GF turning 26 in 1.5 months and losing insurance - what to do ahead of that?

[ketchup]

Hey guys,

My girlfriend is turning 26 in about a month and a half and therefore will lose her dad's insurance.  We're still figuring out what to do after that happens (an ACA plan or tying the knot and get her on my insurance; how romantic), but in the meantime:

What should she "get done" while she's still on her dad's (excellent) insurance?  She's already getting a crown fixed next week and has a gynecologist visit scheduled.  She has basically done no recent specific preventive anything health-wise, but is healthy with no prescriptions or chronic health issues.  I figure a standard doctor's office visit can't hurt, but we've kind of drawn a blank for anything else.  Any ideas?

Thanks.

[Cranky]

Ask the dentist if her current insurance will cover another round of dental sealants. My kids all got that done before they aged out.

[LifeHappens]

A standard physical and blood work would be good.

[Raenia]

If she's on a vision plan, a new vision test and spare pair of glasses (if she wears them) couldn't go amiss.

[Bateaux]

Welcome to true adulthood.   Make your vote count.

[civil4life]

Good suggestions so far.

Only thing I would add is when she sees a primary care doctor ask about vaccinations.

Also tell the doctor that as well.  They will definitely be able to make recommendations.

Get that done ASAP in case there needs to be any follow up.

[AZDude]

an ACA plan or tying the knot and get her on my insurance; how romantic

The nonsensical nature of US healthcare. Young people get married just to have insurance.

Anyway, I would say that whatever option you look into, make sure your current providers take the new insurance, if they are quality providers. Having a long standing relationship with a provider has been proven to cause fewer medical mistakes.

[KBecks]

Is she looking for a job with health insurance?  That would be on my list.

[Candace]

Whatever birth control she's on, order as much as she can that's covered before losing her dad's insurance. She could talk to her OB-GYN about her situation to see what they suggest.

That also goes for any other prescriptions, if there are any. Stock up if possible.

[ketchup]

Thanks for all the ideas everyone!

Whatever birth control she's on, order as much as she can that's covered before losing her dad's insurance. She could talk to her OB-GYN about her situation to see what they suggest.

That also goes for any other prescriptions, if there are any. Stock up if possible.

No prescriptions, and I took care of the birth control side of things myself last year (snip).

Is she looking for a job with health insurance?  That would be on my list.

She's self-employed (photographer) and wouldn't have it any other way, so she's on her own there.

an ACA plan or tying the knot and get her on my insurance; how romantic

The nonsensical nature of US healthcare. Young people get married just to have insurance.

Anyway, I would say that whatever option you look into, make sure your current providers take the new insurance, if they are quality providers. Having a long standing relationship with a provider has been proven to cause fewer medical mistakes.

It wouldn't be "just" to have insurance, but it'd be on the list.  We've been together for almost seven years now, and it's definitely the plan regardless of insurance.  It would just be a matter of timing.  But yes, the fact that it's even a conversation is just silly.

That's a good idea to verify if current providers will take the insurance she ends up on (whether mine or another).  I'll make sure we look at that.

[therethere]

Any chance you are already qualified as a domestic partnership in your state? Then you could add her to your insurance at the next benefits enrollment and get married (or not) on your own time.

[SimpleCycle]

I'd get a physical and ask her doctor if she needs anything else - I am not a fan of using it just because it is there.

If she's healthy, I'd consider an ACA catastrophic plan until she's 30.  This is an area where you can "self-insure" for the little routine stuff, and use insurance as true insurance instead of a way of paying for routine stuff.

[Pennsylvanian]

Has she looked into COBRA eligibility? If she qualifies, she can stay on the plan for up to another 18 months and pay the premium to her dad's company. It would be the amount that the company pays for her coverage under the group plan, but it would give her a patch to figure out next steps.

From the COBRA Q&A:

Q5: Who is entitled to continuation coverage under COBRA?
In order to be entitled to elect COBRA continuation coverage, your group health plan must be covered by COBRA; a qualifying event must occur; and you must be a qualified beneficiary for that event.
Plan Coverage - COBRA covers group health plans sponsored by an employer (private-sector or state/local government) that employed at least 20 employees on more than 50 percent of its typical business days in the previous calendar year. Both full- and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of a full-time employee, with the fraction equal to the number of hours that the part-time employee worked divided by the hours an employee must work to be
considered full time.

Qualifying Events - Qualifying events are events that cause an individual to lose his or her group health coverage. The type of qualifying event determines who the qualified beneficiaries are for that event and the period of time that a plan must offer continuation coverage. COBRA establishes only the minimum requirements for continuation coverage. A plan may always choose to provide longer periods of continuation coverage.

The following are qualifying events for covered employees if they cause the covered employee to lose coverage:
 Termination of the employee's employment for any reason other than gross misconduct; or
 Reduction in the number of hours of employment.
 
The following are qualifying events for the spouse and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:
 Termination of the covered employee's employment for any reason other than gross misconduct;
 Reduction in the hours worked by the covered employee;
 Covered employee becomes entitled to Medicare;
 Divorce or legal separation of the spouse from the covered employee; or
 Death of the covered employee.

In addition to the above, the following is a qualifying event for a dependent child of a covered employee if it causes the child to lose coverage:
 Loss of dependent child status under the plan rules. Under the Patient Protection and Affordable Care Act, plans that offer coverage to children on their parents' plan must make the coverage available until the adult child reaches the age of 26.

[use2betrix]

Cobra will be very expensive most likely - probably $500+ easily.

If she has a decent amount of savings, a catastrophic plan is good, but only if Trump has eliminated the requirement for minimum coverage or pay I fine. Last I checked it was in the works but not solidified. A lot of time the fine outweighs the benefits depending on income.

[iris lily]

Is the girlfriend unable to buy health insurance, and why?

Our 44th President put forth a plan that sets cost limits on insurance premiums for people just like the girlfriend. Why doesnt she use an A a plan?  Wait—could it be that she doesnt affordable insurance plans mandated by The Affordable Healthcare Act? Does this mean the 44th President was wrong?

Inquiring minds  want to know.

MOD EDIT: Starting a fight for no reason doesn't help this poster. Or anyone, really.

[chasesfish]

Why not just go on an ACA plan?  Loosing your group coverage is a qualifying event.

[iris lily]

Why not just go on an ACA plan?  Loosing your group coverage is a qualifying event.

yes, what I want to know.

[Paul der Krake]

Domestic partnership implies that the premium paid by ketchup's company on ketchup's GF's behalf will be a taxable benefit. Most group health plans cost 5-7k per year in premiums per head. This means that ketchup, if he is in the 24% bracket, would pay $1200-17000 per year extra in taxes.

COBRA can be obtained for 36 months, but if ketchup's GF's dad has a good plan, the premiums may be even more than the 5-7k I quoted earlier, and she'd pay all of it.

So your only options for cheap insurance are:
- ACA with subsidies if she qualifies
- get a W-2 job with insurance
- get married (about $50 at the courthouse)
- leave the country

Those are the choices.

[ShoulderThingThatGoesUp]

There are lots of good reasons to get married. Insurance timing was a major scheduler on my wedding. We were planning on getting married anyways, so it made sense.

[ketchup]

I'm not sure why everyone's thinking she can't buy insurance.  She can, she's just self-employed so her options are going to be expensive and presumably less-awesome than her current coverage.  As others have said, unless we do get married, she'll probably just be getting a catastrophic plan (possibly with ACA subsidies, haven't done all the math yet, and "unfortunately" her income is a lot higher this year than previous) since she's young, healthy, no prescriptions or chronic issues, and this crap is expensive.

I have my own opinions about healthcare in this country, but let's please not get political in this thread...

[chasesfish]

I'm not sure why everyone's thinking she can't buy insurance.  She can, she's just self-employed so her options are going to be expensive and presumably less-awesome than her current coverage.  As others have said, unless we do get married, she'll probably just be getting a catastrophic plan (possibly with ACA subsidies, haven't done all the math yet, and "unfortunately" her income is a lot higher this year than previous) since she's young, healthy, no prescriptions or chronic issues, and this crap is expensive.

I have my own opinions about healthcare in this country, but let's please not get political in this thread...

I understand.  Its worth just doing the math for income and go to the exchange website and estimate cost.  If that amount is way too much, you could always consider the "convenience" marriage before the actual ceremony.   I have an employee planning on leaving a month before she gets married.  She is debating between COBRA, the ACA, or a courthouse wedding a month before the ceremony.  Her fiance has great insurance.

[Paul der Krake]

I'm not sure why everyone's thinking she can't buy insurance.  She can, she's just self-employed so her options are going to be expensive and presumably less-awesome than her current coverage.  As others have said, unless we do get married, she'll probably just be getting a catastrophic plan (possibly with ACA subsidies, haven't done all the math yet, and "unfortunately" her income is a lot higher this year than previous) since she's young, healthy, no prescriptions or chronic issues, and this crap is expensive.

I have my own opinions about healthcare in this country, but let's please not get political in this thread...

I understand.  Its worth just doing the math for income and go to the exchange website and estimate cost.  If that amount is way too much, you could always consider the "convenience" marriage before the actual ceremony.   I have an employee planning on leaving a month before she gets married.  She is debating between COBRA, the ACA, or a courthouse wedding a month before the ceremony.  Her fiance has great insurance.

COBRA is retroactive for up to 60 days. She can go without insurance for a month, and sign up retroactively if anything happens between her last day and marriage.