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Question about signing up for ACA

Posted: May 1, 2014

I am covered through my husband's insurance for the time-being (until he retires in 2 years), so I have not had any reason to go on the Obamacare website. My question is, when signing up for it, do they ask if you have healthcare through your employer and if so, do you have to say yes or can you say no (even if you do), and continue with the application. Do they ask you how much you make in a year and if you don't tell the truth, so that you are eligible for a subsidy or for medicaid, do they check up on that before you can complete your application? When you complete your application and you are signed up for Obamacare, do you have to pay your premium in order to get a card showing that you are covered under Obamacare before you can go to the doctor and get treatment that is covered? If you don't get a card, how does the clinic/hospital know what kind of coverage you have and how much they should be collecting from you up front for your deductible? If I walked into a clinic in another state, could I just tell them that I have Obamacare and I would get treatment with no questions asked?

I have many more questions, but I'll wait to see if anyone can answer these first.

;

Since this is in 2 years, - sm

[ In Reply To ..]
Before 2 years, you have plenty of time to get your card before you go to the doctor. Since your provider coverage is determined by the insurance carrier that you choose, you will have to abide by the insurance companies policies regarding going to other clinics. My private insurance company has a list of in-network providers and otherwise it is best to get pre-authorization (always been that way.)

As far as application process, your state may has its own application process, so you need to do your own research. Subsidy is based on income and will certainly be verified at some point.

Follow-up - Laura

[ In Reply To ..]
I gave the 2 years as a reason why I have not accessed the site as of yet. However, my questions remain - simply put - what if the person applying for Obamacare is not honest in their application - what measures are built into the system to catch that? For example, if I were someone who was told that I need open heart surgery and I don't have insurance, could I go onto the website and give my income as much lower than it is - sign up for insurance, either with a subsidy or Medicaid, have the website tell me that congratulations - you now have insurance - go in next week and have my open heart surgery - the hospital/doctors will believe me when I say I have it - do I have a proof of insurance card - I have not paid a premium (if the site tells me that I need to) - and never pay for anything? Just asking.....

sounds like you are planning a scam. - NM

[ In Reply To ..]
XXX

No scam - - Laura

[ In Reply To ..]
Just curious whether obamacare is run like most government programs where anyone who wants to can use the system to their advantage. I have not heard these issues addressed - the possibilities of abuse and wondered what is built into the system to prevent. I haven't gotten any answers yet.

Well do you think ACA representatives - reside on this board?

[ In Reply To ..]
You are asking questions that *most* people here wouldn't have an answer to - at most a guess.

I see your post as a transparent attempt to point out *potential* flaws in the plan. Sure, one could probably do as you say, but if income is found to be fraudulent at a later time, not only will that person be subject to fines they would likely be charged with fraud.

I had to provide a PHONE NUMBER to the person at my job who could confirm details I provided.

There are checks and balances. I am sure there are glitches in the system as well for would-be cheats. And I think THAT is the worst reason to be opposed to the ACA as the vast majority will not be trying to scam the system.

Please go onto the site and try to sign up - when you input certain data

[ In Reply To ..]
You will see they list your employer(s) from last year, so I believe it is not as easy to fool them about income as you would think.

An issue I would have is that you need to gauge your income for yourself and your entire family for the year you are applying, which can change dramatically for some families, meaning your premiums could be way underpaid or overpaid, which could result in issues later on of repaying or what have you. However, you will not be able to fool them that much anyway and I guess they have to have something to base the premiums on.

If you have employer offered health insurance, they pretty much say that you are not eligible for ACA. For you to still be eligible you need to prove the cost of the insurance is more than 9% of your income, which is tricky because the MTSOs typically pick low premium, high deductible, high out of pocket plans which make it difficult to prove it will cost more than 9%, but if you are on a large amount of meds or have a condition that requires constant visits of some kind, that might be a possibility.

I hope you are genuinely trying to see what this is about, and not just trying to make it seem scary to people. I would suggest you try it out and see.

Another way to see what your premiums/coverage would be if you WERE eligible is ehealthinsurance.com. They have a box to click to tell you what your subsidies would be, and that is where I found out I would be much better off with Obamacare than my MTSO insurance, but unable to apply unfortunately.

You are exactly - right!

[ In Reply To ..]
My MTSO provided insurance, EXHORBITANT premiums, so I have been without insurance for that reason. Initially ACA said I wasn't eligible because employer offered insurance but when I put in the premium amount, AND THE EMPLOYER phone number for it to be confirmed, voila! I was eligible.

I was eligible for expanded Medicaid in my state, and yes, I had to provide - income verification. nm

[ In Reply To ..]
nm

Your questions appear sincere and valid to me. - sm

[ In Reply To ..]
There are people on this board who are a little sensitive (paranoid?) to anything negative implied or said about Obama and his signature health care law. Pay no mind to them. The questions you ask are valid. I'm sure the answers will become apparent in the months to come, especially when the next round of signups occurs and when, and if, the BO administration decides to publish the facts and figures about how many enrollees actually paid, what the health care received has been like, etc., etc. Good luck to you, Laura.

oi vey - but you had no answers

[ In Reply To ..]
to her questions.

Because I don't know the answers. - sm

[ In Reply To ..]
I don't think many people do know them at this point. I think it's a wait-and-see thing.

Nancy P. may not even know yet. - Remember...

[ In Reply To ..]
...when she said they would have to pass the bill to find out what's in it? I think we're finding out.

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