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Post by 2peafaithful on Jun 10, 2016 19:20:12 GMT
My dh has very good health insurance. We have been on it for 8 years. Enrollment is every fall so we usually confirm a few things together like which plan we want to be on (ppo or hmo), what amount for our medical spending account we want for the following year and confirm that my boys (we have 3 and 2 our from my first marriage) will be continuing on it the following year. His insurance is better than their dads so we have always kept them on ours.
We had that talk last November. I reminded him to not forget to sign up for the vision care plan because they changed it a couple years back and you have to sign up in addition to the medical and he missed that the first year they made the chnage and we didn't have vision coverage that year. He agreed, conversed and that was that.
My son is 24, married last year after graduating from college and doesn't have the option of health insurance through his job. I asked him last fall did he want to stay on ours or his dads and he said, yes he would stick with ours and was grateful.
He is healthy and hadn't been to the doctor all year. He went to make an eye appt this week (he wears contacts) and they couldn't find his coverage but they did see the plan and his brothers name but not his. He called me. I told him I would call my husband to check into it. I called him and he was working so I got his vm.I called our health insurance just to double check that he was on our plan. As of Jan 1, 2016 he wasn't on it.
I had no idea. It was not what we discussed and he never brought it up. When my dh called me I asked him if he had his enrollment info from last fall and he said yes and he was pulling it up. As he did that I shared with him what I had found it. He told me that he knew that and he hadn't enrolled him due that he was 23 (at the time) and married.
He made an assumption he wasn't eligible. Sigh.
Too much time has lapsed (31 days or longer) and there hasn't been a qualifying event recently that would make it allowable is what our documents read and was confirmed when he called his HR dept today. I checked with his dad and he is going to check with his employer to see if that is an option or not to add his. Both of us have late fall enrollments with Jan 1st start dates.
I have also been made aware of the the fine if you haven't had health coverage and need to figure out what would be the best solution until we can enroll him this fall and begin coverage Jan 1, 2017.
Any ideas? He is 24, doesn't drink or smoke and is healthy. Because we led him to believe he would be covered, he passed up his dads coverage we feel like we should cover it. He doesn't reside in our state. Not that it matters but just giving a few additional details. My son needs some contacts really quickly. Does anyone have a quick solution to that? They just moved to the area they are in less than 3 months ago so he doesn't have a eye doctor there yet and was trying to schedule it.
TIA
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Post by not2peased on Jun 10, 2016 19:27:40 GMT
are you sure they are talking about your health insurance and NOT your vision plan?
ACA does not require coverage for adult children no longer in school for anything other than medical. vision, dental, etc, are not required of ACA. I would be very surprised if either of your insurances allowed vision coverage for your son.
could you have misunderstood and he isn't on your vision plan but is on medical?
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Post by not2peased on Jun 10, 2016 19:29:00 GMT
I believe he qualifies for COBRA at this point but since he just needs contacts, it might be a lot cheaper just to pay for the contacts.
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Post by 2peafaithful on Jun 10, 2016 19:31:37 GMT
are you sure they are talking about your health insurance and NOT your vision plan? ACA does not require coverage for adult children no longer in school for anything other than medical. vision, dental, etc, are not required of ACA. I would be very surprised if either of your insurances allowed vision coverage for your son. could you have misunderstood and he isn't on your vision plan but is on medical? OK, sorry I will go back and try to clarify it. It started with the vision plan. He hadn't been to any other kind of doctor all year. He went to his eye doctor for a routine eye exam and check up to get new contacts. They couldn't find him on our family vision plan. In the midst of that it gave me huge concern why would he specifically not be on that??? So I called our medical insurance company to check that he was covered under it and thats when I was informed that he had not been covered medically, dental or vision since Jan 1, 2016. |
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Post by littlemama on Jun 10, 2016 19:33:51 GMT
He would not be eligible for vision or dental insurance under your dh's employer plans due to his age. He would be eligible for health insurance. The discount for vision insurance isn't that great and usually doesn't cover the contact lenses themselves, so he should probably just go in for the exam and order the contacts.
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Post by not2peased on Jun 10, 2016 19:35:45 GMT
sounds like the medical drop was a mistake as they cannot deny coverage. you should be able to work that out with your DH's employer, but your son will no longer be eligible for vision under any of his parent's insurance.
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Post by elaine on Jun 10, 2016 19:42:45 GMT
sounds like the medical drop was a mistake as they cannot deny coverage. you should be able to work that out with your DH's employer, but your son will no longer be eligible for vision under any of his parent's insurance. It wasn't the employer's mistake, the OPs DH did not enroll him this year. Granted, DH didn't understand that the son could be covered, but it wasn't the employer's fault. So, I don't think that they have to enroll him until next fall, even though it would be nice if they did. OP, what does your son's wife do for health insurance? I think that it is important for them in terms of finances - in addition to health - to BOTH have health insurance. |
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Deleted
Posts: 0
Oct 7, 2024 9:29:24 GMT
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Post by Deleted on Jun 10, 2016 19:42:56 GMT
So you're looking for medical coverage for him until you can get him on your husband's plan in the fall? Just clarifying -- I don't really have an answer.
As far as the contacts, they probably aren't covered in any case. He might as well just go ahead and get them. It's only the health insurance that he can stay on your plan until 26.
I'm bummed that I can't keep my 21-yo daughter on our health plan. She has a job out of state, so our plan won't cover anything but emergency services. It wouldn't have cost us anything to keep her on, but now she has to pay through her new job.
ETA: I was going to ask about his wife's coverage, too. Is she covered under her parents' plan?
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Post by Linda on Jun 10, 2016 19:46:27 GMT
I'm surprised that he didn't receive a COBRA letter when he was dropped from the coverage. We (deliberately) dropped our adult son in January when he graduated from Navy Boot Camp because he was covered by military healthcare and he received at least two letters letting him know he was dropped and how to sign up for COBRA.
contacts - probably going to need to be out of pocket - Walmart or Sams or Costco might be the best bet there.
If he's young and healthy - he (you) need to weigh the options of paying for marketplace coverage or paying the fine (and being uninsured if something happens) - the fine is calculated when he does his taxes in the spring but there's probably something on the IRS.gov website that will help you estimate. Marketplace plans - check healthcare.gov - also check with his state, if they have extended Medicaid coverage, he might be eligible.
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keithurbanlovinpea
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Post by keithurbanlovinpea on Jun 10, 2016 19:48:47 GMT
sounds like the medical drop was a mistake as they cannot deny coverage. you should be able to work that out with your DH's employer, but your son will no longer be eligible for vision under any of his parent's insurance. But they did not deny coverage. He specifically was not listed as a covered person during open enrollment. I am pretty certain there will be no exceptions made on the part of the employer's plan. He should, however, be eligible for an open market ACA plan. It won't have vision, and it will probably be crazy expensive with bad coverage. But better than nothing. Fines kick in when you go more than 60 days without coverage. Then it is a prorated amount based on the uncovered period after the 60 days. |
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Post by krazykatlady on Jun 10, 2016 19:57:32 GMT
sounds like the medical drop was a mistake as they cannot deny coverage. you should be able to work that out with your DH's employer, but your son will no longer be eligible for vision under any of his parent's insurance. Our son, age 24 and married, is still covered by our medical and dental Insurance. |
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Deleted
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Oct 7, 2024 9:29:24 GMT
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Post by Deleted on Jun 10, 2016 20:13:06 GMT
He would not be eligible for vision or dental insurance under your dh's employer plans due to his age. He would be eligible for health insurance. Correct. The Affordable Care Act says medical coverage is up to age 26, but doesn't mention vision or dental. However, each employer's benefits may be different so I would check as to the age limits. |
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Post by not2peased on Jun 10, 2016 20:21:24 GMT
sounds like the medical drop was a mistake as they cannot deny coverage. you should be able to work that out with your DH's employer, but your son will no longer be eligible for vision under any of his parent's insurance. Our son, age 24 and married, is still covered by our medical and dental Insurance. my mistake-the coverage isnt required under ACA-that's great they will still cover |
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Post by not2peased on Jun 10, 2016 20:21:59 GMT
sounds like the medical drop was a mistake as they cannot deny coverage. you should be able to work that out with your DH's employer, but your son will no longer be eligible for vision under any of his parent's insurance. It wasn't the employer's mistake, the OPs DH did not enroll him this year. Granted, DH didn't understand that the son could be covered, but it wasn't the employer's fault. So, I don't think that they have to enroll him until next fall, even though it would be nice if they did. OP, what does your son's wife do for health insurance? I think that it is important for them in terms of finances - in addition to health - to BOTH have health insurance. I misunderstood-thanks |
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Post by Darcy Collins on Jun 10, 2016 20:30:43 GMT
He might look into short-term insurance - I hear it's cheaper than a traditional insurance plan. Does NOT cover pre-existing conditions, has max benefits and other issues, but it may work for the next 6 months. He's most likely going to be on the hook for $695 or 2.5% of his income for non-coverage. Was his marriage recent? His move out of state? Any other event that might constitute a qualifying event?
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Deleted
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Oct 7, 2024 9:29:24 GMT
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Post by Deleted on Jun 10, 2016 22:19:13 GMT
Honestly I would have him try to find a long term solution. Because he will be dropped the month he turns 26. Even if he re-enrolls in January 17, that only gives him a year or so on that plan. Being out of college and married, it might be time for him to find something for him and his wife now rather than wait until then.
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Post by 2peafaithful on Jun 10, 2016 23:51:52 GMT
sounds like the medical drop was a mistake as they cannot deny coverage. you should be able to work that out with your DH's employer, but your son will no longer be eligible for vision under any of his parent's insurance. It wasn't the employer's mistake, the OPs DH did not enroll him this year. Granted, DH didn't understand that the son could be covered, but it wasn't the employer's fault. So, I don't think that they have to enroll him until next fall, even though it would be nice if they did. OP, what does your son's wife do for health insurance? I think that it is important for them in terms of finances - in addition to health - to BOTH have health insurance. Correct. Totally my dh choice and mistake. His wife also has it from her parents (she is a year younger than him so potentially she could have it 3 or so more years from her parents) and he can't get coverage there unless she did too. I don't blame them at all. They have had it for free and it is a very high % of their income at this time. We will make sure he has coverage and very soon. |
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Post by 2peafaithful on Jun 10, 2016 23:54:02 GMT
So you're looking for medical coverage for him until you can get him on your husband's plan in the fall? Just clarifying -- I don't really have an answer. As far as the contacts, they probably aren't covered in any case. He might as well just go ahead and get them. It's only the health insurance that he can stay on your plan until 26. I'm bummed that I can't keep my 21-yo daughter on our health plan. She has a job out of state, so our plan won't cover anything but emergency services. It wouldn't have cost us anything to keep her on, but now she has to pay through her new job. ETA: I was going to ask about his wife's coverage, too. Is she covered under her parents' plan? Interesting. I had no idea out of state might have changed anything. He is now out of state so I wonder if that is just a question we didn't know to ask. |
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Post by 2peafaithful on Jun 10, 2016 23:59:41 GMT
He might look into short-term insurance - I hear it's cheaper than a traditional insurance plan. Does NOT cover pre-existing conditions, has max benefits and other issues, but it may work for the next 6 months. He's most likely going to be on the hook for $695 or 2.5% of his income for non-coverage. Was his marriage recent? His move out of state? Any other event that might constitute a qualifying event? Good to know about short term insurance. I haven't heard of that before. Yes, the penalty will be there. Marriage was last June and move out of state was this April. |
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Post by 2peafaithful on Jun 11, 2016 0:06:32 GMT
Honestly I would have him try to find a long term solution. Because he will be dropped the month he turns 26. Even if he re-enrolls in January 17, that only gives him a year or so on that plan. Being out of college and married, it might be time for him to find something for him and his wife now rather than wait until then. Soon he will have to do that or it will happen naturally with a job change but not right now. |
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Post by christine58 on Jun 11, 2016 0:23:16 GMT
So you're looking for medical coverage for him until you can get him on your husband's plan in the fall? Just clarifying -- I don't really have an answer. As far as the contacts, they probably aren't covered in any case. He might as well just go ahead and get them. It's only the health insurance that he can stay on your plan until 26. I'm bummed that I can't keep my 21-yo daughter on our health plan. She has a job out of state, so our plan won't cover anything but emergency services. It wouldn't have cost us anything to keep her on, but now she has to pay through her new job. ETA: I was going to ask about his wife's coverage, too. Is she covered under her parents' plan? Interesting. I had no idea out of state might have changed anything. He is now out of state so I wonder if that is just a question we didn't know to ask. I guess that's something you need to find out. He might not have been covered anyhow. |
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Grom Pea
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Post by Grom Pea on Jun 11, 2016 0:27:28 GMT
He could look into private catastrophic insurance, my health insurance company, Kaiser Permanente offers it for people who are younger, I think under 25, so I didn't look into it myself, but it sounded like it was for coverage in case you have a horrible accident or illness, and met aca guidelines without providing any regular coverage, eg prescriptions or doctor visits, those were out of pocket. It might be better than nothing.
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Post by Darcy Collins on Jun 11, 2016 0:37:22 GMT
He might look into short-term insurance - I hear it's cheaper than a traditional insurance plan. Does NOT cover pre-existing conditions, has max benefits and other issues, but it may work for the next 6 months. He's most likely going to be on the hook for $695 or 2.5% of his income for non-coverage. Was his marriage recent? His move out of state? Any other event that might constitute a qualifying event? Good to know about short term insurance. I haven't heard of that before. Yes, the penalty will be there. Marriage was last June and move out of state was this April. I'm pretty sure moving states is a qualifying event to at least to get an ACA compatible plan outside of the typical open enrollment window - but there's a new window which I THINK is 60 days. He would then at least not have to pay the penalty for the second half of the year. He should compare the cost/benefit of a short term plan and paying the penalty versus the cost of an ACA compatible plan and only owing a penalty on the first half of the year. |
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Post by 2peafaithful on Jun 11, 2016 0:41:41 GMT
Good to know about short term insurance. I haven't heard of that before. Yes, the penalty will be there. Marriage was last June and move out of state was this April. I'm pretty sure moving states is a qualifying event to at least to get an ACA compatible plan outside of the typical open enrollment window - but there's a new window which I THINK is 60 days. He would then at least not have to pay the penalty for the second half of the year. He should compare the cost/benefit of a short term plan and paying the penalty versus the cost of an ACA compatible plan and only owing a penalty on the first half of the year. Thank you. Very good to know and I will pass that on. |
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Post by Eddie-n-Harley on Jun 11, 2016 0:55:28 GMT
Contacts: I go to the eye doctor at a big box store. I have never had any problems. The vision exam is something like $60 (well under $100) but the contact exam (fitting/measuring eyes) is another $30 or so. My insurance ONLY covers the vision part; I pay out of pocket for the contact exam part. I opt against an extra vision policy, as I lose money by paying the premiums based on what they will actually cover.
I also pay out of pocket for the contact lenses; I have bad eyes so my contacts are about $55 per box. HOWEVER: your son has a right to have a prescription written out for those lenses so he can take it anywhere to be filled.
AND when he goes in for the exam, he should explain to the doctor/assistant that he's out of lenses, and ask if he could please have a trial pair to tide him over until he can get the lenses. Most places will dispense a pair for you. At least, the ones I've been at always have.
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Post by cindyupnorth on Jun 11, 2016 1:34:28 GMT
Yes, if he has moved out of state is the medical facilities there even under their coverage area? That would be the 1st question I would have asked. Like I have insurance thru my work. It's very specific to certain medical facilities.
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Post by 2peafaithful on Jun 11, 2016 3:26:57 GMT
Contact lenses are complete. He had some in a travel bag that he had forgotten about and my xdh's FIL is an eye doctor and can get him some to tide things overs.
I will check on the change of state being an issue but i don't believe it is as he lived FT in another state the entire time he was college and almost a year following.
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freebird
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Post by freebird on Jun 11, 2016 12:55:47 GMT
Christian Healthcare ministries.
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Post by peasapie on Jun 11, 2016 13:34:39 GMT
I'm surprised that he didn't receive a COBRA letter when he was dropped from the coverage. We (deliberately) dropped our adult son in January when he graduated from Navy Boot Camp because he was covered by military healthcare and he received at least two letters letting him know he was dropped and how to sign up for COBRA.  |
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Post by littlemama on Jun 11, 2016 13:47:17 GMT
I'm surprised that he didn't receive a COBRA letter when he was dropped from the coverage. We (deliberately) dropped our adult son in January when he graduated frottm Navy Boot Camp because he was covered by military healthcare and he received at least two letters letting him know he was dropped and how to sign up for COBRA. That would only be the case if the plan is COBRA eligible. |
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