Can I Ask Personal Advice Here? How Do I Get Health Insurance?

Sep 13, 2016

  1. SueNami
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    SueNami Expert

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    Hope no one minds this- but maybe it will be something others can learn from as they read it too...

    Situation is I'm in process of divorce. STBX (soon to be ex...) skipped the state and is living across the country. I found out that when he moved and took a new job he did not insure myself and our son even though a court order in my state said he should (and apparently the employer doesn't care much about enforcing an out of state court order)

    That's all fine- but what do I do? I understand the process of enrolling in health insurance 0% since the obamacare started up. Can I buy a direct plan? Is all health insurance obamacare? Do i have to go through the exchange? Do I have to wait until open enrollment? (though I just found out, the gap of insurance has been more than 30 days)

    I'd love to hear anyone's suggestions... Thanks in advance!

    I live in PA if it matters...

    Edited to add- other than being plump, I'm in great health. We both are. We saw a doc for the flu this past year otherwise nothing...if anything we don't see the dr enough compared to most people's standards. (checkups= yuck)
     
    Last edited: Sep 13, 2016
    SueNami, Sep 13, 2016
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  2. Yagents
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    Yagents Guru

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    If your loss of coverage is within 60 days, you can still get Obamacare at Healthcare.gov or by calling them at 800 318 2596. You can try to buy a direct plan, but most insurers have hidden those plans. Easier to buy thru gov't (can't believe I just said that)

    If you're past that 60 day point, you will have to wait until open enrollment in Nov for a Jan 1st eff date.

    If shut out til first of yr, then consider buying a short term major medical to cover the gap. You may owe a small penalty for not being covered with compliant coverage for remainder of the year.

    An agent in PA might pop in here, or suggest you find one.
     
    Yagents, Sep 13, 2016
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  3. tonyisme
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    tonyisme Guru

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    It's just my opinion maybe send the court order to his employer HR dept. But before you do that you might want to talk to somebody with legal knowledge.
     
    tonyisme, Sep 14, 2016
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  4. rcduggan
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    rcduggan Super Genius

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    it's not the employer's responsibility to pay for dependent coverage and really depends on how the master application is setup for the group outlining dependent contributions. nowadays most employers pay 0% for dependent coverage so i dont think you can blame the new employer. your STBX forgot to check a few boxes and input you and your child on the application but i could be wrong.

    secondly, timing is key in a situation like this. yagents has explained it perfectly. has it been more than 60 days or less since loss of coverage?
    if less than 60 you can qualify for special enrollment period and apply to any carrier.
    if more than 60 you're left with short term medical plans only and they require minimal underwriting in order to qualify. i am PA licensed with STM but none of the traditional health carriers out there. if you want an STM plan to cover you if a "bolt of lighting strikes" then i can give you a link to enroll. PM me and we can chat more if you like
     
    rcduggan, Sep 14, 2016
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  5. kgmom219
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    kgmom219 What's Next?

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    I'm going to give a TX response on this, but most states do it the same way.

    If there is a court order in place for health insurance, whether the employer pays any part of the premium or not is irrelevant. And it IS the employers responsibility to report to the court if a court order is not being adhered to, whether its because the employee declined coverage or the employer doesn't offer coverage.

    TX law furthers requires employers who are withholding child supoort, but NOT showing child health insurance coverage (when available) to report that info to the AG.
     
    kgmom219, Sep 14, 2016
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  6. tonyisme
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    I never said it was the employers responsibility to pay dependent premium. But certainly the employer should be aware if there's a court order and his / her employee isn't in compliance
     
    tonyisme, Sep 14, 2016
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  7. kgmom219
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    kgmom219 What's Next?

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    I quoted RC...do you have 2 identities on the forum???
     
    kgmom219, Sep 14, 2016
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  8. tonyisme
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    Only one. I am of the opinion that the employer needs to be aware of an employee's court obligations especially when insurance is involved.
    The employee's HR department will confront the employee about this if they have the court documents in hand but ultimately it's up to the employee to cover the dependents. Just take it a step further if I was the wife I would send the court order copies via registered mail to the HR department of that spouse's employer so that she has proof she at least made an effort to try to get coverage.
     
    tonyisme, Sep 15, 2016
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  9. kgmom219
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    kgmom219 What's Next?

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    I agree with all that...

    RC's comment saying that its not the employers responsibility because there is no employer contribution is what I took exception to....
     
    kgmom219, Sep 15, 2016
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  10. rcduggan
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    rcduggan Super Genius

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    I completely agree with you on the court order and the employer SHOULD be aware. I can almost bet though this STBX jumped state, got a new job and purposely didn't "check the box" for dependent coverage probably because he would have to pay 100% for that coverage. and why would I have two IDs here? who does that? :goofy:
     
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