Exceptional Circumstances Question

Feb 13, 2016

  1. yorkriver1

    yorkriver1 Guru

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    Have any of you had an escalation for exceptional circumstances?

    Family has had illness that prevented spouse from keeping up with bills. I find it interesting that the loss of coverage reason was not questioned by the rep at HC.gov, more the length of time of the lapse.

    Am also pursuing STM, but want to find carrier that does more than 6 months, as back to back has some risks. Only have UH1 now, seeking other carriers.

    Update: spoke to well informed Tier 2 person at HC.gov. The special situation has to be tightly defined as much more disabled than those in my client's situation. The good news is that they are policing this pretty well, with the exception that the front line rep did not ask if the lapse in coverage was due to not paying premium on time, which it was. They would have gone ahead on the front line, I think, if I had not brought that up, but it was also past 60 days, too. Less than 60 days, no reason asked. Not that all reps would fail to ask the right questions.

    So, clear path to STM, and would still like to find a longer than 6 month carrier.
    Last edited: Feb 13, 2016
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