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I would like to answer your question. However, I would strongly suggest that you moderate your tone and not thoughtlessly criticize concepts which you do not understand.
If one could purchase insurance at any time of the year, there would be a huge incentive for people to buy it only when they get sick. However, having a stable and affordable insurance pool requires that a majority of enrollees be relatively healthy. That is why people are generally only allowed to enroll once a year.
With respect to government requirements, they don't just make these standards up for the hell of it. These standards exist to protect consumers and ensure that people have comprehensive coverage. You say you don't care about whether your coverage meets any government standards, but I'm pretty sure you would definitely care when you go to use your bargain-basement unregulated insurance plan and find out that it covers basically nothing.
Anyways, tell me, what is your recent coverage history? Are you transitioning from other coverage, or were you uninsured? Also, what state do you live in? This will determine what your next move will be. If you just recently lost your insurance, you may still be eligible to sign up through a "special enrollment period". And, depending on what state you live in and how much money you make, you may be eligible for government-funded health insurance (Medicaid).
Addendum: Also, I know this is a place for answering people's insurance questions, but you should really think about using Google. It took me less than 5 seconds to find the relevant page on healthcare.gov.
https://www.healthcare.gov/coverage-outside-open-enrollment/your-options/
Here's a little info:
https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant/
It states that pregnancy is an essential health benefit and has to be covered by qualified health plans. However, if you have an individual plan that's been grandfathered or your employer health plan is 100% self-funded they would be allowed to exclude pregnancy coverage but shouldn't be allowed to exclude pregnancy because of how you became pregnant. It would have to be a complete exclusion.
Maybe this will help guide some research but without reading your actual policy I can't give much more info.
Pregnancy generally is not considered as a pre-existing condition. Link
Her parents insurance should cover her if she is insured through them.
Getting married is a valid life status change event and would allow her to enroll in her employers health insurance should she choose to do so.
Call the providers and find out for sure as I'm not sure where you are located.
Marketplace insurance is interested in the income of your tax household. If you file your own taxes and you're unmarried with no dependents, they're only interested in your income. However, any cash support you get from your parents has to be included as part of your income. Here is the healthcare.gov article on this question:
https://www.healthcare.gov/income-and-household-information/how-to-report/
If the limited facts you present (living in Indiana and income of around $14,400/year, are correct then she qualifies for Indiana's expanded medicaid program at no cost. Because of this she would not qualify for any discounts on private insurance plans through the Obamacare network which is why her premiums have been so high. She needs to confirm her eligibility for Medicaid and switch to that ASAP.
She has two days to sign up for January 1 insurance changes as the deadline is December 15. If she can not understand the system herself she needs to get into an office ASAP or call the phone number on the www.healthcare.gov websige and they'll walk her through it. If she misses that deadline she still needs to get her application and paperwork in ASAP to meet the deadline for Feb 1 enrollment as the open enrollment period extends for an additional month or two.
She sounds confused. The ACA has a open enrollment period from November - January, but losing your job is a qualifying life event that triggers a special enrollment period. Tell her to go to healthcare.gov
>Special Enrollment Period A time outside of the open enrollment period during which you and your family have a right to sign up for health coverage. In the Marketplace, you qualify for a special enrollment period 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. Job-based plans must provide a special enrollment period of 30 days.
For the first year.
Then it goes up. By year 2, it's $325 or 2% of your income, whichever is higher. PLUS you get to deal with your own medical expenses.
https://www.healthcare.gov/coverage/birth-control-benefits/
>Plans in the Health Insurance Marketplace must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.
>These plans must cover the services without charging a copayment or coinsurance when they’re provided by an in-network provider. This is true even if you haven’t met your deductible.
If the insurance that your employer offers meets minimum standards for affordability and coverage, you are not eligible for tax subsidies. Most employer offered plans do meet these minimum standards. If you're not sure, you should ask your employer to fill out this Employer Coverage Tool: https://www.healthcare.gov/downloads/employer-coverage-tool.pdf
Going to healthcare.gov will lead you to your state exchange if there is a state exchange. Looks like you're in Washington, which does have their own exchange. https://www.wahealthplanfinder.org/ You will receive a subsidy through Washington's site.
However, unless you had a qualifying life event, you will not be able to purchase subsidized health insurance until the next open enrollment period which begins November 1, 2015, for coverage starting January 1, 2016.
You aren't fined if the cheapest insurance available to you costs more than 8% of your income or you should have qualified for Medicaid but aren't in an expansion state-- you can claim the exemption on your tax return next year. Info here.
Apply for Obamacare anyway. Losing your current insurance is what's called a "qualifying event" and you will be eligible to apply for insurance outside the open enrollment period.
https://www.healthcare.gov/how-can-i-get-coverage-outside-of-open-enrollment/#part=2
What that, interested in the history of insurance? Boy have i got a treat for you.
Hmm...
I'm assuming you're contracted with federal/state/local government, or as a subcontractor to a firm that is contracted with one? B/c private firms don't ordinarily have such a requirement for their subcontractors.
I'm really suspicious of that 'mandated coverage' they're offering - it's as if they're trying to make money off it independently of the work you're doing for them.
Can you provide an insurer name/policy name/whatever the materials they've given you describing the coverage call it?
Plus your age (no need to get too detailed; 'age within 5 year increments' would be fine. I'm 10-15 myself .... kidding!
That will help figure out this policy a bit more.
Meanwhile, have you visited healthcare.gov to see if you might be eligible for a special enrollment period? If so great, you may have options that are more affordable and/or cover treatments you seek.
If not, you'll have an enrollment opportunity in November, but it won't take effect until January.
FYI sometimes there are other options for health care on weekends that are usually cheaper (like the CVS minute clinics) for things like sinus infections.
I totally understand being in pain and going with what you knew as an option. I'd just be careful to check how the ER bill comes out, because the insurance can deny the claim after the fact.
This is what WebMD about preparing for emergency room visits: https://www.webmd.com/health-insurance/insurance-tips-for-er
I am currently in a similar situation. Here is what I know so far (or at least think I know):
- One day of insurance of one month counts as the whole month
- Her current coverage ends December 1 so she gets credit for all of December
- Her future coverage started on March 4 so she gets credit for all of March
- To my knowledge, the penalty starts after 3 months
- If I am doing my math correctly, she will only have a gap for 2 months and will avoid the penalty
- Better depends on your risk tolerance
- Example, one major health need will largely offset the 2 months of not paying for Cobra or cheaper option
- My Cobra option was too expensive
- I am currently searching here for cheaper insurance and encourage you to do the same
I don't know what state you are in, but...
If you earn over 400% of the FPL (so are eligible for no discount whatsoever) you may also want to contact a local independent broker to see if buying outside of the marketplace gets you better coverage at the same price point. They can also sell marketplace plans, so this isn't any more work for you.
Note that plans outside of the marketplace are only available in some states and that you must make sure that the summary of benefits confirms that the plan qualifies as minimum essential coverage. You will be medically underwritten, so if you have lots of pre-existing conditions this may not work out better than the marketplace.
Details are at https://www.healthcare.gov/private-plan-exceptions-outside-open-enrollment/
If you do choose a high deductible plan, make sure you can
- Actually afford the deductible (have at least that much in your HSA) and
- Could actually afford the out-of-pocket max if it comes to it.
A plan where you can't afford either may be a poor choice.
Assuming the other driver is at fault (not sure about the rules in Alabama):
a) I believe this is one for the health insurance professionals; but any services provided after August 1 would not be covered by your fiancees health insurance.
b) Marriage is a qualifying life event so you would be able to add your fiance to your health insurance (note that there may also be increased premiums for you). But losing one's job (even voluntarily) should be a qualifying life event for your fiance to be able to obtain her own health insurance through the exchange.
c) If the at fault driver has sufficient bodily injury limits on his/her insurance policy, you should absolutely bill it to the insurance of the at fault driver (but then you'd have to work with their adjuster). Note that your fiancee's health insurance policy is absolutely going to be billing everything back to the insurance of the at fault driver. If limits are insufficient, you can then go after the driver directly (assuming there are assets to be taken). If limits are insufficient - there's a reason that most insurance professionals would insist on uninsured/underinsured motorists bodily injury coverage.
Here are some good high level rankings by consumer reports: http://www.consumerreports.org/cro/homeowners-insurance/buying-guide
Usually pretty spot on.
You can also check AM Best and JD Power ratings.
See https://www.healthcare.gov/have-job-based-coverage/if-you-lose-job-based-coverage/
tl;dr: No, COBRA is not your only option, you can also purchase a plan from the Marketplace.
Also: Often, follow-up appointments and post-surgical consultations are generally covered under the initial surgery fee and copay; ask your surgeon about that one.
The individual maximum out of pocket expense should not be $9,700 if this is a marketplace plan. $6,850 is the maximum for an individual for a marketplace plan in 2016. You are responsible for the individual deductible and individual maximum out of pocket expense. The deductible counts towards the maximum out of pocket.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
I would suggest that you use medicaid. I'm not trying to downplay your concerns, I think they're legitimate. However as someone who has used the medicaid system for my own children. I think you will be fine if you make sure you are comfortable with your dr and go to a different one if you aren't. Many good dr's accept medicaid.
When I say marketplace I mean Healthcare.gov. This is the place for your girlfriend to go for her coverage. Any other website is just going to be a middleman. All the major insurance providers will be on Healthcare.gov. This is also the only way for you to get a subsidy on an individual health plan.
Edit: as long as there is a qualifying event (losing her job-provided insurance should qualify) the plans on Healthcare.gov cannot disqualify her. as SabrinaFaire said plans sold off of Healthcare.gov operate under different rules. Applying here will also get the ball rolling on medicaid if she qualifies.
you kind of have it backwards. you must be insured for 10 of the 12 months in a aca compliant plan to avoid the penalty.
https://www.healthcare.gov/health-coverage-exemptions/exemptions-from-the-fee/
Copays apply to out-of-pocket maximums on all ACA-compliant plans, so your statement is incorrect.
Here's a link that discusses this.
https://www.healthcare.gov/health-care-law-protections/pre-existing-conditions/
>Health insurance companies can't refuse to cover you or charge you more just because you have a pre-existing condition. They also can’t charge women more than men.
>Your insurance company can't turn you down or charge you more because of your pre-existing health or medical condition like asthma, back pain, diabetes, or cancer. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition.
See also the info on Grandfathered Plans: https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/
It's possible the company is offering one of these, but they have to be upfront about it, and they still have to cover all pre-existing conditions.
Hmmm. I'm assuming you'll be on your own for income tax purposes too.
What about your: age, general health status, whether dependent coverage is an issue for you?
Why not start with healthcare.gov and size up exchange coverage options that may be available to you? Even if that turns out not to be your best option, it will give you ideas about plan designs, their relative premium costs, and premium subsidies you may qualify for.
EDIT: I should mention that I'm not a fan of student health policies at all, for reasons I won't bore you about (mostly their generally low value for premium paid, and the shenanigans some schools pull apparently in an attempt to turn student health insurance into a profit center...). That said, The plan design of the policy you've posted links to doesn't look too bad - maybe more coverage than you need, if you're pretty healthy - and such a policy may be just the thing for you. What's its premium cost (sorry in advance if it was provided in a page of the stuff you linked to - I didn't see it and am too lazy to revisit right now...).
Fully licensed guy here in the US of A.
The best rule of thumb I can give you is the same one the government uses. If your health insurance through work costs more than 9.5% of your income then it costs too much and you should use https://www.healthcare.gov/see-plans/ to see what fits. All things being equal I recommend a "Silver" plan. It has the best bang for the buck because the government subsidizes that one the most when it comes to deductibles.
As far as Cobra is concerned you don't need to worry about it. You use Cobra because you've lost group coverage. Use to be a big deal, but today if you lose group coverage as long as you sign up through the Affordable Care Act within 60 days of losing coverage you're automatically accepted with all the subsidies.
Aetna doesn't care jack all about you as far as pricing goes.
State specific vs. National is for non-emergency situations. Found a weird lump and you go to an out of network doctor? You'll have some fees. Have a weird lump that suddenly appears and explodes blood so you rush to the emergency room? Covered no matter where you are. So you have to ask yourself how important is it that you have a doctor you can go to check for lumps always nearby?
In the end I'll tell you the same I tell other people. Find a licensed independent broker in your area (best way is to ask friends and families who they trust) because they'll know the ins and outs of your area's specific carriers and will be able to give you face to face advice.
Good Luck with this all!
I apologize I should have asked if she was a citizen as well.
First if she is not I would contact an immigration lawyer who can get you set up. Shouldn't be expensive. Than I would visit Illinois's state exchange: https://getcovered.illinois.gov/en
You will be able to sign up for health insurance there pretty quick. Moving to the states should be a qualifying event. https://www.healthcare.gov/glossary/qualifying-life-event/
I am not 100% sure how it will work if she is not a citizen, but a change of address should give you the ability to sign up for coverage outside of open enrollment. Plus with the ACA abolishing preexisting conditions, if she gets on a plan they will cover the pregnancy.
Hope everything works out.
Actually it may be an option, “Individual with Non-immigrant Status, includes worker visas (such as H1, H-2A, H-2B), student visas, U-visa, T-visa, and other visas, and citizens of Micronesia, the Marshall Islands, and Palau” are eligible to purchase through the marketplace. https://www.healthcare.gov/immigrants/immigration-status/
So it’s worth looking into especially if you work for a smaller company, but your school or employer may have a cheaper option.
It's based on household income. Ugh, yeah, if you can get it through you or your husband's employer, that disqualifies you for a lot of assistance, although you can still buy individual plans on the exchange without the subsidies. Can you get it through your employer? Employer's are required to pay 50% of premiums for individuals and 33% of premiums for families, and it has to be "(affordable)[https://www.healthcare.gov/glossary/affordable-coverage/]", meaning an individual plan can't cost you more out of pocket than 9.69% of your household income. This is usually the most affordable option.
It's expensive everywhere. Good luck.
Qualifying Life Events are the same for pretty much all insurance nationwide. If you have one of these, you're definitely allowed a special enrollment period to buy new insurance. A list of events and more information can be found here
I'm actually not sure what makes open enrollment periods on employer group health insurance a thing, but they're definitely not easy to get around without a qualifying life event. I can't speak to the legality of your employer giving you wrong information.
I believe that insurance obtained through the ACA exchange/marketplace is only available if you don't have work insurance available or if the work insurance would cost you an amount in excess of a certain percentage of your household income. And you are supposed to update the ACA if the facts change during the year.
There is nothing in federal law that prevents a health insurer from selling anyone health insurance. The only restrictions are on subsidised sales through the marketplace. It is up to insurers whether they want to sell outside of the marketplace.
Details are avaliable at https://www.healthcare.gov/private-plan-exceptions-outside-open-enrollment/
However, many insurers (or state laws) require sales to go through a licenced insurance agent rather than direct to the insurer. I do not know Illinois specifically.
You can find a list of local licenced brokers at https://getcovered.illinois.gov/en/Pages/GetCovered/agent-broker-search.aspx. Ring and ensure that they are independent brokers and will quote for all insurers, rather than tied to one.
You can also ring your state's Department of Insurance for help finding a broker who will sell health insurance, or if you have any state specific questions. They are on (877) 527-9431
I can't find anything in the public domain quickly about a rate increase for Farmers in Missouri, but I don't doubt that they filed for one and received it from the state.
Here is a Consumer Reports article about why rates are going up and why it isn't the insurance companies screwing with you.
It's a shame she didn't take insurance at her new job. Even if it's crappy or more expensive it's almost always cheaper/better than other options.
If it's been less than 60 days she may qualify for cobra but it's very costly.
Are you able to fend for yourself since you're likely paying? Check the marketplace.gov and see if you qualify for a credit to help you cover the premiums. Chances are that's your best value for a student without medical. You can also check with your university to see what programs/options/support they provide for students without medical coverage.
Edit: here's the link for healthcare.gov
Note:
You DO qualify for a Special Enrollment Period if:
- Your COBRA coverage runs out.
- Your former employer stops contributing to your COBRA coverage, requiring you to pay the full cost.
So, if either the COBRA policy terminates, or you have to start paying the full cost, you should be eligible to go to healthcare.gov, or go see a local agent and get insured that way. At least that way they won't be stuck without insurance.
As per healthcare.gov..."You leave a job where you had health coverage (even if you left your job by choice or were fired)."
Not to be confused with still working and dropping coverage. https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
Another source: Losing health insurance for any reason except not paying your premiums https://www.nerdwallet.com/blog/health/qualifying-life-event-special-enrollment-period/
I would review these lists if I were you.
Dude, that fucking sucks. Thank you for sharing. As an insurance broker, it helps to hear about stories like yours, so I know how companies treat my clients.
If your story is legit, you need to talk to your State Department of Insurance. They will be able to give you more info about your rights, and possibly conduct an investigation. Also, try talking to a lawyer about suing to settle your medical bills, as it is their fault, and no fault of your own. I'm not a lawyer, but to me that sounds like they are "not acting in good faith".
As for covering yourself, you are more than 60 days past the time your coverage was cancelled, so you are correct, that you do not fall under the "qualifying event" category, to get new coverage. Here is a list of qualifying events. You might consider "moving" to a new Zip Code, as this seems to be a fairly easy way to qualify.
Also, look into finding a local insurance broker. Do Not go to an "Agent" who works for Aflac or Allstate, they only represent the 1 company they work for. Go to an actual broker, who can shop multiple companies. They will help you find the best option, and give you plenty of info.
Let us know what develops!
he's switching jobs, very well could have a special enrollment/loss of coverage.
27/M, zip 64101, 2nd lowest cost silver is $285/mo from Cigna. Even has $25 PCP visit.
https://www.healthcare.gov/glossary/special-enrollment-period/
Divorce is considered a life event. Also your ex losing their job could be considered a life event if you were on their insurance and their insurance was through their job.
An important question to ask yourself is; would you rather pay more every month and have less financial responsibility (lower deductible) or would you rather save that money and have more financial responsibility?
It's all about planning for that moment when you'll actually need to use your deductible. Can you afford $10-12,000 in medical bills or is $6-$8,000 more doable with a higher premium? You mentioned that you don't go to the doctor often, will that continue to be the norm? If so then there are plans for that.
I'm just throwing out numbers without knowing what you're actually comparing coverage-wise and what your financial state is at 19. But those are some of the important questions to consider.
If you haven't done so, I would contact a health insurance agent in your area who can help you. There's also https://www.healthcare.gov/ to help you compare rates and you're probably eligible for some great discounts from the Affordable Care Act, cause heaven knows I wasn't rolling in cash at 19.
I'd say his parents are making him no longer a dependant, opening him up for a special enrollment period.
If the health insurance offered through your company meets "minimum value standards", then you can sign up for a plan through Obamacare, but you will not be eligible for any subsidies. See: https://www.healthcare.gov/have-job-based-coverage/change-to-marketplace-plan/
>A health plan meets the minimum value standard if pays at least 60% of the total cost of medical services for a standard population and offers substantial coverage of hospital and doctor services.
>In other words, in most cases a plan that meets minimum value will cover 60% of covered medical costs. You’d pay 40%.
If you don't know if your plan qualifies, ask your employer to fill out a Employer Coverage form for you: https://www.healthcare.gov/downloads/employer-coverage-tool.pdf
They absolutely can because I work with several of them. Even my own father's health insurance policy is grandfathered through his employer.
Edit: https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/
Here you go.
You are incorrect about losing cobra coverage and the special enrollment period. Losing coverage is a special enrollment period even regardless if it's pre or post COBRA.
I've done it with clients many times.
You may have been thinking about the rule where you can't just drop COBRA before your eligibility is over in the middle of the year and jump onto the marketplace. You can drop it during the marketplace open enrollment period though.
you've moved to a new location, you probably have the option to choose exchange coverage in a special enrollment period. try healthcare.gov and find out
Your loss of job qualifies you for a special ACA enrollment period. Right now. Then, you can, if you like, choose again during the 'regular' enrollment period in the fall, for coverage effective 1/1.
I'd almost wager that your price for comparable ACA coverage will be lower than whatever you would pay for COBRA continuation of your employer-sponsored coverage. Let us know!
This page of Healthcare.gov's website that addresses Getting health coverage outside Open Enrollment seems to address it for you. The short answer is, your becoming ineligible for coverage at 26 qualifies you for a special enrollment election, and pre-January 1 coverage start date.
I haven't committed the chapter & verse to memory but my hunch is that you will benefit from TWO enrollments: your special election, which addresses your post-parents-plan coverage window, and another election period in the fall in which you may - but would not have to - revise your Special Election choice for 1/1/16 and beyond.
In effect you have a "special" trial window of a few months for your post-parents-plan coverage.
Take a look at the linked page and let us know if that helps you confirm your election & coverage options.
>How do I know what qualifies as preventive care? Do they have a specific definition?
https://www.healthcare.gov/preventive-care-benefits/
>it has just negotiated a cheaper price for me to pay?
It means they negotiated a cheaper rate.
It no longer depends on the state, company policy, or other surrounding factors. As long as the plan covers children, whether it's a plan through work or an individual policy, the ACA mandates that children be allowed to stay on their parents' insurance even if they are married.
Are you in the US? If so, losing coverage is a qualifying event under the ACA. Literally the front page of https://www.healthcare.gov/ is a button you can click to SEE IF YOU CAN GET COVERAGE! So I'd start there.
Health insurance in the US doesn't cover dental and vision, you have to buy separate plans. Vision is basically only VSP and it's a discount on glasses/contacts.
What state do you live in ? either they go to their state's board or they go here if their state never made their own site. https://www.healthcare.gov/
>Special Enrollment: A time outside of the open enrollment period during which you and your family have a right to sign up for health coverage. In the Marketplace, you qualify for a special enrollment period 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. Job-based plans must provide a special enrollment period of 30 days.
Was the travel medical insurance for international travel? If so, would you qualify for this exemption: https://www.healthcare.gov/exemptions-tool/#/results/2015/details/citizen-abroad
I don't know of any way to backdate health coverage to March, so at this point I think it's either pay the penalty or qualify for an exemption. I'm sure you've already gone through this, but if not, exemptions are here: https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/
Are you still eligible to be on your parents' health plan?
Have you compared the school's plan to an exchange plan?
I recommend http://www.healthsherpa.com as a well-designed website for helping figure plan rates & coverage.
Do keep in mind that you'll need to have a "qualifying event" if you want to join an exchange policy outside of open enrollment. The federal government lists some qualifying events here.
Some states/insurance companies are allowing purchases outside the exchange, and hopefully a CA broker will chime in here. You can also try nahu.org and "find an agent" in your area to get answers.
Short term could be an option to consider as well.
Other than that I think you're kinda screwed.
https://www.healthcare.gov/glossary/special-enrollment-period/
I know airbnb covers homeowners up to one million dollars, in case of bodily injuries and property damage. Surely this can also be done for Uber drivers, or not?
Google is a fickle friend. Sometimes she finds amazing helpful info, sometimes she shows you the true scope of your despair by showing you the other lost souls.
I'm trying to fight that. Thanks for letting me know it's working.
P.S Consumer reports just released a report about car insurance pricing, which mentioned the affects of credit scores and their secret ratings for price sensitivity. Check it out.
http://www.consumerreports.org/cro/car-insurance/auto-insurance-special-report/index.htm
It doesn't compare prices, but if you want to know more about the quality of insurance companies, Consumer Reports has been rating them for several decades. Their most recent review is online at http://www.consumerreports.org/cro/homeowners-insurance.htm, although you need to be a subscriber to see the full ratings. If you can get access to the print magazine, the May 2014 issue has the review.
I suggest contributing the max to your HSA until your balance matches your max out-of-pocket for the family. That way you can weather any medical emergency without having to dip into savings, or, heaven forbid, borrow.
HSAs are a fantastic investment tool. You may want to direct funds there even after you have saved the max out of pocket. (sauce)
There are some really good points in this thread. Overall the commission rates are going to be higher and you're going to have more flexibility. You can create a brand and market yourself however you want. I have seen some agents who got very creative with social media and it really drove their growth. I'm curious what part of the country you're in? The reason I ask is that you should look in to what smaller carriers write business in your area. Many of them are hungry for market share and and from what I've seen have very loyal agents. If you're in the upper midwest for example you'll find a lot of Erie or Cincinnati agents. Everyone has Progressive but there is a lot of value in the smaller carriers. You'll also want to look in to technology. You'll want some kind of client management system (QQ Evolution and Hawksoft are both affordable and feature rich) and something to help you rate all those carriers (SEMCAT is affordable and accurate). You have to be able to recreate the efficiencies that were built in to your captive agency and there are a lot of options out there. I found reviews about rating systems here.
The first year will be a struggle but you seem to have the knowledge base to get you through it. The biggest advantage to being independent and the reason so many people many to have a successful agency? Renewals, renewals, renewals... Good luck to you!
ACA created a floor for how much you can trim off your coverages. You can always just raise your deductible. You can go for a plan that has minimum essential coverage.
You might also do better gambling on not getting or needing your insurance and just pay the penalty
You might also qualify for medicaid or medi-cal or whatever you state provides. It all depends on the income levels!
Most importantly get on the horn today since open enrollment is November even though you have a qualifying event now.
*not an insurance agent or qualified in any way
Do you have a source for that? Eligibility under an employer's plan does not qualify as a reason for parent's health insurance to refuse coverage. I can't find anything about actually being enrolled in the employer's plan though.
First, you won't pay any penalty. You only pay the penalty if you're uninsured for more than 3 months. https://www.healthcare.gov/what-if-i-dont-have-health-coverage/
Second, you'll just need to sit on the phone with the company until they resolve your issue. Also try reaching out to the company's social media, they sometimes are able to escalate issues faster.
If that fails, maybe try term health insurance, which is used for short term coverage during transitions like yours, although I don't know if you'll be able to start coverage for that mid month.
You can anonymously browse individual health insurance plans on the federal and most state health insurance exchange websites. If you know the state and city you're moving to you should be able to just put that information in and get quotes for various coverage levels from all companies participating in the exchange in that market (which might not be all companies in that market but should be representative). Start here.
See bullet number 2. The new healthcare law doesn't just affect the ACA marketplace; it affects all health insurance carriers doing business in the US.
https://www.healthcare.gov/how-does-the-health-care-law-protect-me/
(one exception though, so check on it - edit: the exception is an individual plan that you bought yourself before the law took affect, and they recommend calling to talk about buying a marketplace plan that works. If you have insurance through your employer, you should be fine from this point out. If not, they may not be abiding by the laws, and you should consider reporting it.)
>So if I had an emergency, I can sign up for insurance right then and there and I'll be covered immediately? That's definitely true?
NO. Plans generally do not cover expenses that occur before coverage begins, so if you get hurt, go to the hospital for treatment, then apply for coverage afterwards, the insurance probably will not pay for it. (And if it is a real emergency, you probably aren't going to have time to sift through coverage options to decide what to go with before you .)
Additionally, plans purchased through the federal health insurance exchange do not immediately provide coverage. (MA has its own Exchange; I'm not sure what the rules are for it, but Texas has a Federally Facilitated Exchange).
I can't find anything that definitively says when coverage for a plan purchased during a special enrollment period begins, but during the regular open enrollment period that recently ended, coverage would start the month following the month when you bought it.
Since your employment is ending, you will probably qualify for a special enrollment period to apply for coverage. It is probably also likely that you will qualify for another special enrollment period once you move to a new state. You can confirm whether you qualify for a special enrollment period here: https://www.healthcare.gov/how-can-i-get-coverage-outside-of-open-enrollment/
You can learn about different health insurance options available in Texas at this website, which is maintained by the Texas Department of Insurance: http://www.texashealthoptions.com/
I don't have a ton of time right this moment, so I'll give you the TLDR first that directly answers your questions then try to come back to fill in some of the details.
If she quits, yes she can continue her coverage for up to 18 months (though I can't guarantee it will be affordable) as she would likely be eligible for Cobra benefits.
With the new healthcare laws it's never been easier to switch coverages while pregnant. She won't be disqualified and the plan won't exclude maternity coverage based on it being a "pre-existing condition".
Working for 2 months before quitting won't really make much difference. If she plans on taking a leave of absence so that she could continue the coverage from the school that's of course a different story, but if she's leaving the job no matter what, then it really won't change things. Though this point is tough to give solid advice on without getting into the nitty gritty of your income/the premiums/plan benefits.
They have really good ratings on TrustPilot - https://www.trustpilot.com/review/clearcover.com You should give them a try and tell me how it goes so I can buy too. :)
My credentials are on the about me portion of the site. I will be adding my linkedin profile to it soon. I hve been in the auto insurance business since 2002. I started in sales, became a new business underwriter, now work in auto claims. I have claims licenses in about 12 different states. Here is my linkedin profile https://www.linkedin.com/profile/view?id=304933236 . I am new to blogging and new to web design so I am taking it slow and developing as I go. My plan is to help educate the common person with how auto insurance actually works and how professionals in the business, like ourselves, handle the business.
[It's available on Amazon for $16.84].(https://www.amazon.com/Life-Insurance-Handbook-Louis-Shuntich/dp/1592800572)
Maybe this isn't the sub you think it is.
OP is not asking for advice on how to commit insurance fraud.
>From the way everyone was talking about the app, it seems like you have to have it running after you get your quote and buy a plan. Is this true? Couldnt you just turn it on once a week for a few miles and disable the app the rest of the time?
According to a Root representative in the Google Play store on June 24, 2018: "We don’t require GPS or location after you’ve finished the test drive. Feel free to turn ‘em off if you’d like."
I read somewhere the app does continue logging some data "for research purposes" after conclusion of the test drive, but the company claims not to use it to calculate ongoing rates.
I'm currently doing the test drive and plan to uninstall the app after purchasing a policy, assuming I end up doing so.
Hmm, I'm not sure where you are but you should receive what's called an summary of benefits. In the US, every insurer is required to provide this; even prior to purchase so you can compare.
---THIS IS NOT LEGAL ADVICE, FOR PROPER ADVICE HIRE AN ATTORNEY---
Hello, I would reference you to https://www.healthcare.gov/glossary/federal-poverty-level-FPL/
based on your income of 22,000, if you are a single individual with no dependents, you are within the 100%-400% of the federal poverty line that enables you to receive benefits through the affordable care act.
There are a number of plans available, bronze are generally for health people who dont expect to pay a lot for pre-existing conditions, and gold and platinum plans are for people with a lot of medical expenses or those who anticipate spending a lot on medical insurance.
Your question seems like a tax question though, and the answer is that it depends. From what you said, your gross income is $22,000 per year. It would make sense then that your take home is $16,800 a year in some states after federal and state taxes. To my knowledge, the federal affordable care act subsidy is not factored into your taxes (but i'd welcome a correction on that if anyone has one).
Based on the information you provided in the limited space available, I don't think any tax obligations for healthcare will hit you hard at all due to the fact that most taxes are taken out of your paycheck before you get the paycheck. That said, if you are really concerned about the implications, i would recommend googling free tax and/or legal advice in your geographic area. I wish taxes were lower and health care was fairer, and regardless, I wish you the best in everything!
The MAGI is your AGI (Adjusted Gross Income) with some slight additions. The details are here.
Truly, though, the best way to find out exactly what you qualify for is to apply, as everyone's specific circumstances are slightly different and the application takes it all into account.
> Do different health insurance companies have different policies about what qualifies for what treatment?
They are often similar in concept as they are based on medical research about effectiveness and cost. However, the details of each is where the real differences appear. Also different companies will put in more and or less effort to deny the claims.
> Is that something that HR looks at when choosing a plan for a company or something like that?
Rarely do companies get into that detail when buying insurance. Unless they are large enough to have dedicated HR staff of multiple people they don't have the time. Sometimes they'll ask about a 1 or 2 of them if they have been issues in the past for the company.
> Do you know where I could read more about the rules around these escalations?
Unfortunately the details can vary by insurer, state, and sometimes types of plans. But the concepts will be the same. The below link has some good detail on the process.
https://www.uhc.com/content/dam/uhcdotcom/en/Legal/PDF/AZ_appeals.pdf
Here is something about the final state, external review, from the federal government.
https://www.healthcare.gov/appeal-insurance-company-decision/external-review/
May I ask if your household income is below 200% of the Federal Poverty Level detailed at https://www.healthcare.gov/glossary/federal-poverty-level-FPL/
If it is I may at least be able to point you in the direction of some help.
https://www.wunderground.com/history/daily/us/nh/manchester/KMHT/date/2021-7-20. Send them this?
My deductible is 500 so if I had pre existing damage it would be cheaper if I fixed it. Rather than me shoveling a pile of rocks.
What I meant to say is look at the same coverages with Geico and State Farm and pick the cheaper. Seems like they're mostly the same these days.
Feel free to look elsewhere, you'll see plenty of people possibly offering cheaper still, or insurance companies with better service, etc.
Consumer Reports (http://www.consumerreports.org though a paid subscription is required for most of their content) is a good starting point, after that go to their websites and fill out quote forms. Also calling an agent can be very helpful.
Okay, good to hear that it's not too strange.
For liability limits, what would you say is good? I was basing most of my numbers from here: http://www.consumerreports.org/cro/car-insurance/buying-guide
If the towing is cheap, then I'll probably add it in, I was just removing everything that I didn't think was necessary.
Am damage appraiser who also owns a Tesla and who has also been in a wreck with a Model 3.
It doesn't look totaled to me.
Looks like you need a bumper, fender, headlight, signal lamp, and some underside bits. Tesla actually now sells pre-painted versions of both the fender and the bumper, but it's hard for me to imagine that the color match up well on any color other than black (which is a non-tinted color on Teslas). I've yet to see what a pre-painted one looks like on a car.
The end of your right frame rail is directly below where the front tip of the fender is on the inside of the headlight. With the bumper off the car it looks like this.
Per the forums the repair times and parts are a bitch right now, so if you have a sense of humor I'd go get one of those giant band-aid stickers or one of these until you can get it in the shop.
Some German cars like Audi, VW, or Mercedes have a pyro disconnect fuse that disables the battery connection if there is an impact detected.
Like this: https://www.amazon.com/Dorman-601-702-Overload-Protection-Volkswagen/dp/B08BG9B2PS
The car won't start until it's replaced.
If I'm reading the link right, the plan would become effective on the first of the month.
If your lost / quit your job, your current plan often goes through the end of the month, so.. you know, check that end date too.
If you are legitimately without coverage, then yeah, it's all out of pocket.
Regarding the ACA penalty, read https://www.healthcare.gov/fees/fee-for-not-being-covered/ -- pay attention to both the times mentioned, and the exemptions you can apply for if you don't have coverage.
You could argue that, however flu shots are covered preventive services, PrEP is not. Not all preventive services are covered at 100% The law is very specific about what is covered and when.
Why is your insurance no longer valid when you turn 19? Are your parents on Medicaid?
And yes, you would be exempt from the fee: https://www.healthcare.gov/health-coverage-exemptions/forms-how-to-apply/
Routine visits you typically pay copay, anything else you pay 100% until you reach your deductible, then (smallish percentage, depending on plan) until you reach your out of pocket maximum. Healthcare is so expensive if you have to do anything significant you can hit your out of pocket maximum pretty quick, and for 2017 that can be as much as $7,150 if your actuarial value isn't boosted. This is why is so important to reach the poverty line in your income estimates for next year.
Oh yep you're correct, I didn't notice you asking about after the 15th. I just went to the website and it states open enrollment ends on January 31, 2017, so I'd assume coverage would start February 1st. There's a number listed as well for additional questions.
Practically speaking, if I were in your shoes, I'd find the listings like this one that call for a few years of experience, and apply for them. In the cover letter, write that you'd like to start inside and move to the cat position as quickly as they feel comfortable with your skills.
Especially if you can find one of the property claims managers on linkedin and address them directly.
Hey u/anatomizethat - a follow up to your novel, does anything change?
-HDHP
I am a healthy 30 y/o male with a healthy 30 y/o wife and a 2 month old baby. We may try for another child in 2022. (Knock on wood for current health)
Here's my logic - tell me if I'm wrong.I would be saving ~3k on premiums by going with HDHP, and could also save ~2k on taxes if I were to max out my HSA (if I'm doing the math correctly, 7k contribution and over 30% tax bracket).
+$5k for Closed_Won = +1 for HDHP+HSA.
Where I'm struggling is this:
- The EPO only has a $3k family deductible, and I'm not seeing and co-insurance throughout the document (just minor co-pay here and there) that would give me any reason to believe I would sniff the $14k OOP Max. Am I missing something?
- Only significant costs I am seeing on the EPO document are ER visit and Imaging.
- Maternity Services seems vague in both documents.
Thanks again.
I know that's not true. We confirmed that he can stay on his mother's plan until he's 26 regardless of marital status.
I may look into the marketplace, thanks. You're the first person I've heard who says they got a bethere deal there.
So, my first question is: Do you have a Qualifying Event?. If you have been without coverage and you have not had a QLE in the past 60 days, you cannot get any coverage. Full stop. You will have to wait until open enrollment.
In regards to Covered California, I only recommend going through there if you are eligible for a subsidy. Note if you are under the subsidy level in terms of income, you will be routed to Medi-cal.
- You might be out of luck with enrolling in a new insurance plan right now. If you didn't have a qualifying life event within the past 60 days which it doesn't seem like any of your events have been that recent. See this link if you would qualify for enrolling under a special enrollment period. If you don't qualify, you will have to wait until the next open enrollment which would be for coverage effective in January. Based on what you wrote, I would recommend a silver or gold level plan.
- I don't think there is much you can do. Sorry to come out harsh, but you should have been aware of what health benefits you have and how they work. Especially if a facility or provider is in-network or not.
I think you can get an exception if you l could have qualified for Medicaid but live in a state that didn't expand it. You can also get an exception if the plans offered to you exceed a certain percentage of your income.
https://www.healthcare.gov/health-coverage-exemptions/forms-how-to-apply/
Even if your dad voluntarily dropped you during open enrollment, you should still be able to apply through the Marketplace, as long as your previous coverage ended fewer than 60 days ago. Check out their website for more info: https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/. You should also look into your state's Medicaid.
https://www.healthcare.gov/fees/fee-for-not-being-covered/
>>You owe the fee for any month you, your spouse, or your tax dependents don’t have health insurance that qualifies as minimum essential coverage
Get on that site, and get some quotes going. You should be able to see a wide range of qualified policies with varying prices, deductibles, etc.
First, were you insured from January - August?
You may want to consider filing a hardship application with the Marketplace.
Know that it wont go into effect May 1st, you will have to wait til June. However, since you are 25 you could be added to your parents insurance, but you will have to check and see if they allow an open enrollment or if you qualify for their enrollment exceptions. COBRA can be quite expensive.
I am sure. It falls under it having to be "affordable" Because they are changing the cost you are allowed to reassess everything to keep their plan or choose something else.
QLE-Your job-based health plan is ending for the year and you choose not to renew it. Note: If this plan is affordable and meets minimum value standards, you won’t qualify for a premium tax credit that lowers the cost of your plan, even though you can buy Marketplace insurance.
https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
Are you sure about that? I wasn't under the impression that a change in /cost/ of the employer based plan was a SEP and it isn't one of the reasons listed on healthcare.gov
You're probably out of luck.
>Losing individual coverage doesn’t allow you to qualify for a Special Enrollment Period if you ... lose coverage because you didn’t pay your premiums
https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/