Walk me through getting Obamacare (Covered California)
December 4, 2022 1:37 PM Subscribe
In (I think) April I posted a question about when I should quit my county job that I hate to be a therapist full-time. I didn't have the courage of my convictions just then but I'm taking the leap soon. I need some advice about getting health insurance through a system that isn't THAT complicated but is the kind of thing I find daunting. So, questions:
I'm hoping to give notice for mid January. I understand January is still open enrollment for what I gather is called "the marketplace." (How quaint! I hope there is wassailing and stuff!) I don't even know if it matters if it's open enrollment because on the one hand I have a change of work situation that miiiight be a qualifying event or is that only if I lose a job?
I don't know a great deal about choosing a plan but I suspect I'll choose whatever is cheapest for the moment. I've heard there's some way to talk, for free, with someone in a broker-ish position about these but I haven't found it.
I also don't know how long it takes and if I'll need to do COBRA for a while or if this should be pretty seamless?
Do I just estimate my yearly income for them based on what I'll be making with a half full caseload at the time I quit my job? Or?
If you have answers for these questions or just a few bullet points of "here's what you do" I'd be grateful. This is in California; not sure if it's similar state to state.
I'm hoping to give notice for mid January. I understand January is still open enrollment for what I gather is called "the marketplace." (How quaint! I hope there is wassailing and stuff!) I don't even know if it matters if it's open enrollment because on the one hand I have a change of work situation that miiiight be a qualifying event or is that only if I lose a job?
I don't know a great deal about choosing a plan but I suspect I'll choose whatever is cheapest for the moment. I've heard there's some way to talk, for free, with someone in a broker-ish position about these but I haven't found it.
I also don't know how long it takes and if I'll need to do COBRA for a while or if this should be pretty seamless?
Do I just estimate my yearly income for them based on what I'll be making with a half full caseload at the time I quit my job? Or?
If you have answers for these questions or just a few bullet points of "here's what you do" I'd be grateful. This is in California; not sure if it's similar state to state.
Best answer: Open enrollment for 2023 is right now. However, you're still employed and will be till January. You can do special enrollment when you lose health coverage. General info here.
You don't need to do COBRA, and probably Obamacare will be cheaper.
That page says you qualify for special enrollment if you expect to lose insurance in the next 60 days. That would apply just before you quit your job.
You apply at healthcare.gov. It's pretty simple, but you will need to estimate income for the year. If you're wildly off, you report it to the same site when you know that, sometime next year. (If you make less than you said, you may qualify for higher subsidies. If you make more, you want to inform them because you'd get less subsidy and that'll affect your taxes in 2024.)
posted by zompist at 2:18 PM on December 4, 2022 [1 favorite]
You don't need to do COBRA, and probably Obamacare will be cheaper.
That page says you qualify for special enrollment if you expect to lose insurance in the next 60 days. That would apply just before you quit your job.
You apply at healthcare.gov. It's pretty simple, but you will need to estimate income for the year. If you're wildly off, you report it to the same site when you know that, sometime next year. (If you make less than you said, you may qualify for higher subsidies. If you make more, you want to inform them because you'd get less subsidy and that'll affect your taxes in 2024.)
posted by zompist at 2:18 PM on December 4, 2022 [1 favorite]
Best answer: Not CA, but I was able to get coverage through the exchange in a reasonably timely manner. (I think I was looking on a Thursday or Friday for a Monday coverage start). I did run into a tricky part... I was expecting no income in the first month of loss of coverage for reasons -> this was going to send me to the state's review department for Medicaid eligibility. I knew I wouldn't be eligible for Medicaid, and this review process would take time I didn't have. So I had to put a higher than expected estimated income for this first month, which permitted me to stay on the exchange site. Working through this process at the last minute was more stressful than it could have been had I begun the process earlier. However it still worked.
Do consider (and confirm) that your employer may pay for health insurance for the entire month. So it may be a better deal (from a health insurance perspective) to have one's last day of employment be towards the start of a month.
posted by oceano at 2:20 PM on December 4, 2022 [1 favorite]
Do consider (and confirm) that your employer may pay for health insurance for the entire month. So it may be a better deal (from a health insurance perspective) to have one's last day of employment be towards the start of a month.
posted by oceano at 2:20 PM on December 4, 2022 [1 favorite]
Best answer: > Do I just estimate my yearly income
IIRC, you can sign up with estimates but are required to update your profile if your info changes (may affect eligibility and amount of subsidies).
If there is an over-/under-payment of subsidies, you can reconcile them in your tax returns.
The CA website can be clunky and slow and somewhat mysterious, but keep at it till you get your insurance! You can sort out questions via customer service.
Also, heads-up in case you want to consider for taxes: Depending on your new business situation (solo, self-employment, etc), there are some requirements/things-to-check to claim the expenses as a deduction (e.g. IIRC the plan has to be in your name or your business name, you can't be eligible for a plan via employer--see the IRS rules for self-employed healthcare deduction).
Good luck with your new venture!!
posted by Sockin'inthefreeworld at 2:42 PM on December 4, 2022 [1 favorite]
IIRC, you can sign up with estimates but are required to update your profile if your info changes (may affect eligibility and amount of subsidies).
If there is an over-/under-payment of subsidies, you can reconcile them in your tax returns.
The CA website can be clunky and slow and somewhat mysterious, but keep at it till you get your insurance! You can sort out questions via customer service.
Also, heads-up in case you want to consider for taxes: Depending on your new business situation (solo, self-employment, etc), there are some requirements/things-to-check to claim the expenses as a deduction (e.g. IIRC the plan has to be in your name or your business name, you can't be eligible for a plan via employer--see the IRS rules for self-employed healthcare deduction).
Good luck with your new venture!!
posted by Sockin'inthefreeworld at 2:42 PM on December 4, 2022 [1 favorite]
I'm pretty sure for California you want to enroll via coveredca.com, not Healthcare.gov. (Their The Marketplace in your state page confirms that.)
I agree with the answers above that you should definitely talk with a patient navigator and specifically ask them how long it will take for coverage to start, and whether you have to do anything special as a self-employed person; I also agree that it should (should) kick in pretty much right away (within a few days to a week or so, probably).
As for deductions and taxes, things may depend on whether you'll be a sole proprietor, a partnership, or a corporation. If you have a tax person (and you SHOULD have a tax person for your self-employed business!), they should be able to answer those questions. TurboTax Business has pretty good walk-throughs to get you the right deduction; it can be weird and complicated, so getting help from software or a professional or, ideally, both, is highly recommended.
Good luck and congratulations on starting your new career!
posted by kristi at 1:34 PM on December 8, 2022
I agree with the answers above that you should definitely talk with a patient navigator and specifically ask them how long it will take for coverage to start, and whether you have to do anything special as a self-employed person; I also agree that it should (should) kick in pretty much right away (within a few days to a week or so, probably).
As for deductions and taxes, things may depend on whether you'll be a sole proprietor, a partnership, or a corporation. If you have a tax person (and you SHOULD have a tax person for your self-employed business!), they should be able to answer those questions. TurboTax Business has pretty good walk-throughs to get you the right deduction; it can be weird and complicated, so getting help from software or a professional or, ideally, both, is highly recommended.
Good luck and congratulations on starting your new career!
posted by kristi at 1:34 PM on December 8, 2022
This thread is closed to new comments.
posted by lapis at 1:44 PM on December 4, 2022 [1 favorite]