ACA auto renewal panic
January 2, 2019 6:44 AM   Subscribe

My family and I had an ACA policy for several years. In December 2017 we finally were able to get coverage through my husband's employer, and the timing worked out so I didn't renew our ACA coverage. This has proved to be a mistake:

Last week it came to my attention that somehow our ACA policy automatically renewed for 2018 without our knowledge or consent, and without any notification. When the policy renewed, the premium amount skyrocketed to over three times the amount of previous years. Given that we are low income, we had qualified for the cost sharing assistance which meant the government paid a large portion of the premium, plus premium assistance locally through United Way, I have been told that we will be on the hook to pay back the cost sharing amount, which was paid directly to the insurance company, not us. This amount (with the huge premium increase) means we could owe almost $10k. I don't know if this policy was used in 2018, but I will find out as soon as possible. The company we have our employer coverage through is the same company as our ACA coverage was, which possibly added to the confusion and leads me to believe that the ACA policy could have been billed.

I have executive dysfunction, anxiety, depression, and multiple chronic pain conditions and my husband (who I am now separated from) is beyond useless. I have no idea what to do. There is quite literally no way we can pay this, and I don't know what the next steps should be. Is there a way we can resolve this without paying? How do I even get started on contesting this? I would appreciate any help or advice on how to proceed. Thank you!
posted by altopower to Work & Money (4 answers total) 1 user marked this as a favorite
Start by calling your state insurance ombudsman (or similarly-named office/agency). They're there to advocate for citizens and help them navigate health insurance bureaucracy. And they are used to people crying/panicking on the phone so don't worry about that.
posted by Eyebrows McGee at 7:02 AM on January 2, 2019 [2 favorites]

I suggest that you try to find a Community Health Worker in your state, by googling that phrase and the name of your state. Your changes in circumstance (e.g. change in household size), may be helpful in fixing this, i.e. you may be eligible for Medicaid, and it may be possible to have it applied retroactively.

Also, I suggest that you try to avoid crying and panicking on the phone if at all possible, because this does not help with clear communication and it does not help people help you - however, a Community Health Worker may be able to help you get access to health insurance help, because it is recognized that this can be a stressful process and their job is to help with that.

Also, some communities offer legal clinics for ACA issues - I googled "ACA legal help" and found things like this, and this, so I encourage you to run a similar search with the name of your state to see if there are clinics or other assistance in your state.

In addition, offers an online search tool to find local help.
posted by Little Dawn at 7:12 AM on January 2, 2019

I would recommend speaking to an ACA navigator (the "local help" link) before going to your state's dept of insurance/attorney general, as the former will be better-versed in the nitty-gritty detail.

For future reference, auto-renewal is a standard feature of ACA plans because forcing people to re-enroll every year would seriously jeopardize retention, and of a lot of other insurance because they're hoping to gather premiums due to your inattention. If you want to make sure your enrollment in just about any form of insurance has ended, you need to affirmatively cancel it.
posted by praemunire at 7:40 AM on January 2, 2019

The company we have our employer coverage through is the same company as our ACA coverage was, which possibly added to the confusion and leads me to believe that the ACA policy could have been billed.

See if your husband's employer has anyone you can talk to, either through employee assistance or if there's a union. Depends a lot on the company but they might have some leverage if there has been, for instance, a billing snafu like you are speculating about.
posted by BibiRose at 2:44 PM on January 2, 2019

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