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AA7295
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Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 3:30 am

To preface this post, I must point out; I'm pro-Obama and pro-universal healthcare.

Can someone please explain why it is a requirement that in order to gain healthcare coverage in 2014, you must enroll in a healthcare plan by 31st March 2014?

It seems incredibly illogical, I mean, what happens to all the US citizens who live abroad and permanent residents who enter/return to America after this date? What they are non longer covered?

I like Obama, but this is downright stupid. Here in Australia and like in the UK, if you want private health cover, you purchase it and either 1 week, 2 weeks a month or whatever timeline stipulated in your policy you get coverage from that date.
 
Ken777
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 3:42 am

Quoting aa7295 (Thread starter):
Can someone please explain why it is a requirement that in order to gain healthcare coverage in 2014, you must enroll in a healthcare plan by 31st March 2014?

The open enrollment ends on that date. After that date you would have to pay a fine.

The reality is that those who are not yet covered and elect to "take a chance" and not get insurance face far greater financial risks than the fine.

Quoting aa7295 (Thread starter):
what happens to all the US citizens who live abroad and permanent residents who enter/return to America after this date? What they are non longer covered?

Like in the past if you are covered where you reside then you are covered. If, however, you decide to visit the US then you had better take out some travel insurance that covers medical. But that has always been the case.

Where we fail (compared to Australia) is that we don't have a system of core health care paid for by taxa. That results in huge levels of cost shifting and THAT results in private insurance here costing 5 times what it costs the Aussies.
 
rfields5421
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 3:42 am

It is mainly a date for insurance companies and companies funding insurance for employees.


They offer plans, and need to have those plans finalized by X date - including knowing how many people will be on the plan, how much income they will have, etc.

This is very standard in the health insurance industry.


Over the years, most people have a yearly sign-up/ option period - some three months - some times six weeks. For personal benefits including health insurance options - from our employer.

Folks on Medicare have a Oct 1 - Dec 7 ? - window to change their health plan each year.

Folks signing up for the ACA will have a similar window each fall to change plans/ coverages if they wish.

Quoting aa7295 (Thread starter):
what happens to all the US citizens who live abroad and permanent residents who enter/return to America after this date? What they are non longer covered?

The same thing that happens when you go to work for a new company, or you go on Medicare.

You have X number of days to sign up and will pay for your coverage until the next open enrollment period, when you can make changes if you wish.
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DocLightning
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 3:47 am

Quoting Ken777 (Reply 1):
Like in the past if you are covered where you reside then you are covered. If, however, you decide to visit the US then you had better take out some travel insurance that covers medical. But that has always been the case.

Here's what I wonder and I don't get: let's say I have health insurance through my employer and I leave my job (or get fired). Can I buy into the exchange in August? Similarly, if I am starting with my employer on January 8th, do I have to pay for coverage for those 8 days? Can I cancel my coverage in lieu of my employer's on such little notice?

The law must take such situations into account, but I don't know what the rules are.
-Doc Lightning-

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adh214
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 4:23 am

Quoting DocLightning (Reply 3):

I am also curious about this. In group plans, you usually get an enrollment window if you have "life event," like changing jobs, getting married, etc. Does O care have the same practice?
 
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DocLightning
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 4:28 am

Quoting adh214 (Reply 4):

I am also curious about this. In group plans, you usually get an enrollment window if you have "life event," like changing jobs, getting married, etc. Does O care have the same practice?

I guess it must, right?
-Doc Lightning-

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rfields5421
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 4:33 am

Quoting DocLightning (Reply 3):
let's say I have health insurance through my employer and I leave my job (or get fired). Can I buy into the exchange in August?

COBRA will still exist, or if you do not want to pay the full costs yourself, you can obtain a new policy from the Marketplace plans. They will be operational throughout the year. One goal of the ACA is to eliminate the period of no-coverage which is very common today when people change jobs.

https://www.healthcare.gov/what-if-i-am-losing-job-based-insurance

Quoting DocLightning (Reply 3):
Similarly, if I am starting with my employer on January 8th, do I have to pay for coverage for those 8 days? Can I cancel my coverage in lieu of my employer's on such little notice?

I don't have a reference for those exact questions - however the tax penalty only applies if you do not have minimum essential coverage for three months of a year. Not day for day penalty.


NOTE to OP - that is the big deal about Mar 31 as a deadline date - if a person doesn't have coverage by Mar 31, that person has crossed the "3 month" grace period - and incurs a penalty.


Moving from a Marketplace plan to a employer plan should work just like changing jobs/ insurance companies/ COBRA today.

Remember the Marketplace plans are all commercial health insurance policies - the only difference between today and last year is the Marketplace interface to compare policies.

Quoting adh214 (Reply 4):
Does O care have the same practice?

Yes

https://www.healthcare.gov/how-can-i-get-coverage-outside-of-open-enrollment


EDIT - Okay, I don't know how to make https links clickable.

[Edited 2013-12-24 20:38:43]
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adh214
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 5:33 am

Thanks for finding those links. It is good to know that I have options other than COBRA if I lose my job. COBRA can be crazy expensive.

Andrew
 
ltbewr
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 1:20 pm

My current individual policy term runs out in mid-March 2014. I live in NJ, which does not have it's own state-run marketplace, I have to use the Federal website. My provider Horizon BCBS will require me to use the Federal website to get a new, ACA compliant policy.
If I do not have a policy in place to take over by mid-March and fail to get one within 3 months, then I will have mandated coverage for less than 9 months in 2014 and have to pay the 'tax' penalty from any overpayment of taxes on my Federal return.
You must have coverage for at least 9 months (about 270 days) to not face the penalty for that year. This is part of the mandate law to make sure people have health insurance policies.
 
planeguy727
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 1:40 pm

Quoting DocLightning (Reply 3):
Here's what I wonder and I don't get: let's say I have health insurance through my employer and I leave my job (or get fired). Can I buy into the exchange in August? Similarly, if I am starting with my employer on January 8th, do I have to pay for coverage for those 8 days? Can I cancel my coverage in lieu of my employer's on such little notice?

As others have said, if you lose coverage from your current provider (employer plan in your example) this is a qualifying life event that allows you to be added to another plan outside of the typical open enrollment period (usually in the fall). This applies to marketplace plans.

When you join an employer plan you need to see what the coverage dates are. For example, at my employer if you are on payroll at the first of the month you have coverage for that month. If you join the organization after the first your health insurance is effective the first of the following month. While it is best to not have gaps, part of the ACA was structured to allow for these potential situations (the 3 month piece explained above).

An important clarification, while people keep insisting on saying enrolling in obamacare, there is no such thing. The Affordable Care Act established minimum standards for health insurance plans and created the marketplaces to provide individuals without access to plans through other means a method of obtaining health insurance. When individuals enroll in a marketplace plan (also know as the exchanges), s/he is enrolling in a health insurance plan offered by known insurers (Blue Cross, Aetna, United, etc.).
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rfields5421
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 3:37 pm

Open enrollment for calendar year 2015 will be Nov 15, 2014 - Jan 14, 2015

This changing coverage due to life events has been a big topic on RV forums.

Another big discussion has focused on HMO based plans vs PPO based plans. Since much of the RV community is very mobile - traveling from state to state - from the north in the summer to California, Arizona, Texas and Florida in the winter - the Marketplace (exchanges) have been very useful for people to find plans which cover them across the country. Most HMO based plans only have a provider network within a state, or portion of one state.
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larshjort
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 10:06 pm

I live in a country with healthcare provided by the state. I am employed by a big multinational corporation who provides all emplyees with a private health insurance. I can buy health insurance at any time I want be it March, June or December, from your comments above it seems like in the US you can only change your health insurance in a specific timeframe during the year. Why is that? Is it a holdover from the old days before computers wher the insurance companies had to keep track using books? It seems like a big intrusion in peoples life if you cannot change your plan when you want.

/Lars
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AA7295
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RE: Why You Must Enroll In Obamacare By 31st March?

Wed Dec 25, 2013 11:18 pm

Quoting ltbewr (Reply 8):

My current individual policy term runs out in mid-March 2014. I live in NJ, which does not have it's own state-run marketplace, I have to use the Federal website. My provider Horizon BCBS will require me to use the Federal website to get a new, ACA compliant policy.
If I do not have a policy in place to take over by mid-March and fail to get one within 3 months, then I will have mandated coverage for less than 9 months in 2014 and have to pay the 'tax' penalty from any overpayment of taxes on my Federal return.
You must have coverage for at least 9 months (about 270 days) to not face the penalty for that year. This is part of the mandate law to make sure people have health insurance policies.

What happens if you are not in the contiguous US for the most part of that year?
 
rfields5421
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RE: Why You Must Enroll In Obamacare By 31st March?

Thu Dec 26, 2013 2:35 am

Quoting larshjort (Reply 11):
Why is that?

Just a guess, but I assume the system grew the way it is due to a combination of union contracts, business planning practices and insurance company desires. One period a year to make changes works well for almost everyone. It is common across private and public employers, union and non-union jobs, etc. It is also part of the Medicare insurance process for old-age medical care.

One reason the employers like the system is that costs are pretty much fixed after the end of the open enrollment system for the next year. As mentioned above - some 'change' events do occur - marriages, divorces, births of children, etc - but that only occur to a small part of the employee group.

I used to work for a big multi-national company, and varying costs for benefits when people decided to change in mid-year in some countries was a concern. It required extra people on the payroll in those countries to keep up with changes.

Quoting aa7295 (Reply 12):
What happens if you are not in the contiguous US for the most part of that year?

If you are not in the United States - the ACA requirement for insurance doesn't apply to you. There is no penalty if you have no insurance coverage.

If you only come back to visit for less than three months - the ACA requirement for insurance doesn't apply to you.

However, as with any travel to a country not your residence - I encourage the detailed investigation of what your current health insurance plan covers or does not cover. And the purchase of supplemental insurance for foreign travel. I am retired US military and have that health insurance. While traveling in most foreign countries - including Mexico and Canada - I have reimbursable health insurance coverage - i.e. I'm responsible for all costs and can file for reimbursement of my expenses.


Note - Non-contigious United States because Alaska and Hawaii and some territories are under the ACA requirement.
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Braniff747SP
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RE: Why You Must Enroll In Obamacare By 31st March?

Thu Dec 26, 2013 5:30 am

Quoting rfields5421 (Reply 13):
some

Who isn't?
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rfields5421
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RE: Why You Must Enroll In Obamacare By 31st March?

Thu Dec 26, 2013 12:01 pm

Quoting Braniff747SP (Reply 14):
Who isn't?

You made me do more research - the ACA law defines the law as applying to "each of the 50 states and the District of Columbia". However, the requirements for insurance companies to cover all applicants, provide 'minimum essential care' and limits on premiums are part of amendments to the previously existing Public Health Service Act. Those apply to the territories.


http://www.washingtonpost.com/blogs/...s-theyre-nothing-compared-to-guam/
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planeguy727
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RE: Why You Must Enroll In Obamacare By 31st March?

Fri Dec 27, 2013 12:35 am

Quoting rfields5421 (Reply 13):
Quoting larshjort (Reply 11):
Why is that?

If individuals were allowed to change plans at any time you could see people that need expensive procedures moving to the better coverage plans, having the procedures, then moving back to the lesser cost plans. This would put undue cost burdens on the plans. By allowing an open enrollment period annually each person has the option to review and modify the choice of coverage should her/his needs have changed in the past year. Part of the way insurance works is to spread the high cost situations across a larger group of people over more time.

Also think of the administrative costs if you have staff that can change plans at any time. The need to process all of that information and actions makes is an unwise idea. Remember part of ACA is capping the administrative costs that can be part of the premium collected by insurance companies.
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