Do I Have to Buy Obamacare if I lost my Heath Insurance ?

I once had a coworker who told a client over the phone, “The Insurance Industry is a big steamy pile of poop.” Sadly, this is reality for a lot of people who recently found out they lost, or will be losing their health coverage. Who wants to spend thousands of dollars a year on a plastic card, that is essentially used when something bad happens? Or even worse, what if you already have ongoing maintenance, treatments and medications?

Every person has their own unique situation and there are many factors to consider. If you have just recently lost health insurance the first thing you need to think about is preexisting conditions. Ask yourself this one simple question: Do I, or does my family (if this is for a family plan) have any preexisting conditions that could bankrupt me if they were not covered by insurance?

The reason this question is so important is because there are only a few plans that are required by law to cover preexisting conditions. If you answered YES to this question, here are your options (assuming you qualify):

• Medicare — For the disabled & 65+
• Medicaid/CHIP — For the very low income and children (Varies by State)
• Work Insurance/Group Polices — Major Medical Insurance benefits via employer.
• Cobra — 18 months of previous Work Insurance and typically very expensive
• Healthcare.gov/ACA/Obamacare — Major Medical polices that almost anyone can apply for during “open enrollment” (Nov 1st— Dec 15th). Individuals who have recently lost qualifying health coverage have what is called a “Qualifying Life Event.” This is a Special Enrollment period (60 days after losing coverage) that allows them to enroll into an Obamacare plan if they lost health insurance out of no fault of their own.

Here is a total hypothetical that could burn someone if they didn’t know better:

Lets say I speak with a potential client. Lets also say his favorite News Network and favorite talk radio host told him Obamacare was very bad. He declared from the beginning, “My wife is pregnant and I don’t want Obamacare!” My response simple- or so I thought, “Sir, That is the ONLY plan that will cover her pregnancy outside of Cobra, period! And it’s half the price with a lower deductible. Why on earth wouldn’t you do that?”

What happened next was incredible. Someone, with a pregnant wife, was about to let their personal political opinions dictate how they purchased health coverage.

CLIENT — Mister, that man represents EVERYTHING I stand against, I absolutely will not buy an Obamacare plan, an ACA plan, or whatever the hell you call it! What else do you have “

ME — I have short term plans she won’t qualify for because of the pregnancy, and I have a plan that won’t cover her pregnancy but will discount it, only if you stay within a certain network. If you will not buy Obamacare, that is all I have. Unless she qualifies for Medicaid (she did not), or she get Obamacare (the devil), your only option is something that will discount her services. That’s it. Case closed. End of discussion.

CLIENT — How do I sign up for that discount plan?

5 months and about $8,000 in medical bills later, his wife calls. She explains that she just gave birth and their newborn daughter has a condition that will require ongoing medical treatment. They still don’t qualify for Medicaid. “What should we do?” She’s asks. “Well,” I reply, “The only thing that will cover what you need are Obamacare plans.”

I genuinely feel bad at this point because she is telling me she knows that is what they need, but her husbands too hell bent on his political beliefs. “You really don’t understand, he like really, really doesn’t like Obama.” she said with an anxious tone.

“Okay, here is what you need to tell him. Tell him he doesn’t have to like Obama. He doesn’t have to vote democratic or start referring to himself as “woke”. But if he DOES like his daughter. If he DOES like you, and he DOES like the idea of not going bankrupt, he will absolutely buy Obamacare and never question it ever again.”

**Even though this is just an example, these buying mistakes happen every day**

If you are healthy with no major preexisting conditions, there are solid Private Market Health insurance plans, like “Short Term plans.” This is what you could almost consider “catosrophic” coverage. If you can get qualified, it’s usually very affordable and will probably be the best “bang for your buck.”

No insurance is perfect (Union insurance is close), but if you or your family have preexisting conditions, don’t let your political ideology dictate your families healthcare. Think of Obamacare as one of things that just are they way they are.

Like that saying goes, “only focus on the things that you can control.”

Chris Young is an Independent Insurance Broker who specializes in Healthcare. If you need help with your insurance needs, contact Chris directly 330–578–7707