You Need Obamacare When You Are Sick, Low Income, Pregnant, or Have a Million Kids!
When You Need Obamacare Can Be Tricky
Obamacare is great for those that need it – it covers pre-existing conditions, mental illness, pregnancy and delivery, medications, etc etc… so we recommend it big time for those that need it! We are ready and willing to help when it comes to getting you enrolled! For those of you that are healthy though… you may be spending too much money for stuff that you don’t need. That’s where our expertise comes in. Sometimes it is so black and white it’s ridiculous… but sometimes it can get tricky! Some people need it but can’t qualify, some people qualify but don’t need it! See what I mean?! Assessing your situation is second-nature to us. Like I say often… we’re like doctors, except we didn’t go to as much school, and don’t get paid as much… but sometimes we do actually help in a small way in saving the lives of the people we come in contact with! Below is a description of the major reasons why you would need Obamacare.
When you have a pre-existing condition, you may not have a choice but to use Obamacare. Outside of an employer’s plan, there’s not much insurance that covers pre-existing conditions unless you’re a veteran or something like that. If you’re currently sick, or had some tests run for something potentially serious, then you may be rejected for everything else except Obamacare. It can get complicated though, because if you were really sick more than 5 years ago, then some insurance companies won’t look back that long and you may qualify to get other insurance at that point. But overall, if you’re sick you should expect that Obamacare will take the best care of you to meet your medical needs.
You’re Low Income
People who have a low income have a hard time affording most insurance options. It’s tough out there…! Healthcare facilities are expensive, and insurance companies all want their money too, so it’s a delicate balancing act between all parties involved. Obamacare has created a system where if you meet certain low income requirements, you can get a hefty discount on your insurance monthly cost… sometimes you can get your insurance for $0 per month. This will depend on your household size, and how that relates to your income, and how all of that relates to your zip code and age. Obamacare has a lot of variables when it comes to the decision they eventually come to for your insurance cost. I do not recommend trying to figure it out on your own – it’s just too risky. Sometimes the difference in your insurance costing you additional hundreds of dollars is simply a matter of reporting a couple thousand more or less on your application for your monthly income projection for the year. Without our help, you’ll probably miss something that will cost you money.
Pregnant women, or women who think they may get pregnant in the calendar year need to have a conversation with us ASAP. If you are already pregnant, you may find a hard time getting the necessary coverage, because Obamacare will not qualify you alone by simply being pregnant… you’ll have to have another Qualifying Life Event, or Special Enrollment Period… because GETTING PREGNANT is not the QLE.. it’s the DELIVERY that counts as the life event. But if you don’t have insurance already when the bun is in the oven, then you might be out of luck. There are exceptions, and we have some tricks up our sleeves to fix the situation, but it’s a case by case basis. So… again… call me.
You Have a Million Kids!
Having a lot of kids sometimes makes your income look a lot lower, then the low income rules will apply to you like they do to someone who makes less but is a single bachelor/bachelorette. I’m not suggesting you go out an adopt a bunch of kids to qualify, but having a lot of kids can help you qualify for Obamacare. You’ll also most likely need Obamacare if you have a bunch of kids, just because it may be a good option for so many variables in a family. But, it’s not always the case. Sometimes if the family is perfectly healthy, I can look into other options.
You Just Lost Your Job
You won’t NEED Obamacare when losing your job, but you’ll definitely qualify. After you leave your job where you previously had insurance benefits, you will have 60 days to enroll into something else. After the 60-day window, if you haven’t gotten something else yet, Obamacare shuts its doors to you and you no longer are eligible.
Can Anyone Just Sign Up Anytime?
Nope. Outside of Open Enrollment, you have to qualify. If you don’t qualify, you can’t get it. Then I’d have to look into alternative insurance programs for you. Outside of Open Enrollment, they have Special Enrollment Periods, which require a Qualifying Life Event to Qualify for. Like the above example… You lose insurance because you lost a job = you have 60 days to get insurance. Another example, you just delivered your baby = you have 60 days to get enrolled in Obamacare. You have a death in the family = you have 60 days to enroll in a new plan. You get married = 60 days again. See the pattern? That’s why we stress over and over – DON’T PROCRASTINATE! CALL NOW! Because it’s so easy to put things off, and I see it every day – people calling at the last minute and I have to disappoint them! We will do an entire blog post of Qualifying Life Events, and you’ll be able to see that information in more detail there.
The Bottom Line
Obamacare is sometimes black and white, and sometimes its a gray area. For most people, all they see is the gray area. We see it all. We can decipher in a matter of minutes what is best for you, and will not stop until we get you exactly what you need. Obamacare will make you pull your hair out, and make you grind your teeth into powder before you figure everything out. You have the pain of having to do it once a year which is what makes it so confusing – you only think about it once a year. We, as brokers probably access that site every 30 minutes every day for 12 months… so we know it pretty dang well. Put your trust in my experience, and I promise I won’t let you down!
Nick “The Health Insurance Guy” Ferrin
What is Obamacare?