The Market Place…

I am not going to claim to be an expert but I do have first hand experience with Obama Care.

Affordable Health Insurance to be had on The Market Place.

Also referred to as The Exchange by health insurance companies.

In the middle of March, while still staying with my mother-in-law, I decided,

“Nothing ventured, nothing gained” and signed onto the Government website to see what was on offer and just how affordable health care coverage could be?

I found, with tax credits, a policy could be had for as low as $0!

That’s right!  Nothing!

The catch was the acronym,

HMO.

I was excited about the zero price tag but hubs wasn’t at all convinced that a Health Maintenance Organisation was the way I wanted to go.

Brilliant for those who need it though!

As far as the government website went I have to say the workings were all very easy and after a couple of dry runs, where I plugged in information to find out how much of a tax credit Daughts and I could qualify for the level of health coverage available, I decided to do some research.

I began by calling a real person at healthcare.gov and planned to quickly follow up by talking to the major players in the healthcare market, BCBS and Aetna.

For me when something is too easy a red flag goes up and I wanted to make sure I didn’t get caught in a scam!

I called The Market Place and spent the best part of the next six hours going round and round with them, yes them!  Each time I called back I had a long wait and another operator to explain my situation to because by now,

I had a situation!

The phone room I was calling into was high volume and open all the time.

As my friend says,

“365-24-7!”

My daughter is under 26 and qualifies to be on my health insurance so I included her on my application.

My first attempt had generated a verification letter informing me of my tax credit and my eligibility to buy from The Market Place and to,

“choose a plan now!”

My daughter was also eligible to buy from The Market Place but did not qualify for a tax credit.

However,

she could purchase catastrophic insurance at the low cost of $198.00 a month.

Evidently she had to make at least $11,500 a year in order to get a tax credit.  I voiced a concern that perhaps it had something to do with her paying (or not) income tax,

“This affordable healthcare credit has nothing to do with federal income tax…” my operator informed me.

There was a modicum of good news though,

The letter added that Daughts wouldn’t have to pay a penalty for not having coverage.

And here’s the kicker,

She qualified for Medicaid, but…

“Based on the information you provided, the new federal health care law provides that you could be eligible for free or low cost health care through Medicaid. However, the state of TX has chosen not to offer you this new health care coverage at this time. 

You are not required to pay a penalty for not having health insurance because of your income and because the state of TX declined to expand Medicaid to cover individuals in your situation.”

I read this piece of information to my latest captive audience member and she confidently told me she could solve my problem.  I now had a situation and a problem!

She took a look at my latest application and played the you can’t include your daughter on your health insurance policy because… game,

“You’re filing separate tax returns.”  Since when can mother and daughter file their taxes jointly?

“She’s over 26!”  Not correct, she’s 22!

“She doesn’t live at home?”  According to qualifying situations this doesn’t matter.

“She’s not a financial dependent…” absolutely but she doesn’t need to be.

“She’s filing her own taxes.”  yes she is but how else is she going to pay bills if she doesn’t work and isn’t financially dependent on me?

According to the government web site I was currently on here’s the criteria she needs to meet in order to qualify:

Children can join or remain on a parent’s plan even if they are:

  • married
  • not living with their parents
  • attending school
  • not financially dependent on their parents
  • eligible to enroll in their employer’s plan

“These rules apply to both job-based plans and individual plans you buy yourself, inside or outside the Marketplace.

“Adult children may be enrolled during a plan’s Open Enrollment period or during other special enrollment opportunities. The employer or insurance company can provide details.

“When you apply for a new plan in the Marketplace, you can usually sign up your under-26-year-olds on the same application. Be sure to include them on the list of people to be covered.”

(I had!)

“Important: If your child under 26 is not your dependent for tax purposes, you’ll need help to fill out your application correctly. This is true only if you or anyone who’ll be part of the same application wants to qualify for premium tax credits and lower out-of-pocket costs based on household size and income.

“If this applies to your situation, contact the Marketplace call center at 1-800-318-2596 (TTY: 1-855-889-4325). Explain your situation and the representative will tell you how to fill out your application.”

Oh, if only I had that representative!

Instead I asked the one I had,

“Where can I go for help getting my daughter included on my plan?  Apart from Mr. Obama of course?”

I was met with a stony silence.

“Surely I can’t be your only customer who has this dilemma?”  I persisted.

“No Ma’am, you’re not.”

She put me through to Special Services another high volume department, and after waiting for 30 minutes my line went dead.,

By the end of 8 hours I had created and removed five different applications and still was no further than I had been when I decided,

“Nothing ventured, nothing gained,”

Time and my patience were running out.

Understandable I was also worried about my social security number.

Was it now exposed to all and sundry?

I had lost confidence in the government’s ever so user friendly website and ran off with my tail between my legs to wait another day.

 

 

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