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So here I am again in trouble because of this new disgraceful Exchange plan.
Originally I had picked United Gold with a $600 deductible. after a month, thank (or not) to this forum, I realized that because of my low income if I selected a silver plan I could get a $250 deductible. Well, I switched right away and the representative over he phone confirmed that info was correct, $250 deductible, how can you go wrong?? APPARENTLY YOU CAN!!
Fast forward today, I receive a claim for $200 for a med lab. I called stating I had already reached my deductible to be told that my deductible is $1400!!!!
WHAT? WHO? WHERE? HOW DID THAT HAPPEN?
I called United and they told me to call Exchange, I called Exchange and ... yes, you guessed right, they told me to call United, but I didnt fall for it and told them to put in a complaint.
Well, now I am stuck with a $200 claim bill , plus they lowered my tax credit out of nowhere without even sending me a notice, I just saw it when I went to pay ...
Now, my question is, do I have to pay the $200 claim?!
Well, hopefully next month I am getting out of This Exchange craziness and get a regular plan.
How are you getting a non exchange plan? General enrollment is over for the year. Cancelling your exchange plan volitionally is not a triggering event. I believe you are stuck until next year.
You state they lowered your "tax credit" out of nowhere. What are you referring to here? Are they stating that your stated income may be different from what you originally told them or anticipated? It is your yearly income, if found to be higher, that your deductibles and other fees would change. If it turns out to be higher than you originally told them, then they may raise your costs. But this seems unlikely to me at this juncture, but since this is all new, we are not really aware of the means of checking income etc., that may be available to them to keep people honest.
If you know it is not this, then the trouble is with the insurance company. And as Weichert said, United Health Care has a tainted reputation in the billing dept (except for Medicare). Though it may drive you crazy, and take a good deal of your time, you should be able to get it sorted out. Just make sure you keep a log of who you talked to on what day, and what they said.
I so so so loved my Healthy NY plan, it cost just as much as the current one (without tax credit) and I ONLY had to pay a $20 copay, no matter what I had to do. Even most expensive stuff were only $20 copay. I really did not care about not having a max out of pocket.
With new individual plan I have $600 deduct (which is not too bad but still ...) and I think $25 / $35 copay, total couple deduct is 1200 though, so I am not sure I have to reach 600 or 1200 ... So freaking confusing.
I can enroll in an individual plan any time, you can enroll in the Exchange cr*p only at specific time of the year (nazi insurance).
They changed my plan out of nowhere, not sure based on what they decided to lower my tax credit by $100/ month and now my Silver plan has a 1400 deductible, while they had told me it was going to be 250 if I picked the Silver plan because I was low income, unfortunately I didnt save the page that said so as I didnt think they were going to try to screw me (wrong! Always assume they ARE going to try to *********, lesson learned) . Liars, liars liars, I am not paying another United exchange bill till they figure this mess out.
The "enrollment time" rule is valid only for the Exchange, they cant force their muscles and abuse outside of their stupid plans. If I go individual it's not of their business anymore, i am going private, I paying all out of pocket, they only have to shut up. I hate hate hate hate the exchange, did I mention that I HATE THE EXCHANGE?! I HATE THEM.
The "enrollment time" rule is valid only for the Exchange, they cant force their muscles and abuse outside of their stupid plans. If I go individual it's not of their business anymore, i am going private, I paying all out of pocket, they only have to shut up. I hate hate hate hate the exchange, did I mention that I HATE THE EXCHANGE?! I HATE THEM.
Wrong. The enrollment period pertains to all policies sold whether on or off exchange unless you have a qualifying event. This was done to prevent people from buying a plan just as they got sick.
Go see a broker. Maybe they can be creative about a qualifying event to allow you to buy a different plan outside of the exchange.
Be prepared for sticker shock. Private plans in NY are very expensive. Far more expensive than what the Healthy NY plans were as they were subsidized.
Financially speaking, you'd probably still be better off with a lower subsidized Exchange plan.
Let us know what quotes you get. My plan terminates next month, so I'll be signing up for Non Exchange plan as I probably won't get a subsidy, so I don't want to be with the Exchange plans and their issues right now.
How did you get a group plan from the Exchange? The SHOP exchange wasn't open yet.
Or are you going to replace the individual plan with a group plan? I do believe groups need to be 3 or more members now, not the old 2 members. I know groups of 2 were forced to go into the individual market in NY starting 1/1/14.
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