with the OON charges.
David Anderson
@bertinTX: Good question — how much is adding him to your employer plan costing you? Is he a high cost person or a typical 23 year old with the major risk to his health is bad luck and bad judgment? How much does he make?
If you’re happy with the plan that you have at work AND what it costs you, spend 5 minutes looking at HC.Gov to see if there is not an amazing deal, but don’t worry too much.
bertinTX
Given my family situation with a daughter and wife already on my plan, it looks like I should just sit tight. My premiums won’t change if I drop him from my plan. I was worried about his ability to show continuous coverage in case the ACA gets totally gutted, but his being on my plan would show continuous coverage, correct?
Ceci n est pas mon nym
@David Anderson:
@Proudgradofcatladyacademy:
Bottom line, you confirm what I suspected which is that there’s nothing to be done now, and all I can do is hope the exchanges still exist in May/June.
I’d already been budgeting for COBRA as the worst-case scenario but that’s only temporary, right? I vaguely thought it was 90 days, guess it’s time to check.
ProudGradofCatLadyAcademy
@Ceci n est pas mon nym:
18 months I believe. Dave would know more, I worked more on the Financial services side-FSAs, HSAs, and a bit in Behavioral Health for Employers and now Healthcare Exchange for eligibility. As always, I have friends on the COBRA side I can ask if you would like.
thruppence
I currently have coverage with Kaiser Permanente through Covered California but I have to move (suddenly) to Colorado. Kaiser is there too but different regions have different plans and I can’t get any Colorado phone tree to recognize my ID and I can’t get through to a human being.
workworkwork
Since the ACA saved my life last year, I re-enrolled as soon as I possibly could. My premiums went up but still not as expensive as COBRA.
Just got my annual physical today.