Daily Delawhere 9.18.13

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1. waterpirate says:

   September 18, 2013 at 6:30 am

   Carey’s Camp in Millsboro.

   With less than 2 weeks to go before the roll out for DE version of AHCA, I must give them an F. All we have so far is fluff, with no substance. Anyone who has been responsible for trying to unravel our current HC system and shop for or compare different plans can tell you that 60 days is NOT enough time to make an educated decision about dick.

   I am excited that if it all it was advertised to be, I may see a rate reduction. But again 60 days is not enough time IMHO.

2. cassandra_m says:

   September 18, 2013 at 9:46 am

   We’ve all wondered why we haven’t gotten information on the plans and the costs. But the Open Enrollment for the Exchanges starts in October and ends in March.

3. waterpirate says:

   September 18, 2013 at 12:50 pm

   The anniversary date for everyone’s insurance in DE is December 31st, so unless there is an inclusion for the exchange, if you do not sign up when your current policy times out on the 31st you will be subject to penalties in regard to your deductibles if applicable under the current highmark plan.

   That leaves 60 days to make a plan.

4. cassandra_m says:

   September 18, 2013 at 1:40 pm

   Well, I don’t know what to tell you. Open Enrollment opportunities in the private sector are rarely longer than a month or two. If you can’t decide within 60 days which of the three plans in the DE exchange will be suitable, maybe you should reach out and get some help.

5. Blu Gal in DE says:

   September 18, 2013 at 4:01 pm

   My Dear Mr./Ms. Waterpirate,

   Me thinks you are a bit confused. Are you over age 65? If so, yes, your Medicare Supplement plan would renew January 1st each year. Open enrollment for Medicare Supplement policies is Oct. 15th to Dec. 15th each year. This is your opportunity to change plans, change insurance companies, etc. Your new coverage would go into effect January 1, 2014.

   If you are over age 65, then you will not be eligible for the Exchange. If you are under 65, you have from Oct. 1, 2013 to March, 2014 (not sure about specific March date) to enroll. If you enroll before Jan.1, 2014, your coverage will go into effect January 1, 2014. If you enroll after Jan.1, your coverage will probably be effective the first of the following month.

   Not sure what you are referring to as to deductible penalties. None exist with the Exchanges. You can enroll as explained above, or, at any time during the year if you lose coverage. Open enrollment for the Exchange will occur at the same time each year – October to December.

   The only penalties I know about is with Medicare Part B. If you don’t enroll when you are first eligible (turn 65, retiree after 65, become disabled prior to 65), there is a premium penalty of 10% for every year past your first eligibility date. Also, in order to enroll in a private Medicare Supplement or an employer sponsored retiree supplement, you must show proof that you are enrolled in both Part A and Part B Medicare.

   The following tip is for everyone – If you are thinking of leaving your job, get laid off, etc. after Jan.1st, here’s how the Exchange and Cobra will work. If you work for an employer with more than 20 employees, they must offer you Cobra Continuation coverage. If you are laid off or quit, you can keep Cobra for up to 18 months. The cost is 100% of the employer cost plus 2% administration fee. In Delaware, this can be quite pricey – anywhere from $300 to over $600 per month for single, I’ve seen family rates from around $1300 to over $2000!!!

   If you enroll in Cobra then decide to drop it and enroll in the Exchange, you won’t be allowed to do it off open enrollment. For example – you quit your job in December, enroll in Cobra in January. In April, you take a look at the Exchange and want to just drop Cobra and enroll. Not allowed. You’ll have to wait until the next open enrollment period or until your Cobra is exhausted.

   So, if you think you’re ready to go out and start a new business next year, take a look at both Cobra and the Exchange – coverage comparison, cost comparison to make an informed decision because you’ll have to live with that decision for a while.

   And yes, I know Delaware has a “mini Cobra” program for small employers (available for up to 9 months, not 18). However, when that went into effect, they set it up to end Dec. 31, 2013 knowing the Exchanges would be available Jan.1, 2014. So, if you leave your job between now and Dec. 31st and work for a small employer, you can enroll in Cobra, but, just know that will end Dec. 31st so you probably need to take a look at the Exchange.

   Oh, one other Exchange/employer tip – if you are currently employed and have medical insurance through your employer, this does not preclude you from dropping your employer’s coverage and enrolling in the Exchange. If your income qualifies, you can even get a subsidy to offset the costs. However, you will not enjoy the benefit of the portion of your premium that your employer pays now. Employers are not obligated to pay their portion for insurance obtained outside their sponsored plan. For most, you’re better off staying in the group plan. It might be advantageous, however, to take a look at the Exchange for your dependents since a lot of smaller employers don’t pay anything towards dependent costs.

   Hope all this helps someone!

6. Joanne Christian says:

   September 18, 2013 at 9:37 pm

   Blue Gal did great. Couldn’t agree more–if you need 60 days to decide which plan, you better pick a plan that includes a life coach.

   Being stuck in COBRA now at the tune of near $1600/month for the family(and w/ the 10k deductible), you bet I’m waiting to see the roll-out. My reality now is $28 THOUSAND + dollars out of pocket, before that lil ol’ antibiotic for a kid’s strep throat is picked up. But isn’t it great–they handle the paperwork prior to my meeting the deductible, so I know at what point in time the COBRA CAR arrives w/ balloons and streamers to announce “the rest is on us……hhhmmmm until December 31st!” The upside? That once thought of unobtainable federal deduction for medical expenses beyond a certain percentage of income gets realized! And to think we saved for college.

7. waterpirate says:

   September 19, 2013 at 6:13 am

   Thank you blu gal, it does help. For those of us with ongoing medical expenses. We have been painfully punished at every turn with the ever-changing face of healthcare in DE. Increasing deductibles and being penalised for changing providers at the wrong time to re-start the deductible clock are all hard financial lessons. That is why people are starved for information and details about the exchange.

   Are the income brackets published somewhere yet? Like the life coach advocate above, I currently pay far more than what the AHCA defines as affordable.