ST Alpha - "ST, help me understand something about health insurance and the ACA." (Reading a Post)

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ST, help me understand something about health insurance and the ACA.

Posted by mara Sep 24 '13, 10:07

I know that open enrollment in the marketplace starts october 1, and goes through march. Marketplace enrollment are also how lower income people get subsidies.

But for the people who don't enroll through the marketplace during that period, they can still buy private insurance later, right? Do the health insurance companies selling individual policies have to comply with the requirement to cover pre-existing conditions?

Are insurance companies simply going to call all their individual private policies part of a grandfathered plan?

What I'm wondering is what will prevent somebody from not buying insurance until the day they're in a car accident or the day they get diagnosed with a disease. If they can skip the marketplace enrollment, then just buy a policy at any time, and not have to worry about a pre-existing condition.

https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/ (www.healthcare.gov)

Responses:

I emailed Dr. Aaron Carroll to ask. -- nm - Kim Pine Sep 24, 10:54
[deleted] 4
- The fee is $95 in the first year, payable in 2015. -- (link) - mara Sep 24, 10:19 2
  - or 1% of adjusted gross income (after deductions), whichever is higher. - GregW Sep 24, 10:48 1
    - Yeah, I shouldn't truncate that. -- nm - mara Sep 24, 10:50
- No, I'm talking about buying an individual policy from a health insurance company, and whether it can be denied for a pre-existing condition. -- nm - mara Sep 24, 10:17
Does this help? -- (link) - TWuG Sep 24, 10:11 16
- I looked at that earlier. It doesn't say if buying a non-compliant plan will be available to people with pre-existing conditions. I guess I'll assume - mara Sep 24, 10:16 15
  - What is preventing this person from using the exchanges? -- nm - TWuG Sep 24, 10:18 14
    - those creepy Uncle Sam commercials? -- nm - znufrii Sep 24, 10:20
    - Stubborness and stinginess, basically. -- nm - mara Sep 24, 10:19 12
      - Then I don't feel sorry for them not getting coverage after the period is up. - TWuG Sep 24, 10:21 11
        
        I'm just trying to understand if the law is saying health insurance companies can or can't continue to deny coverage for pre-existing condtions, - mara Sep 24, 10:24 10
        
        It certainly sounds like it won't be covered since the available products won't meet ACA standards. -- nm - TWuG Sep 24, 10:31 9
        
        Yeah, I can't find anything that clearly state non-compliant policies include not complying with the pre-existing condition requirement, but that - mara Sep 24, 10:37 8
        
        Aren't some providers complying voluntarily ahead of the law, also? - con_carne Sep 24, 10:39 7
        
        My person is not looking for health insurance. It's a person saying "What happens if I don't buy a policy until I'm sick or injured?" - mara Sep 24, 10:41 6
        
        So they want the benefit of the law, without participating in the law. That would seem to be an abuse - con_carne Sep 24, 10:44 4
        
        :-) It's just something people need to understand as fully as possible. -- nm - mara Sep 24, 10:49 3
        
        It is a great question, and I hope you find an answer. Um, please post here if you find one? :-) - con_carne Sep 24, 10:52 2
        
        I think I might use the chat feature on healthcare.gov to ask it, actually. -- nm - mara Sep 24, 10:53 1
        
        Buena suerte -- nm - con_carne Sep 24, 10:56
        
        Like this example : "if I can insure anytime, after I'm unhealthy, why do so while I'm healthy?" -- (link) - mara Sep 24, 10:44
*rages* nm -- nm - groiny Sep 24, 10:08

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ST, help me understand something about health insurance and the ACA.

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