Client Leaving COBRA to ACA...few ?s

Nov 4, 2015

  1. agentjhc
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    agentjhc Guru

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    I met with a lady tonight. Her COBRA expires this month. Needs a plan for 12/1, and then ACA plan for 2016. She found a plan she likes well enough (but is in shock at the cost compared to the former employer plan) but needs something for December. Her husband mentioned going without, but she shot that down.

    I know there are Short Term Plans that are available, is that a good option? She is 60, currently healthy and takes a few generic drugs.

    Newby at this and trying do the right thing for this lady.
     
  2. TxOnline
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    That's what I'm doing.
    Using Short Term for ONE month....when they are in shock over the "Affordable" Care Act premiums.....and seriously considering going without coverage....AND understand the following:
    - If they have a pre-x condition, it's NOT covered
    - If they have an unexpected illness or injury (that's not pre-x), they have $2 million in coverage. I don't think they could use that up in 1 month.
    - Certain wellness benefits are probably not covered (read your ST policy)
    - SOME ST policies do NOT cover out-patient rx's

    ST is better than going without...to protect their assets.
     
  3. Chazm
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    Chazm Guru

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    Wouldn't she have an SEP to start an aca plan dec 1?
     
    Chazm, Nov 5, 2015
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  4. MBSC
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    She qualifies for an ACA SEP since COBRA is expiring. If her income is low enough, she may also qualify for December APTC. There is no SEP when voluntarily ending COBRA.
     
    MBSC, Nov 5, 2015
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  5. agentjhc
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    Yes....she qualifies, she wanted to look for a cheaper way out for December. She has a plan she likes (except the price) for December if needed and 2016.
     
  6. Medigap Bill
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    Medigap Bill Super Genius

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    I have a similar situation. However, my question is how do I quote a 12/01/15 effective date? Norvax, competitor site and individual carrier sites are all defaulting to a 1/1/15 effective date and I don't see an option to change the effective date.

    Second, when getting a 12/1/15 effective date do you just let it ride for the year or do you have to get them another plan a month later?

    UPDATE: After sitting on hold UHC's answer is do a paper app and fax it in for 1 month for 2015. Quote, "I can't really give you a premium but it may be lower. Quote them the 2016 plan."

    This situation is off exchange.

    Short Term for a month isn't looking so bad if client is OK with it.



     
    Last edited: Nov 6, 2015
  7. Chazm
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    If it's on exchange I know healthscherpa lets you view 2015. I just did yesterday
     
    Chazm, Nov 6, 2015
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