patrick.net

Gupta ran a tighter ship...

Gupta Rajan: "Do you have an appointment?" Viktor: "Uh?" Gupta: "I'm sorry, I don't let anyone to look at my trash without an appointment." Viktor: "Uh?" Gupta: "I have an opening next Tuesday." Viktor: "Tuesday. Tuesday, Monday, Tuesday, Wednesday, Tuesday." Gupta: "Tuesday." Viktor: "Tuesday." Gupta: "It will be good time for you to come back and get lost. Okay, goodbye. Sorry."

You're lucky you have until the 15th.

It took me a week to log in. The insurance information was too superficial and the "more info" links led back to a previous page in an endless loop. I tried to ask questions via e-mail, and got only auto-replies promising an answer within two days, but never any answers. I tried the online "chat," which put me on hold until the session timed out; it kept doing that until the "chat" representatives' hours ended. I phoned, and was told to keep waiting for answers to my e-mails.

BUT, I got a letter in the mail telling me I must sign up by December 7. That's an extension from the first deadline they told me, which was November 7. The President said on TV we have until the end of March, so CA gave me until December 7.

The law says we must BUY. It doesn't say we have any right to information about what we're buying. As Nancy might say, "We have to buy the plan to find out what's in it."

I have a question.

My fiancée and I just moved in together.

She does not have health insurance. She qualifies at the moment for a number of low income services. Income is roughly $30k.

My workplace does not allow for domestic partnerships until you've been living together a year, so I cannot put her on mine.

She does not qualify for CA health exchange subsidy due to my income. She is several years younger than me( in her mid 30's), in good health, and with no pressing issues. From what I've seen, the bronze plans are NOT cheap...$228/mo and huge deductibles. The cheapest decent plans are near $5k a year. She cannot afford that. I can, but it would be an expense we really don't want to take on.

Is there any problem with not being covered for a year until I can add her to my employers plan, and just paying the $250 penalty on next years taxes?

dodgerfanjohn says

She does not qualify for CA health exchange subsidy due to my income. She is several years younger than me( in her mid 30's), in good health, and with no pressing issues. From what I've seen, the bronze plans are NOT cheap...$228/mo and huge deductibles. The cheapest decent plans are near $5k a year. She cannot afford that. I can, but it would be an expense we really don't want to take on.

If you look more closely at the arithmetic you'll decide the Bronze plan is the best deal due to the big big premium difference between the levels amplified by the ability to pay health care costs through the silver level with pre-tax dollars.

$228/month is $2264 / year less than $5K/year and will cover "huge deductibles" if your girlfriend is generally healthy.

The actual difference is even more significant because High Deductible Health Plans (where the deductible is at least $1500 and out-of-pocket maximum $6250) allow the use of Health Savings Accounts that let you pay for almost everything except insurance premiums using pre-tax money.

Take that $2264 / year and divide by (1 - your girlfriend's tax rates) to see what she'd accumulate for the same difference in take home pay.

For example, in the 15% Federal and 4% state income tax brackets that go with gross income of $30K that'd be like $2265 / (1 - .15 - .06) = $2796/year.

This ignores the subsidies which are available - $30K is 260% of Federal poverty level for one person which should cap her out-of-pocket spending to under $2500/year for a Silver Plan.

Is there any problem with not being covered for a year until I can add her to my employers plan, and just paying the $250 penalty on next years taxes?

Sure. If anything somewhat bad happens plan on your girlfriend being stuck with a limp or limited range of motion for the rest of her life because the best sports medicine people won't see people without insurance. You may also want to decide ahead of time whether you'd pay a six figure debt off over time (generally five years which would mean $1666/month per $100K) or declare bankruptcy.

drew_eckhardt says

the best sports medicine people won't see people without insurance.

I haven't seen surveys narrowed to sports medicine, but in general the best doctors won't take Obamacare, and in growing numbers they won't take any insurance - cash only. If you have a source saying that's different in sports medicine, I'd be curious to see it, but it's an odd specialty to focus on in this context, and unless your fiancée is Barry Bonds it's unlikely you'd get a $100k bill in sports medicine.

"The deadline imposed by President Barack Obama's appointed "fixer" Jeff Zients has passed... The underlying systems to which the [federal] site ties are still causing problems for some state health exchanges.
***
Just being up more often than it's down is a major achievement for the site, which, according to the report, was unavailable nearly 60 percent of the time in October. But it's clear that much of the work being done now should have been addressed well in advance of the site's launch. And the architecture of the site itself—in part dictated by the Affordable Healthcare Act and by the rules created to govern how individuals are screened to determine if they are eligible for care—is the antithesis of what people have come to expect from a modern Web commerce site."
***
The same hub system that powers HealthCare.gov also connects state exchanges, such as Maryland Health Connection. The federal hub is used in part to determine eligibility. State systems have to access data from the Department of Veterans Affairs (VA), the IRS, the Social Security Administration, and the Immigration and Naturalization Service to determine whether applicants are eligible for subsidized plans (or for coverage of any kind). Eleven days after launch, HHS' War Room report noted that there was still a major problem with the VA's system—it was reporting back more than 75 percent of those checked for VA eligibility as "deceased."

BoomAndBustCycle says

Now it's early December... And I've contacted them twice through email, tried to update my information.. (change it to my email address instead of my wife's for easier correspondance). And it's been an absolute failure.

Yeah, I agree the website is clunky. And that's after having defended it earlier. But I've had the same experience. The signup went very smoothly, but the followup seems poor. I couldn't even locate my enrollment information. I finally clicked on "renew", even though that didn't make any sense, and there it was. It says I am supposed to get an acceptance letter in the mail with the payment information. This is what the website says:

"Then, we will send you a “Notice of Acceptance” in the mail. It will include instructions about how to
make your first premium payment. And, it will have a payment coupon for you to fill out. You will need
to mail it to [the insurance company] with your first premium payment.
Please wait for the Notice of Acceptance to
come in the mail before you make your payment."

It does say it takes them several weeks to contact the insurance company that I signed up for.

drew_eckhardt says

the best sports medicine people won't see people without insurance.

Is that true? I would think any doctor would be more than happy to accept a cash payment. Why wouldn't they want cash?

Homeboy says

Why wouldn't they want cash?

Because most people don't have a full brick of hundies along when they get injured, to flash to the doctor before he'll even consider working on them like medicine's a god damn lap dance.

Homeboy says

Is that true? I would think any doctor would be more than happy to accept a cash payment. Why wouldn't they want cash?

All doctors will accept cash, but the good ones have very high rates. I am guessing it will be $400-700 a visit for a top doctor and the payment is due that day. Assuming there are no procedure performed.

Homeboy,

thanks for sharing your experience with coveredca. The company that I work for took an offer from Anthem to renew the current plan for another year at 9% premium increase and then the plan will be cancelled at the end of next year. The recommended replacement plan is a 40% increase in premiums.

We are applying for SHOP to see if there is a better deal.

tr6 says

All doctors will accept cash, but the good ones have very high rates. I am guessing it will be $400-700 a visit for a top doctor and the payment is due that day. Assuming there are no procedure performed.

Sure, but since dodgerfan says they will have employer insurance in a year, it might be worth the risk, if the alternative is $228/month with a $5000 deductible. Even if she had to visit a doctor and pay cash, she would come out ahead vs. buying insurance for that year. And since guaranteed issue is now the law of the land, there is no longer the risk of ending up uninsurable. She would simply have to wait until the next open enrollment period.

Homeboy says

Even if she had to visit a doctor and pay cash, she would come out ahead vs. buying insurance for that year.

That's a rare admission from Homeboy, who usually insists that everyone must be required to buy insurance in order for the whole thing to work.

curious2 says

That's a rare admission from Homeboy, who usually insists that everyone must be required to buy insurance in order for the whole thing to work.

No, that's wrong. You are required to buy insurance OR pay a penalty. And I still believe there's no way the system could be solvent without that requirement. I am in no way advocating that the requirement be removed. In this case, dodgerfan would opt to pay the penalty rather than buy insurance.

And back to ignore for you....

Homeboy says

back to ignore

LOL - you and marcus make a funny couple - you choose ignorance and then you even fail at that. Anyway more than twice as many people ignore you as ignore me, so if your goal in pretending to ignore me was in some childish way to insult me, you've insulted yourself more than twice as much.

So is the penalty roughly $250?

Thats where my concern lies.

Yeah, I add her on my insurance next year...one year from now. Then I only pay something like $120/mo and she has great insurance. I don't even know if there is a deductible on my plan and it really doesn't matter cause co-pays are around $15. The only other thing I'd have to pay is taxes on the amount my employer pays for her part of the insurance.

The subsidy thing is out the window anyway becuase even if she qualified herself, they go by household income.

Forbes says the penalty is as much as $285 or 1% of your income, whichever is greater. But the formula appears to be very complicated, so that's an oversimplification.

http://www.forbes.com/sites/beltway/2013/11/07/how-big-is-the-penalty-if-you-dont-get-health-insurance/

DodgerFanJohn,

I don't think your income factors at all into your girlfriend's subsidy eligibility. As long as you're not married and don't file taxes together... She's still single and for all the government knows... you two are roommates and she pays her share of the rent.

If she makes low enough income.. she should still qualify for a subsidy.

by the way.. i signed up for a Gold PPO plan thru Blue Shield on their site tonight for my wife and child... Much easier and faster than the CoveredCA. Setup the premium to be deducted monthly from my bank account.

CoveredCA still shuts down every evening for maintenance.... it's really pathetic... I think CoveredCA has gotten worse while the main Govt website has been improving.

BoomAndBustCycle says

DodgerFanJohn,

I don't think your income factors at all into your girlfriend's subsidy eligibility. As long as you're not married and don't file taxes together... She's still single and for all the government knows... you two are roommates and she pays her share of the rent.

If she makes low enough income.. she should still qualify for a subsidy.

Ok, thank you for that. Makes sense.