Yesterdays Post

Updated on October 24, 2014
S.R. asks from Kansas City, MO
17 answers

I am so confused! Yesterday I posted about switching insurance companies or going with a private one. I took someone's advice and contacted a Broker. They were not any help at all! We called him and gave him our scenario and he said that ever since Obamacare had come into play, they have changed the law 38 times????? Does this seem right? He said that no one really knows what is going to happen with the insurance laws and he couldn't give us any straight answers, he would have to do a work up and then let us know. I do not have an option of quitting my job, I have too. There is no before or after school care or summer care for my special needs child. My personal life is affecting my job schedule. They have already accommodated my schedule at work once but bc of my SN child health history, I am usually late coming to work bc her para's cannot take her before 8am. I have requested 2 IEP meetings through the school district and they will not pay a para to come and get my DD before 8am, they said they do not have the funds for that, which I am sure is correct. I am supposed to be to work at 8am but don't get here until about 8.15 after I drop my DD off at school. My HR person told me that I need to start adjusting my schedule or else they were going to drop me for insurance bc I cannot be considered full time if I am not getting the contracted hours at work. It is causing unneeded stress on us so that is why we have decided that the best thing for our family is for me to quit. They have absolutely no summer programs for SN kids where I live. AT least one that requires 1:1 care. That is why I am looking into getting single coverage for myself or just going on DH plan. This is so frustrating!
And then this Broker told us that I wouldn't even be eligible for coverage until Jan of 2016. I have never visited the Affordable Healthcare website bc I had no need to, until recently. I am not sure this Broker really knows what he is talking about or is this insurance thing going to be the biggest disaster for us American people? What do you think?

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So What Happened?

Thank you to those who responded with positive feedback! I think we will make another phone call. And also, thanks for letting me explain my situation a little bit without being judgmental or shaking your head. Sometimes it feel nice to write it down and get it out and also getting good positive answers back! Thanks again everyone! :)

Featured Answers

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O.O.

answers from Los Angeles on

Find O. that knows what they're talking about.

Gotta wonder why someone that "has to" quit working would write two very long posts instead of going to healthcare.gov and getting some information...smh

For a family of 4 in Jackson County St. Louis, income of 100K per year, you will not get help paying for it but there are plans with monthly premiums from $122/mo to $811/mo.

That took me about 10 seconds.

Or--perhaps this is a thinly veiled political rant?

8 moms found this helpful

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J.B.

answers from Boston on

Call another broker, one who isn't swayed by a political agenda and actually knows what she or he is talking about. Don't let one idiot add to your stress.

8 moms found this helpful

E.A.

answers from Erie on

I did not fill out a 12 page application for health insurance. I did, however, spend a long time on the phone giving my information to the ACA. They don't even verify your income until you file your return next year, they based our rates on last year's income.

I know you are frustrated and this all seems very confusing but my husband and I haven't had health insurance for over 20 years, and it only took about an hour of my time to sign up for it. Don't use the website, call the number, have your financial info ready, and they will help you find a policy.

I have not had any doctors drop me, my deductible is $100, my yearly out of pocket is limit is $500. My co-pays are $5-$10, hospitalization is covered 90%. At full price the policy would have cost me $220 a month. What's not to like? I don't see this "disaster" everyone is talking about. This program was set up for people like you and me, please don't let your political views prevent you from getting the health insurance you deserve. Just call them!

7 moms found this helpful

T.S.

answers from San Francisco on

Call a different agent, this guy doesn't sound like he's experienced or well versed in health insurance.

5 moms found this helpful

D.B.

answers from Boston on

You got a terrible broker. Just as in any profession, there are competent and incompetent ones. Changing the law 38 times? That has nothing to do with the Affordable Care Act and probably isn't true - unless your state requirements were so far out of whack and the insurance commission/state legislature broke it up into little increments because a) they are inefficient or b) wanted to create a political firestorm by saying "See how complicated this is?"

You have a lot going on with your child, and of course you have to look at para availability and summer services. Frankly I'm appalled that HR is telling you that you need to leave because you can't get there until 8:15. What job these days is so dependent on starting right at 8 rather than having you be able to flex your hours a little bit. Even assembly lines give people breaks. Flex time and telecommuting have been "out there" for 20 years and people can easily cut 15 minutes off lunch or breaks to get the hours. Sounds like you have a very unreasonable company with an agenda or other reason to want to cut you back.

The problem with your husband's plan was the high premium, right? So "just going" on that one was the original reason for your first post. So go back to another broker - and I'd even consider making a call to the insurance commission, Labor Department, Commission on Discrimination, an employment lawyer or your member of Congress (regardless of party or how you voted, they work for you!) to ask if it's legal for your HR department to be pushing you off insurance when you have a special needs child and state services aren't available until 8 AM.

5 moms found this helpful
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G.♣.

answers from Springfield on

I still think you need to try the exchange. What's the worse thing that could happen? You spend 20 minutes on the website and don't get anywhere? Then at least you'll know you tried, and you didn't waste too much time.

Best case scenario? You have a much, much more accurate picture of what insurance will cost and what companies have what you are looking for.

Give it a try? What do you have to lose?

4 moms found this helpful
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A.V.

answers from Washington DC on

I would get a second opinion. Many states have an office to help people navigate the new system.

You have a lot on your plate. Take it one step at a time. http://coventryone.com/individual-health-insurance/missou...

3 moms found this helpful

T.R.

answers from Milwaukee on

S., on your own, try checking out ehealthinsurance.com

I put in a KC zip code (64101) & looked up individual plans. For yourself (using basic parameters) there are some plans as low as $200ish/month. Keep in mind, they do have higher deductibles, but if you are on a high-deductible plan, you are also able to set aside money pre-tax into a Health Savings Account.

This website might let you play around to find a better plan for your family as well. Worth looking into before meeting with someone, to just have a bit of "background info" to come to the table with, and compare, or get more details about.

Good luck! T. :)

3 moms found this helpful

S.T.

answers from Washington DC on

so, you got a crappy broker.
maybe it's time to stop insisting that the ACA is the enemy, and call them.
khairete
S.

3 moms found this helpful
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J.T.

answers from Dallas on

I meant to chime in yesterday and forgot, I'd strongly encourage you to go in your husbands plan or go private.... Many many many providers do not accept the healthcare exchange plans, and I suspect the ones that don't are only going to increase! Good luck

2 moms found this helpful

J.S.

answers from St. Louis on

Did you tell him you wanted to go through the exchange? 38 times seems low.

Private insurance you should be able to enter on a monthly basis but maybe that was one of the 38 changes. Still losing or quitting your job, in other words losing your insurance should be a qualifying event.

Anyway, I agree with your assessment that this broker doesn't know what he is talking about. He should be looking at both private and exchange unless you specifically said go through the exchange.

I still think your husband's insurance will end up cheapest

2 moms found this helpful
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G.B.

answers from Oklahoma City on

Please call your local child care licensing agency and ask them about special needs child care. In Oklahoma all the better child care centers get certified and they have more training and be better able to help your child with things.

I can't say they'll take kids and pick up kids from your school or that it will work out but I do think there might be an option you haven't found yet.

Why can't a family member or friend come and stay with her for an hour each morning and have the bus? drop her off at that person's house?

We have done this. The mom worked 5 days on and 5 days off. She brought her tween son over on her way to work in the group home she managed and he stayed with us until she got off a few days later.

She was off work during the days while the residents of that house were at work. She was also off the clock during the nighttime hours but her son was not allowed to stay with her so even though she was off work during the night he couldn't stay with her.

His bus picked him up and dropped him off at our house those days then took him to and from home on the other days. It worked out very well. She only paid us a little bit each day. He wasn't any trouble and a real sweetheart.

I think that having to quite work and lose your insurance is a drastic step to take. I am sure you aren't doing it without much consideration and care for your family.

Please find out if there is anywhere at all where your child can be dropped off for child care then go to school and then get picked up and taken back to the center. That's about the only way this will work of course.

2 moms found this helpful
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S.T.

answers from New York on

I work as a broker in health insurance and employee benefits - I've been doing this since 1992. Although your broker isn't wrong - he's not really explaining things properly. The law hasn't been changed 38 times - BUT health care reform has impacted health insurance in many differnet ways - the law has so many different parts - some impact the insurance comapny, others affect employers, some affect individual people. So yes - I would say 38 is an accurate number of regulations - some big, some small - that have affected health isnruance.

I can also tell you that brokers make almost nothing on individual health insurance. The work that's involved and the tiny commission doesn't even make it worth the effort to handle. I will help people from time to time - but I recommend that individual people go online and find health insurance. If your income is not high you may be eligible for subsidies through the "exchange" - but it involves a huge volumen of paperwork. The application for health insurance with a subsidy is more than 12 pages long!!!

If you have the option for health insurance through your husband - I assume through his employer - this is going to be a MUCH BETTER option than getting insurance on your own.

As for your child - I'm not sure what your point is. I'll look at your post from yesterday and maybe I'll "get it".

2 moms found this helpful

W.X.

answers from Boston on

Even if it is a political rant--it is a good question.

As for your daughter's arrival at school--see if there is a neighbor that you can pay to drop your daughter off to in the morning and the neighbor can get her to school.

Second suggestion, see if your work can allow you to stay longer 15 in the evenings or cut your lunch by 15 minutes.

If you quit working, maybe you can do in home day care to make money--there are sure to be parents who have the same work hour challenges that you described.

Good luck.

1 mom found this helpful
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S.S.

answers from Chicago on

Your question is kind of all over the place. Not sure if your looking for insurance info, options for care for special needs daughter, decision on keeping vs quitting job lol. So will answer what might help with the daughter/care part. My daughter was a nurse for a special needs child. And while yes they can not start / pick her up until 8 you could have them pick her up at your work place at 8. That way you will be punched in by 8:01.

1 mom found this helpful

M.D.

answers from Washington DC on

Insurance is more confusing than ever. People are signing up but not getting coverage even if they have paid. Doctors changed, plans changed, it's all unknown. Parts of the ACA are good, but in general it's extremely confusing. I am only saying this from what others have said - my husband is retired military so we use his insurance.

I would call someone else to see what your options are. But don't expect it to be affordable.

1 mom found this helpful
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P.K.

answers from New York on

It is a disaster. I can attest to that. Broker is right. No one knows what's going on. Nov 15 I have to start "the search" again after getting screwed by my medical group and insurance company. I am not looking forward to the hours that will have to be put into this. All insurance policies must cover maternity, pediatric vision etc. whether you go thru marketplace or not. If you do not have a chronic condition and do not have specific docs, you should be able to find something. However, if you can swing it, I would stay with hubby's ins.

1 mom found this helpful
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