Is there an avenue for fighting Healthcare.gov?

[Jfine]

I had insurance through the exchange for many years. Last year, I got married. When I went through the re-enrollment process, I learned that I was not eligible for subsidies because I could now get insurance through my husband's job. This wasn't a surprise. I went through the process to see what the cost would be. The cheapest plan was over $600/mo. So, I didn't enroll and got onto my husbands plan. It's June now, and I just learned that despite the plethora of emails I received reminding me not to forget to enroll, I had already been re-enrolled in my previous year's plan. Healthcare.gov has been paying for a policy for me since January with subsidies that I'm not eligible for! Come tax time, I'm going to owe that money, correct? It's about $750 a month! I spoke to someone at the exchange who told me that the most he could do was "forward my complaint." Because that will be helpful, I'm sure. Is that it? Am I going to be stuck owing $3750 for insurance I never used or wanted?

 

[STIBROKER]

sounds like your fight is with the IRS.....might have to send them docs showing you were on a group plan.....

 

[David Taylor Jr]

It all depends on how your application was submitted. At the end it asks something to the effect of do you want us to remove you from your policy if you enroll in something else. If for some reason that was not agreed to they will not remove you and you could potentially owe money.

Now, as far as an avenue to "fight" healthcare.gov. Yes, you can see if they will let you go through an appeal process. You will need to call the Marketplace, explain the situation, then probably have to ask to escalate it to a supervisor.

 

[Yagents]

I had insurance through the exchange for many years. Last year, I got married. When I went through the re-enrollment process, I learned that I was not eligible for subsidies because I could now get insurance through my husband's job. This wasn't a surprise. I went through the process to see what the cost would be. The cheapest plan was over $600/mo. So, I didn't enroll and got onto my husbands plan. It's June now, and I just learned that despite the plethora of emails I received reminding me not to forget to enroll, I had already been re-enrolled in my previous year's plan. Healthcare.gov has been paying for a policy for me since January with subsidies that I'm not eligible for! Come tax time, I'm going to owe that money, correct? It's about $750 a month! I spoke to someone at the exchange who told me that the most he could do was "forward my complaint." Because that will be helpful, I'm sure. Is that it? Am I going to be stuck owing $3750 for insurance I never used or wanted?

The marketplace is a disaster, especially when you dont use an agent, and have to rely upon *** marketplace 1 800 reps.

The marketplace auto reenrolls clients unless you cancel.

Being a victim, and given the hotel California set up, here is what I would suggest:

Your first problem is with the marketplace, not IRS

1. Cancel your plan asap to stop the bleeding. If not done already
2. Call them and ask them to send your case to escalation dept. That will take 2 months and go nowhere and be lost.
3. Send in your appeal documents and explanation via certified mail.

Your appeal:

I got tax credits in 2018 for $0 premium, then called and went to full price. To go from $0 to $600, any normal human would want to cancel.

I called marketplace on x date, I was offered no tax credits, and rep never cancelled 2018 plan . After telling them i would join group instead.

Because you have $0 premium, you never got a bill in mail.

Send them proof of your new group plan coverage and start date

Show them determination letter generated when u called marketplace and went to $0 credit.

Fyi, marketplace does not record phone calls, so u could remind them u asked for plan cancellation and rep never did it.

Allow 3 months, follow up with them, and if you win, they will take money back from carrier. If u lose, that's when mr IRS will be due and they dont have ability to waive it for you.

Also, I assume u r low income getting those large subsidies, include that affordability issue.

Also, if married last year, u may owe for last year too depending on month of marriage and if they know u had group plan access in 2018.

Good luck

 

[Jfine]

Thank you, everyone. What a pain in the a**.

 

[David Taylor Jr]

Thank you, everyone. What a pain in the a**.

Dealing with the Marketplace is a nightmare for agents as well. I've had countless bad experiences with call center employees at the marketplace, including supervisors, not knowing how things work. Best of luck.