Subsidy Mid Year Increase/lower Deductible, Claims Question

[yorkriver1]

Just did a life change on a Marketplace policy that we hope, based on what the BCBS broker services reps say, will carry over the already high out of pocket accrued expense to the newly reduced deductible and MOOP amounts after 7/1/15. That will mean after 7/1, no out of pocket at all for the rest of the year.

The change was done due to the time off/reduced hours that the situation requires, and resulting lowered income estimate for 2015. The lower premium will help.

My question is whether the carrying over of the calendar year to date OOP/deductible is carrier specific, or the usual way for all carriers on Marketplace, assuming the plan is not changed.

 

[kgmom219]

Just did a life change on a Marketplace policy that we hope, based on what the BCBS broker services reps say, will carry over the already high out of pocket accrued expense to the newly reduced deductible and MOOP amounts after 7/1/15. That will mean after 7/1, no out of pocket at all for the rest of the year.

The change was done due to the time off/reduced hours that the situation requires, and resulting lowered income estimate for 2015. The lower premium will help.

My question is whether the carrying over of the calendar year to date OOP/deductible is carrier specific, or the usual way for all carriers on Marketplace, assuming the plan is not changed.

Is it SUPPOSED to carryover? Yes.

Will it get done automatically? Probably not.

 

[yorkriver1]

Thanks, I will check with BCBS in a few days, after they should have received the premium/deductible/MOOP update, see what they say.