I Can't Be the Only One Not Clear on the ACA 60 Loss of Coverage SEP

[yogooglethis]

I looked for this on the ACA website and can't get a clarification on the 60 day loss of coverage rule or effective dates. I am only familiar with the rules for Medicare health plans so a person who loss coverage involuntarily like my friend did on 4/15/14 would still qualify for a 63 day SEP for 7/1/14 - if it was a Medicare case. So would a person who loss their coverage 4/15/14 still qualify for a ACA SEP .Would the effective be the day applied for or first of the month like Medicare plans? I don't know if it makes any difference but the plan she lost was basically free subsidized insurance she got when she was unemployed for 3 years from a local hospital that ended 4/15/14 when she started making income working for a temp agency with no benefits.

She making less then 28k and has a disabled adult son living with her ( who may or not qualify for disability SSI later this year )so she does qualify for a subsidy if that makes any difference in getting a SEP. The cost of her diabetic drugs are about 300.00 a months so I think she would qualify for the medically needy status to trigger another SEP if it comes to it but that would take longer.

 

[bluediamond]

It's a 60 day SEP and no it looks like she's out of luck. Subsidy amount has nothing to do with the SEP except it may lower her premiums. She might be able to call the marketplace and tell them she asked for a call back and no one ever called. An agent in our office wrote one today doing just that. Who knows if the woman really called the mp that he wrote?

 

[Tkruger]

I looked for this on the ACA website and can't get a clarification on the 60 day loss of coverage rule or effective dates. I am only familiar with the rules for Medicare health plans so a person who loss coverage involuntarily like my friend did on 4/15/14 would still qualify for a 63 day SEP for 7/1/14 - if it was a Medicare case. So would a person who loss their coverage 4/15/14 still qualify for a ACA SEP .Would the effective be the day applied for or first of the month like Medicare plans? I don't know if it makes any difference but the plan she lost was basically free subsidized insurance she got when she was unemployed for 3 years from a local hospital that ended 4/15/14 when she started making income working for a temp agency with no benefits.

She making less then 28k and has a disabled adult son living with her ( who may or not qualify for disability SSI later this year )so she does qualify for a subsidy if that makes any difference in getting a SEP. The cost of her diabetic drugs are about 300.00 a months so I think she would qualify for the medically needy status to trigger another SEP if it comes to it but that would take longer.

Yo Google This...did you Google that? Your sources seem to be askew.