Health Care and Individual Mandate Question

[happyfeet]

I have a question - the individual mandate is now gone.  I am 59 years old.  Covered by COBRA until 2020.  It is expensive but great coverage (former spouse auto exec).

I live in Michigan and any health issues covered by a car accident is built into our insurance.  Weird I know but our auto insurance is the most expensive in the US.

So theoretically,  I could go without insurance and self insure regular office visits etc but if by chance I get real sick(cancer etc) I could go into the open market and purchase insurance at any point in time? There is no pre existing exclusions now with ACA.

Am I understanding this correctly?

[Sibley]

No, you can't purchase insurance on the market place at any time. You'd have to buy it during the annual open enrollment, unless you had a qualifying event which means you could buy outside that enrollment period. I don't believe that any of that has been changed along with the removal of the individual mandate.

However, Congress has been undoing some sections of ACA, so it may destabilize the marketplaces. I'm not paying that close attention and I don't have a crystal ball, but I'm concerned about the long term stability and viability (even more than I had been). In other words - ACA marketplaces aren't guaranteed to be there if you need them.

[MDM]

...the individual mandate is now gone.

Not until 2019.

[Gimesalot]

No, you can't purchase insurance on the market place at any time. You'd have to buy it during the annual open enrollment, unless you had a qualifying event which means you could buy outside that enrollment period.

I just signed up for ACA last week and I can confirm that this is true.  Along with my application, I needed to provide proof of income for subsidy calculation, and proof of a qualifying event, which in my case was the COBRA enrollment letter.  Here is the website that explains which life events trigger a special enrollment period: https://www.healthcare.gov/glossary/qualifying-life-event/

[Sibley]

Also, insurance companies really want to enforce that qualifying event, and require proof. It hurts them a lot if people don't have insurance then sign up as soon as they need it, then drop it when they don't. It's been a problem with the marketplaces since they started. I wouldn't be surprised if Congress/regulators allow them to be really narrow on the topic.

[Greenback Reproduction Specialist]

Another option might be to self insure up to a certain point, and buy catastrophic health insurance. If the required minimum goes away, insurance providers might come up with new plans that don't cover very much of anything except for catastrophic events, they might be really cheap.... We will have to see how things shake out.