Just Getting Medicare for July 1 & Obamacare Penalty

My bad. Are you saying that we have to have coverage for the entire year? I was under the impression that the clock starts ticking on May o1.
 
To clarify,

AC and Ann are right, clock starts ticking 1/1/14

HOWEVER. There is an exemption from the penalty for those who apply during the OEP. Because the OEP runs until 3/31, anyone who applies by that date (5/1 effective) is exempted from the penalty (for 1/1-4/31. Explicitly, not all penalties).

If it's 4/1 and your client hasn't applied, penalty starts effective 1/1.

We still do not have guidance on what happens if you drop coverage mid-year after applying for 5/1 effective. We presume the first 4 months of penalty are waived, but we do not have official text indicating that (at least that I've read).

The current assumption is that the penalty would only be incurred on the months after coverage was dropped. Technically speaking, it could be levied on "months uncovered", which is why I am unsure. It's up to the court's interpretation.

If anyone has guidance on this subject, I'd love to give it a read.
 
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I'm pretty sure that the waiver of the penalty for those who apply during OEP is only for those who lost their coverage under Obama's "if you like your plan you can keep it" fix. For everyone else the exemption is only for the FIRST gap of LESS THAN 3 coverage months.

By the way, a coverage month is any calendar month in which you had coverage more than one day.
 
So Ann,

To confirm:
-If the client was to apply 3/31 for a 5/1 effective, kept it active until 6/31, and went to Medicare 7/1, they would face no penalty.
-Client doesn't apply, goes on Medicare 7/1, would face 6 months of penalty.

I'm pretty sure those are accurate, but here is the trickier scenario:

Client apples 3/31, cancels 5/2 (covered for a day, and applied during OEP). Gets Medicaid 7/1.
-Are they exempt because the "first lapse" was <3 months?
-Are they paying a penalty for Jan/Feb/Mar/April/June (May was covered)?
-Are they paying a penalty on June only (jan/feb/mar/april waived by OEP fix since applied by 3/31 for a 5/1 effective)?
 
Does anyone really think the penalty will be enforceable?
There are currently 14 hardship exemption waivers.
The "catch all" waiver is, "you experienced a hardship with obtaining health insurance".
With all the problems with the Fed & State exchanges, I doubt anyone will pay a penalty for 2014.
Oregon has yet to process an electronic app. All paper.
 
DS4, don't forget these other near impossible to police hardships:

-You were homeless (requires no proof)
-You experienced domestic violence (No proof required, no description of what is included, no time period given.)
-You experienced a fire, flood, or other natural or human caused disaster that caused substantial damage to your property (Explicitly, no time period on this, and no value beyond "substantial" Hurricane Katrina wiped your substantial fence out in '05? Drunken friend destroyed the house?)
-You had medical expenses you couldn't pay in the past 24 months. (No limit on why, what for, or how much it is.)
-You were determined ineligible for medicaid because your state didn't expand eligibility. (requires notice of denial)
-Your individual insurance plan was cancelled, and "you believe other Marketplace plans are unaffordable" (Verbatim from https://www.healthcare.gov/exemptions/, only proof necessary is a cancellation notice.)
-You experienced unexpected increases in necessary expenses due to caring for an ill/disabled/aging family member. (they ask for documentation, "if possible")

-Refer to their document (http://marketplace.cms.gov/getofficialresources/publications-and-articles/hardship-exemption.pdf) for the whole list, and required proof, and the claim form.

Did I mention this applies to "you and/or anyone in your tax household"? The only bold paragraph in the instructions says so.

Should be fun.
 
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