Tag Archives: marketplace

An Inquiry into Healthcare.gov’s “Special Enrollment Periods”

So here we are, the first day the Obamacare exchanges or marketplaces or whatever are open for business.  I think of it more as the day America stepped across the threshold to possibly inescapable socialism.  That’s just me.

I had a rough day as I realized an error in my last post and had to insert an update and correction to my assertion that guaranteed issue would allow waiting to buy health insurance until the onset of serious illness.  This still could be true but only if it would occur in a subsequent open season, the part I had missed.  Even though I had remembered hearing talk of no limits, the open season requirement went past me because I went with what I thought I had heard without checking it out.  Confession.

I should have questioned this because employer provided insurance is provided guaranteed issue and they generally limit enrollment to open seasons, with exceptions for certain life events.  I knew this.  Of course with employers there is an initial screening based on who they hire so they are never looking at people too unhealthy to work or apply for the job.

In my ensuing gloom I decided to poke around the Healthcare.gov website.  I was just visiting to see what it looked like and learn what I could.  Sure enough I stumbled on this part about not missing the open enrollment period:

OpenEnrollment

Just as with an employer there was the exception for “qualifying life event” and, being curious, I clicked the link and found this:

QualifyingLifeEvent

That example “moving to a new state” jumped off the page.  I sensed fun with that one!  In seconds I hopped on the phone and dialed the toll free number at the bottom of the page.  After a surprisingly short dance through options and with almost no wait I was speaking to a live representative.

My question was brief and to the point.  According to what I had seen, could I choose to remain uninsured, pay out of pocket and then, if I experience a serious illness, simply move to another state to buy a policy outside the open season?  If I could just cross that state line would I be good to go?  These sound like silly questions, and my gut tells me that this exclusion would only apply if I had owned a policy before moving.

The representative though, did not explain or answer my question to satisfy my gut.  His response was, what I can only guess, outside the box of his training.  “Well, I guess so, if that’s what it says,” was his answer!  Duh!

And no, I still cannot believe this representative’s response was correct, because if it was then I should further revise and update “Is Paying the Obamacare Tax a Better Choice for the Young and Healthy“, my last post to this blog.

Screen grabs were off of the Healthcare.gov website.

Note: This post was shared to WatchdogWire-Pennsylvania