Obamacare when switching jobs?

July 29, 2014 11:22 AM

I'm moving to Texas for a new job in a few weeks. I have a health insurance question.

Starting a new job in late August/early September. I just found out that my employer won't start contributing to my health insurance until December 1, though I have the option of paying the full premium from my start date through December 1. Since that's expensive (though less than 9.5% of my salary), I would like cheaper short-term options.

My question is threefold:

(1) given the change in life situation, can I purchase from a ACA marketplace for the 3 month period between my hire date and when the employer pays their part of the premium?

(2) Assuming we can use the marketplace, would we qualify for a subsidy? My new salary will be too high for the subsidy, but my old job is well below the subsidy line. So my actual AGI this year will be under the subsidy level.

(3) Where can I go for help on this issue? Allegedly there are supposed to be ACA Navigators, but I can't seem to figure out if they're set up or not in Texas at this time. Who is the person I'm supposed to talk to about this?

Complications: we're hoping that my wife will be pregnant before December 1 and we have a 3-year old daughter. So we'd like to not use COBRA if at all possible.

(Apologies for being unable to Google this, but the politics and FUD around the ACA have made the Internet kinda worthless here.)

Thanks.

posted by griseus to Health & Fitness (7 answers total)

A change of job/insurance situation qualifies you to be able to re-choose your insurance, through the marketplace or otherwise.

Whether you qualify for subsidies depends both on your income and on what other options are available to you. Since insurance will be available (though unsubsidized) through work, you need to see if the price meets minimum essential coverage - the most important criteria is likely whether if you buy insurance just for yourself (even if you are covering wife & daughter) through work, it would cost you less than 9.5% of your income. Since it does, you probably don't qualify for subsidies. If it didn't you might if you meet the other criteria.

The ACA website is super helpful for this -- a lot of the questions you ask here are answered. But a lot of it is "it depends on a lot of really specific details", so more importantly, you can actually just go through the application process and see what the coverage and costs would be, and at that point make a decision about which way to go. You can start that process with estimates here.
posted by brainmouse at 11:36 AM on July 29, 2014

Could you explain why COBRA is not an option here? Neither of the conditions you describe would really affect your ability to get or use it. Or is it just very expensive?
posted by JoeZydeco at 11:39 AM on July 29, 2014

Response by poster: Thanks for the comments so far. I did cruise the ACA site, but found it to be pretty confusing about some of this. But maybe just going through the application process and seeing is the way to go.

JoeZydeco: COBRA is very expensive, more than just paying the full premium through my new employer.
posted by griseus at 11:42 AM on July 29, 2014

In the pre-Obamacare world, you could do a thing where you sign up for COBRA at the last possible minute and then delay paying your premiums until the last possible minute, and you could negotiate a situation where you were in a Schroedinger's state of insurance for three months. If you had no healthcare needs in that time, you can just call to cancel the coverage and owe nothing, but if something went wrong, you could just pay the premiums after the fact and be covered.

I do not know how this interfaces with the ACA and Obamacare.
posted by Rock Steady at 11:44 AM on July 29, 2014 [2 favorites]

I do want to note that you should also make extra sure that if you decline work insurance for August through November, you'll be able to pick it up in December once it gets cheaper-- if that's not in their open enrollment period, it's possible that that will not be an option for you, and you will be stuck with whatever ACA plan for longer than you intend.
posted by brainmouse at 11:46 AM on July 29, 2014 [3 favorites]

When I had ACA questions, I called them up and was able to figure out what I needed a lot quicker than all the time I wasted trying to figure it out myself.
posted by Aranquis at 11:47 AM on July 29, 2014

Here's how to find local help with healthcare.gov: https://localhelp.healthcare.gov/
posted by General Malaise at 12:59 PM on July 29, 2014