Things I’ve Learned About the Affordable Care Act This Month

Things I've Learned About the Affordable Care Act This Month

Things I’ve Learned About the Affordable Care Act This Month | brokeGIRLrich

To begin with – it’s still not all that affordable. It’s actually highway robbery. Mostly because you are essentially paying $300-500 a month for catastrophic coverage, since several tiers of the plan still require you to pay at least $6,000 in expenses before full coverage kicks in.

I don’t know about you, but for me, that means I’m really paying a monthly fee and still covering all my health care expenses.

So why even look into it?

I understand not having health insurance is a really bad idea. The same way I understand someday I will be 65 and not want to work anymore, so I should start a savings account for the retirement of this semi-mythical 65 year old Mel (because I have strong suspicions I’m going to fall off a ladder or get electrocuted and die at work way before then).

For whatever reason, semi-mythical 65 year old Mel is real enough to me that I’ll invest in her.

Sick Mel is a little less real.

Because, let’s face it, 30 year old Mel is invincible right? My last bought of being uninsured passed by entirely uneventfully and the worst I had to pay for was a few physicals between 23 and 27.

And fortunately the year I fell down the steps and really jacked up my knee, I was a full time student in England and covered by their (brilliant and properly done) National Health Insurance.

None the less, 30 year old Mel is also a personal finance blogger who realizes this being uninsured thing is a ticking time bomb waiting to explode.

Don’t get me wrong, I was insured until January 1st, which was my last day of coverage at my old job.

To get that coverage, I showed up, the HR lady said “this is our health insurance” and I was good to go. The same with the circus before that. And after a really lengthy qualifying period (and blatantly ignoring the HR lady who nagged me about how stupid it was to not have health insurance for a while), the same with the cruise line before that.

But now I work for a company that does not offer any benefits to folks out on the road (welcome to life in the real world, any performing arts students who read this blog). And I have literally no idea what I’m doing.

I would happily (and just slightly begrudgingly) hand over that $300-500 a month, if I could figure out how.

It appears that trying to sign up for health insurance when you are not going through the company you work for is a major pain in the butt and an endless confusion.

Affordable Care Act

Mistake #1: You do not have 90 days to sort out new healthcare when you lose your previous coverage.

I was under the impression, thanks to being completely misinformed, that I had 90 days to sign up for new health insurance after leaving my last job. So I tried to apply a few times (see Mistake #2), but didn’t worry about it too much, until around day 87 wen I thought, “you need to do this today.”

Turns out it’s 60 days. Additionally, if you know you will lose coverage within the next 60 days, you can apply in advance.

Totally my own fault, I shouldn’t just trust what someone says, but still. Dang.

Mistake #2: I thought the websites would work.

I was redirected so many times or told to enter my zip code and county, except there was no county box option and then it wouldn’t let me proceed any further since I hadn’t entered my county because it was impossible… I just…

Walked away. I walked away from trying to apply at least 5 times. The first few of those times were actually still within open enrollment.

I remember reading all the news articles about what a mess the websites were, but it was so long ago, I assumed that must’ve all been sorted out.

Another thing that angers me about the website is that it is difficult to find a clear list of events that qualify you for enrollment or solid explanations because the site is set up like TurboTax, which makes it easy for you to navigate personally, by asking you questions specific to you.

You click yes or no to a bunch of questions and then it tells you whether or not you can apply right now. Or it tells you that you make too much money.

It does not provide you with a clear list that says something like subsidies start at $31,000, so if you make $32,000 this year, you can calculate you may lose $3,000 in subsidy help, so (especially you freelancers), it would be good to watch how much you make and not make that last $1,000.

Also, this is not to say the information isn’t there, if you dig and dig, eventually you can find it. I just think it shouldn’t take detective work to figure these things out. At least regarding the qualifying events… how exactly the subsidies work, I haven’t even come close to figuring out yet.

Mistake #3: Expecting reasonable coverage.

My estimated income for this year is $32,000. Give or take. That means that after taxes, on average, I have about $2,000 a month to actually spend on things.

The cheapest plan I can participate in is about $300 a month – as a young, non-smoking female with no previous health issues at all. My deductible – so really, the amount I better have sitting in an emergency fund, per year, would be $6,500.

Affordable Care Act

My deductible would be more than 25% of my income. In addition to the $3,600 I would be paying a year in monthly fees. So if something really bad happens to me, that is half of my income gone.

Not even taking into account that if something bad happens to me, I will probably not be able to work, making me unable to even pay those bills anyway.

Mistake #4: Not making this mistake last year.

I am also really irritated that during the special enrollment period for people who meet exceptions, one of the options is “for those who were confused about open enrollment or will have to pay the 2014 fee.”

See above – I pretty clearly fit in this category, except as I continue to research this and try to apply, it really means it’s open to people who had to pay the fee on their taxes. Since my coverage ended January 1, 2015, this did not apply to me.

Apparently it sure will on my 2015 taxes though.

Finally, I really enjoyed the note on the government website that redirected me to companies that provide short term insurance until the next open enrollment period. The government website was happy to tell me this insurance does not count and will still result in me getting the fine on my next taxes, but at least I’ll be covered.

Sorry, what? If I am covered, how on earth does that not count for the months I am covered???

But to put the cherry on the top of my health insurance frustration, the state of New Jersey does not actually have or permit any short term health insurance coverage.

Nailing it, Jersey, at every turn. This is why I will move to some state tax exempt place in the Midwest when I finally do settle down somewhere. And also why I seriously started running numbers to see if it would be smarter to retain an apartment in the City and just sublet it while I’m away… for my health insurance (for those curious, no, not worth the hassle).

If you, like me, are uninsured but still considering giving in to the evil empire that is the Affordable Healthcare Act, here are a few things you should know:

  • Open Enrollment will be from November 1, 2015-January 31, 2016.
  • If you had to pay the tax fine for this year and are confused about your enrollment options, there is a special enrollment period available right now through April 30, 2015. Some states with their own exchanges have set their special enrollment end dates between April 15th-30th.
  • Qualifying life events are things that let you enroll anytime they happen:
    • Getting married.
    • Having a baby.
    • Adopting a child.
    • Giving a child up for adoption.
    • Losing other health coverage (get that done in 60 days though).
    • Permanently moving outside your plan’s coverage area.
    • Gaining U.S. citizenship.
    • Gaining a lawful presence in the U.S.
    • Gaining status as a member of an Indian tribe or Alaskan Native.
    • Leaving incarceration.

All of this mishigas has led me to start researching healthcare ministries. I am increasingly convinced they are the way to go.

13 thoughts on “Things I’ve Learned About the Affordable Care Act This Month

  1. It’s crazy to me how the system works. My mom was unemployed all last year and looked into healthcare and it would have cost her $500 a month. They talk about how you get tax incentives if you don’t make the income to afford the affordable care, but the problem is that you have to spend the $500 a month all year and hope that you will get a deal when you file your taxes the following year. There needs to be a system in place where the incentives are real time rather than tax time.
    Shannon @ Financially Blonde recently posted…Music Mondays – SexyBackMy Profile

    • I really think that the government either needs to just take the entire thing over or let it go entirely. Other countries keep health care affordable by offering the government contract to whatever company creates the most effective and cheapest form of each kind of testing equipment, vaccines, lab supplies, etc. It doesn’t really work unless you follow something a lot more like that.

    • We’re getting our incentives in real time. I think maybe she should look into that again? Because you have the option of doing either/or.

      It is a crock, though. This whole mess got compromised down to a great deal for the insurance companies. Surprised? Not really. Disappointed and kind of upset that I’m forking over so much a month for health insurance? Absolutely. It’s not affordable, especially if you’re in an area that has limited competition.

      Great post, Mel. Really wish things had turned out differently, and hoping the health care ministries turn out to be awesome!
      femmefrugality recently posted…Summer Ready Feet and an iPad Mini #GiveawayMy Profile

  2. I agree that the “affordable” label in the name of the act is a total joke.

    Since I live in a different state, I somehow lucked out and found a catastrophic plan that’s around $150 per month. But the only benefit is a $20 copay for a gynecologist or a family doctor visit – otherwise I’m paying $6,600 out of my pocket before insurance contributes a penny, and I’m limited to which doctors I can go to.

    I didn’t even use my health insurance one single time last year, and I’ve only used it twice for doctor visits this year. (But I’m waiting for better care on other things until I get to another country.)

    When I signed up, I had the same problems with the broken website – I actually had to get on the phone and wait on hold until I could talk a representative through setting up an application for me. Total headache, but what to do?

    Good luck!!
    Chelsea recently posted…How I Conquered the World on a $9,500 Yearly Income (On Making Your Dreams Come True Even if You Are Flat Broke)My Profile

  3. Okay that is just crazy! You are supposed to pay more than 10% of your income for coverage with a $6,000 deductible? On a side note, I do the ACA reporting for our company and it’s becoming a full time job just to let the government know that we do offer our employees insurance.
    Tre recently posted…Net Worth Update Q1-2015My Profile

  4. I was actually pleasantly surprised with the ACA pricing. We are close to financial independence and will have to start looking for our own healthcare soon. I was expecting somewhere $600-$700 a month. For us, a family of 4 can get healthcare for ~$350 a month. Are you a smoker??
    MoneyAhoy recently posted…How to Increase the Value of Your HomeMy Profile

  5. WOW! What a hassle. I have a retirement health benefit after enduring over 30 years for a company (started when I was 20) that is always under threat and benefit reduced yearly. I pay $740 a month which is 23% of my monthly budget. I have a $3600 deductible if I recall correctly and a 80%/20% type pay plan. The ACA as you describe is only affordable if you have super low income. I think the only real plus is that insurance companies can no longer turn people down for pre-existing conditions but at a cost to everyone. I look forward to reading what you find out about the Healthcare Ministries route.
    LeisureFreak Tommy recently posted…Retirement Confidence Is UpMy Profile

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