Louisiana ACA-Compliant Qualified Health Plans Outside the Marketplace

ardpub

New Member
5
Due to some billing confusion, I missed a payment causing my ACA marketplace individual health plan to be terminated. As I am self-employed and don't qualify for a special enrollment period, it would seem the only option I have for getting coverage between now and 1/1/18 is to buy a short-term policy from a very poorly-rated company, which will still subject me to an individual mandate penalty.

Are there are ACA-compliant, qualified health plans (short-term, ideally) that can be purchased outside the marketplace in Louisiana?
 
it would seem the only option I have for getting coverage between now and 1/1/18 is to buy a short-term policy from a very poorly-rated company, which will still subject me to an individual mandate penalty.

Are there are ACA-compliant, qualified health plans (short-term, ideally) that can be purchased outside the marketplace in Louisiana?
Christian Health plans......
 
Christian Health plans......
This is interesting and worth looking more into but I'd still like to know about more conventional plans. I know healthcare.gov says that private ACA-compliant plans exist but I'm still trying to get a definitive answer as to if there are any viable options in Louisiana.
 
I know healthcare.gov says that private ACA-compliant plans exist but I'm still trying to get a definitive answer .
You got..... CHS plans.....take it out for a few months then get set up with ACA for Jan 2018.....
 
Not that I'm aware of, but I'm not heavily involved in that market in LA. The only companies that I know of that are still writing are BCBSLA and Vantage. I think everyone else pulled out a few years ago whether on the marketplace or not.

You would not have a valid election period regardless. That rule applies whether the Qualified Health Plan is on-exchange (marketplace) or off-exchange.

There is no short term policy that is ACA compliant in the sense that it would help you avoid the penalty. By definition they are not qualified health plans. But for those who can qualify medically, they help limit your exposure should some catastrophic event occur.

I think your options are getting a short term plan or going with one of the Christian plans as Sti recommended.

Were you getting a subsidy? If so it generally would take 3 months for a plan to be terminated instead of the usual one month in the case of plans in which you don't get a subsidy. If you definitely make too much money every year to get a tax credit, you're generally better off to purchase the plan from the carrier directly instead of getting the Marketplace involved since it's generally easier to handle customer service issues with the carrier instead of having to get the marketplace involved
 
Last edited:
Were you getting a subsidy? If so it generally would take 3 months for a plan to be terminated instead of the usual one month in the case of plans in which you don't get a subsidy. If you definitely make too much money every year to get a tax credit, you're generally better off to purchase the plan from the carrier directly instead of getting the Marketplace involved since it's generally easier to handle customer service issues with the carrier instead of having to get the marketplace involved

Thanks for your reply. I guess healthcare.gov is referring to QHP's purchased off the market during the open enrollment period when they say compliant plans will avoid the fee.

I didn't qualify for a subsidy when I bought the plan on the marketplace, which is why I only got 30 days, but I still like to use the marketplace because I can always get the subsidy retroactively as a tax credit if I have a dip in income for the year. What is the advantage of buying outside the marketplace if you're subject to the enrollment period either way?
 
Thanks for your reply. I guess healthcare.gov is referring to QHP's purchased off the market during the open enrollment period when they say compliant plans will avoid the fee.

I didn't qualify for a subsidy when I bought the plan on the marketplace, which is why I only got 30 days, but I still like to use the marketplace because I can always get the subsidy retroactively as a tax credit if I have a dip in income for the year. What is the advantage of buying outside the marketplace if you're subject to the enrollment period either way?

If there's a realistic possibility that your income could drop below 400 FPL, then it does make sense to purchase through the marketplace.

For those who know they won't qualify for a subsidy, going through the marketplace introduces an unnecessary middleman, and one that isn't exactly renowned for customer service. It is possible that things may have changed slightly, but when I was dealing with this regularly a few years ago, you had to contact the Marketplace for minor things like changing a phone number or a mailing address.

Where it is an option, standalone dental should never be purchased through the marketplace even for those who qualify for a heavy subsidy. There is no advantage at all financially and it causes a lot of problems, such as people inadvertently losing their dental coverage.
 
There are sometimes additional coverage options available off-marketplace. This year in TN, Farm Bureau TRH had ACA compliant plans that were 20% cheaper than comparable exchange plans. However, the rules about enrollment periods still hold. If you lapsed for non-payment, there is no way to get onto an ACA compliant plan now without having special enrollment period eligibility, which it doesn't sound like you have. That is why STIbroker said to go to Christian Health Plans. It is not technically "ACA compliant", but you may be exempt from the tax penalty for the months you are without coverage if you are a member of one.
 
Thanks for the replies! Great info. Yes, I do think the Marketplace customer service has gotten much better than it was in the beginning, both through the website and on the phone.

I agree about dental. Still have the same off-market plan I've had since before the ACA and its pennies compared to medical.
 

Latest posts

Back
Top