by Chris Huckins Google+ Email 

 

Health Insurance 101

18 July 2014

Is Signing Up for Obamacare a Trap to Deport Immigrant Families?

Posted in Health Insurance 101

Is Signing Up for Obamacare a Trap to Deport Immigrant Families?

No wonder immigrant families are scared of being deported if they sign up for Obamacare. The health insurance law is nicknamed after a president critics call "The Deporter-in-Chief". 

For immigrants in Los Angeles, it's important to know who will get deported for getting health insurance, considering 1 in 10 residents in Los Angeles is illegally-present. The other 9 are just extras on Californiacation. 

Despite the fact that President Obama removed over 2 million immigrants in the first 5 years of his presidency, he promised no families would be separated when applying for health insurance. But who can blame skeptics when his infamous pledge, "If you like your plan, you can keep your plan" became Politifact's "Lie of the Year".

After Obamacare's first open enrollment period, no one was deported for signing up for health insurance, even if the application scarily asked for race, preferred language, and citizenship status. The Department of Health and Human Services simply collected this data to verify lawfully-present applicants, to meet  demographic enrollment goals, and to improve outreach and education for different groups of people. 

Latinos were targeted by the administration, but not for their paperwork. Latinos make up the highest number of uninsured people in the country and in order to sign them up for health insurance, special consideration went into educating the group. 

As Affordable Care Act outreach started, the Department of Health and Human Services changed the term health insurance "exchange" into marketplace because the original word didn't have a sensible Spanish equivalent. 

Exchanges refer to the organizations that sell public insurance plans, which may come with financial assistance if an individual or family qualifies.

Speaking of qualifications, it's considered a special qualifying event if you just gained U.S. citizenship or you had a change in your immigration status, meaning you can sign up for health insurance now even if it's not open enrollment season. 

Immigrant families with "mixed status", meaning some members are legally present, don't have to hide their relatives when applying for health insurance. By "Get Covered" we don't mean with a giant ceramic rock to evade ICE agents at your doorstep. Anyone who isn't on the health insurance application, illegally present or not, will not be questioned. 

The next open enrollment season starts November 15, so ready your green cards!

20 May 2014

Why Does Open Enrollment Exist?

Posted in Health Insurance 101

Why Does Open Enrollment Exist?

I always hear this Obamacare complaint when someone wants health insurance now that open enrollment season is over: "Why can't I just get insurance anytime?" It's usually followed by, "Don't you want my money?" or "Stupid Obama. He ruined everything." Harsh.

Open enrollment is the period when someone can sign up for health insurance since the Affordable Care Act passed. Last year, it was October 1, 2013 to March 31, 2014 (deadline extensions included).

Its intention is to save individuals and insurance companies from financial ruin, not create it. 

Imagine if there wasn't open enrollment. Sure, everyone could get insurance at anytime. It would be beneficial to insurance agents, providers, sick people. Even President Obama might see a popularity boost; at least in the beginning.

But if anyone could sign up for health insurance at anytime, more people would take advantage of the system. You're probably thinking someone always takes advantage of the system, like before the ACA, when medical bills of the uninsured were paid by taxpayers.

Under the ACA, at least the individual mandate means getting insurance during open enrollment or paying a penalty. Essentially everyone contributes their fair share now. 

This scenario always comes to mind if open enrollment didn't exist: a healthy person is uninsured but gets sick. The individual signs up for an expensive plan and pays for it as long as it covers the expensive medical costs. Then upon feeling better, the individual switches to a cheaper plan with less benefits or drops coverage entirely. 

What happened to the insurance company this whole time? The individual only paid for a few months of insurance premiums but received expensive treatment. If everyone did that, every insurance company would be a sucker.

Not only would insurance companies suffer: everyone who gets insurance would see insurance premiums rise. How else would insurance companies pay for everyone's expensive treatments if everyone switched to cheaper plans or dropped coverage at their convenience? 

Not only does open enrollment exist to prevent the system from getting screwed, but during open enrollment, a monthly insurance deadline remains in place for the same reason. 

Monthly deadlines are when an individual can sign up to start coverage the following month. 

Picking a plan between the 1st and the 14th of the month guarantees the plan would go into effect the 1st of the following month and no sooner. Signing up between the 15th and the end of the month would mean the plan starts not next month but the month after that on the 1st.

If an individual has insurance and wants to switch, it will always take at least two weeks to process, essentially forcing a gap month or longer to occur. 

If an individual calls an insurance company and asks to switch plans, the new plan would always start the next month or later. During that gap, the individual would still have to pay for the current plan if he or she wanted to keep it. There would always be the option to cancel the current plan and become uninsured during the gap month instead.

Deadlines and open enrollment exist to incentivize individuals to keep an insurance plan, not risk being uninsured, and minimize switching between cheaper and expensive plans at the individual's convenience. 

Open enrollment starts again November 15, 2014. Some special qualifying life events allow people to get insurance now, even after the open enrollment deadline. Complaining about Obama isn't one of them.

15 May 2014

Is Pregnancy a Qualifying Life Event?

Posted in Health Insurance 101

Is Pregnancy a Qualifying Life Event?

If you missed getting insurance during open enrollment it's likely tough luck for you. But there's a silver lining at end of the tunnel. And that tunnel is the uterus. 

For most uninsured Californians, waiting until the next enrollment period on November 15, 2014 is the only option to get insurance, unless you qualify for Medi-Cal or group insurance through an employer. 

Plan B (not "that" Plan B) would be to have a child, which qualifies the mother and the child to get insurance outside of open enrollment. Under Obamacare, giving birth is a qualifying life event.

For the mother to get insurance outside of the open enrollment period, she must wait until the date of the child's birth.

A newborn is considered an addition to the family, and changes in family size is a qualifying life event. In fact, the family can enroll for a new plan because its insurance costs would change when more family members are added.

Adopting a child is of course a qualifying life event as well. The adopted child can get insurance from the date he or she is in the parent's custody.  

If Mom didn't have insurance prior to giving birth, but enrolled shortly after, the baby's medical bills from its date of birth and after would be covered by the insurance, but nothing related to the mother's pregnancy would be covered. 

If the mother already had insurance and gave birth, she can place the baby on her existing plan. She has a 30 day grace period to change her mind, in case she opts for a Covered California plan, which may grant her premium assistance

Premium assistance benefits an individual with a gross income between $16,000 and $44,000. The amount changes depending on family size and income. 

If Mom claims her baby on her taxes and sends it on the child star circuit, that income from diaper commercials must be claimed on the health insurance application, just in case you're wondering. 

If women are kicking themselves for not getting insurance while pregnant and during open enrollment period, please don't aim for the baby-maker. 

12 May 2014

How to Get Obamacare After the Deadline

Posted in Health Insurance 101

How to Get Obamacare After the Deadline

So it's past the Obamacare deadline. You missed out on health insurance during open enrollment like the unicorn missed the Ark before the Great Flood. 

Don't feel you'll be extinct without health insurance, though. Special enrollment is allowed for anyone with a qualifying life event such as:

  • Birth of a child (or change in family size, i.e. adoption)
  • Loss of employer coverage
  • Moving to a new residence
  • Getting married
  • Turning 26 (For those under 26, there's the option to stay on a parent's insurance plan)

Open enrollment was October 1st, 2013- April 15th, 2014 (after deadline extensions), but circumstances may have prevented you from enrolling.

If the following Exceptional Circumstances occurred, you can still pick a plan:

  • You experienced an unexpected hospitalization or temporary cognitive disability (being in a coma, believing you're a unicorn, developing soap opera amnesia).
  • A natural disaster prevented enrollment (earthquake, asteroid, Jurassic World attack).
  • The Covered CA website and call center had a system outage.
  • Domestic violence prevented you from getting insurance. 
  • Solange Knowles attacked you in an elevator.

If you were the victim of misinformation or misconduct by an insurance representative, you may still apply. The following reasons allow you to still pick a plan:

  • You didn't get enrolled in a plan but was told you did by a representative.
  • You were enrolled in the wrong plan by a representative.
  • You were eligible for tax credits but didn't receive them.

How do you prove the above circumstances occurred in order to get insurance? 

Once you complete an application, a list will be mailed to your address or provided online, showing what documents are accepted to prove eligibility during the special enrollment period. 

How do you get insurance during special enrollment period? 

Just ask a Certified Covered California agent, who can enroll for free in person or over the phone. Most of the time, the application takes 15 minutes to complete. 

When will my insurance begin if I enroll out of open enrollment?

Your insurance will be in effect on the 1st of the following month if you apply on or before the 15th of the month. If you apply after the 15th of the month, your plan will start the 1st of the month following next month. 

Ex: Apply on or before June 14 --- Get insurance July 1st

Apply on or after June 15 --- Get insurance August 1st

For those who don't have insurance for than 3 consecutive months in 2014, the IRS will fine you and/or your family for lacking insurance on 2014's tax return. How much will you pay?

$95 for each adult and $47.50 for each child without insurance or 1% of the family gross annual income for each adult and .5% for each child - whichever is greater. The limit is $285 for a family.

Still can't get insurance?

The next open enrollment tentatively starts November 15th, 2014. Until then, stay uninsured and safe by keeping out of Met Gala elevators.

04 March 2014

Ancient Viruses Released in Siberia: Can Obamacare Save Us?

Posted in Health Insurance 101

Ancient Viruses Released in Siberia: Can Obamacare Save Us?

Feckless climate change policies may lead to a new age of giant viruses. Just in time for the new Godzilla movie.

Scientists have warned us of rising sea levels caused by global warming, but a new aftermath is trending: ancient viruses once secure in permafrost are thawing and about to wreck havoc on our ill-prepared immune systems.

Jean-Michel Claverie is the Indiana Jones of discovering ancient genomes. A decade ago he unearthed the Megavirus in Chile, which broke the world record for containing the most genetic code (500 genes compared to the HIV virus, which contains 12). 

When out of the jungle, Claverie serves as Professor of Genomics and Bioinformatics at the University of Mediterranée School of Medicine in France. Sadly his father does not call him Junior with a Scottish accent.

Over the past few years in Siberia, Claverie and a team of researchers discovered prehistoric viruses in permafrost they were mistaken for bacteria when observed under classroom microscopes. Not just physically but genetically gigantic, one named Pandoravirus, after the legendary box sealing all the world's diseases, beat the previous record by containing 2500 genes. 

Size doesn't just matter in this case: age does. These viruses are so old that our bodies haven’t built immunities against them in 30,000 years. Careful drilling allowed the scientists to bore out the newly-thawed viruses without affecting nearby ice, so unless you visited the Olympic Village at Sochi, you needn't worry about infections.

After trials of using amoebas as bait, the team concluded that the viruses are relatively harmless to humans and animals. They share only one-third of the same genes as known organisms and 11% of genes with viruses. In other words, they’re practically incompatible with anyone on or off eHarmony.

Claverie noted that it’s not impossible the viruses would plague mankind, but explained that global warming should be the primary concern. The hotter fossil fuels burn, the more permafrost melts, and the more hibernating viruses awaken. So think about the penguins and buy a Prius.

Despite his comforting confession, Claverie warns us that dangerous viruses may be dormant in the Earth, susceptible to drilling, global warming, and Godzilla attacks. Even if they’re unleashed, America has Obamacare, which guarantees insurance against preexisting conditions and prehistoric ones.