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Skip the subsidy Mika. Just buy a regular policy. It took a month to get my nephews plan finalized and all paperwork in and mistakes fixed. But it sounds much too hard for you to be bothering with, so why not just forget about it.
Golfgal, that's what we thought too. This was in September 2013. The rep told him he could apply but would be denied, so that he should keep paying his COBRA and wait until he could buy off the marketplace. That's what he did. I thought they had to approve him, but would just charge him more or refer him to his state's high risk pool. He's not only obese, but also has thyroid problems, high blood pressure & diverticulitis.
It would be interesting to know how many people have purchased insurance direct from insurers vs how many went through the marketplace.
Prior to policies under the ACA, insurance companies could deny coverage to anyone who had any problematic areas. As of Jan 1, 2014, this is no longer allowed under "Obamacare".
I believe what the agent was advising him to do was to hold tight and just pay his Cobra until he could buy an ACA compliant plan that would take effect as of Jan 2014. There is no "have to approve him" anymore. That is one of the major changes to the new ACA. Anyone can buy insurance now. (sick or well, skinny or fat, tall or short, etc.) Only add on cost is if someone smokes.
It might be a good idea to do a little reading so you understand things better. You can order a book from Amazon that is a quick and easy read called:
You can buy a used one for a penny and $3.99 shipping. The only reason for using the exchange is when you or he qualifies for a subsidy.
Please Google ACA subsidy guidelines. If he makes too much for any kind of subsidy, then anyone can just purchase any plan they chose that is ACA compliant directly from the insurance company. Either way, no forms to fill out, no physicals, etc.
Yes, still am if I could get a plan off the marketplace for 1000 I would jump on it but it doesn't exist in NY.
You don't NEED to use the marketplace if you aren't using your subsidies. Go online to United or whomever you want to use and sign up for a plan with them. Once that is approved, cancel your other plans, done.
@Modhatter, I can't afford a regular plan for 1800 for a family of 3, these are the rates off the marketplace.
And the cheaper ones have a network of 10 doctors, which for me is having no insurance as those are not good doctors.
@Modhatter, I can't afford a regular plan for 1800 for a family of 3, these are the rates off the marketplace.
And the cheaper ones have a network of 10 doctors, which for me is having no insurance as those are not good doctors.
My friend lives in rural NY. All of her dr's are in her network with her market place plan, but then again, being that she is that rural, there just are not that many dr's around either. I posted a link to dr's in NY city that take the NY Child Health plan and there were 45+ pages of dr's in that network (over 400 dr's). So, are you just assuming again or have you really looked into this?
I checked every child health plus plan offered on the marketplace (healthplus, health first etc) doctors OUTSIDE of manhattan accept it, you may have searched NY general area, but for me (have no car) taking my baby on a train + a bus + a cab in the snow and back if he has a fever is NOT doable and reasonable. I need a doctor in my area, and by 'my area' I mean 60-70 blocks away is still good. None of the pediatricians I know and trust accept it, the only ones are unknown doctors nobody I know ever heard of, I don't want that for my baby. Would YOU take your baby to a doctor you don't know/trust?!? Anybody who is human would say NO.
I would have been OK with getting a private plan only for my 15 months old and pay full price for him but no insurance allows that.
Plus, because my son was on medicaid last year CHP's system is messed up and shows him still on even though Medicaid is over since January (got a letter from them stating so) and they deny him coverage even if I provided proof that he is not on medicaid anymore. Bottom line, my 15 months old has no insurance thanks to the new reform.
I checked every child health plus plan offered on the marketplace (healthplus, health first etc) doctors OUTSIDE of manhattan accept it, you may have searched NY general area, but for me (have no car) taking my baby on a train + a bus + a cab in the snow and back if he has a fever is NOT doable and reasonable. I need a doctor in my area, and by 'my area' I mean 60-70 blocks away is still good. None of the pediatricians I know and trust accept it, the only ones are unknown doctors nobody I know ever heard of, I don't want that for my baby. Would YOU take your baby to a doctor you don't know/trust?!? Anybody who is human would say NO.
I would have been OK with getting a private plan only for my 15 months old and pay full price for him but no insurance allows that.
Plus, because my son was on medicaid last year CHP's system is messed up and shows him still on even though Medicaid is over since January (got a letter from them stating so) and they deny him coverage even if I provided proof that he is not on medicaid anymore. Bottom line, my 15 months old has no insurance thanks to the new reform.
No, I posted a link to Dr's in NYC--which I'm pretty sure encompasses Manhattan too. You said in an earlier post that your son was put on Medicaid when you went to the Marketplace plan for yourself, and now he's not on it?
As for switching to new dr's, yes, I had to do that every time we moved. People do it all the time. What if the new doctor is better than your old doctor. You are getting a little silly with this. What would you have done if your dr dropped your old plan? People with corporate plans have had to switch drs when their companies moved from one carrier to another, years and years before the ACA was even an idea in someone's mind.
Go to a carrier's site that you want, sign up for a plan that doesn't use your HUGE subsidies, pay for it out of pocket and be done. Your coverage is nearly FREE under the ACA, for that, you do have a limited network. You are ASSUMING those drs are bad but you don't know. Your alternative is to pay $1000+/month..you have choices...
Wish it was 1000+ / month, it's more like 1800+ month, which is a BIG difference. Easy for you people to say just go and pay out of pocket, health plans in NYC are ridiculously expensive.
And yes, my son was on medicaid till january, then the marketplace pushed him on CHP but they denied him because their system still show him on Medicaid. CHP took my money for the month of January to tell me (when I called them) that he was denied.
And I can't pick a regular plan for him as the marketplace doesn't allow that and insurances neither.
Wish it was 1000+ / month, it's more like 1800+ month, which is a BIG difference. Easy for you people to say just go and pay out of pocket, health plans in NYC are ridiculously expensive.
And yes, my son was on medicaid till january, then the marketplace pushed him on CHP but they denied him because their system still show him on Medicaid. CHP took my money for the month of January to tell me (when I called them) that he was denied.
And I can't pick a regular plan for him as the marketplace doesn't allow that and insurances neither.
Call Medicaid on Monday--it's just a computer glitch....
and yes, if you drop your heavily subsidized plans, you can sign him and the rest of you up on a regular plan that you will pay full price for.....
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