Bad Agent Advice Re: ACA

[Yagents]

Ok guys & gals. I need your help.

I have a prospect that is hesitant to buy insurance from me because she was told by a BCBS FL agent that IF she buys insurance today, she will NOT be able to get on to Obamacare and have her pre-existing conditions covered.

She is currently 45 days without insurance, and doesn't want to get insured if that agent is correct. I told her that agent provided bad advice/guidance, and O'care will cover her pre-ex starting Jan 1st.

Who is correct? Me or the BCBS agent?

 

[stuy119]

I hate people. A lot. At least 20 characters worth.

 

[Yagents]

I need real responses to land this client. No snide remarks. Stick to the facts please.

 

[stuy119]

There is a lot going on here.

1. Does FL have a 45 or 60-day period between policies where creditable coverage exists?

2. The existing policy, if it doesn't cover pre-existing now, wouldn't cover them until 6/15 (or whatever policy date is) next year.

3. Unless she purchases a new policy as of 1/1 effective date.

and, lastly,

4. You don't "get on Obamacare."

 

[Dave020]

In 2014, insurance companies cannot refuse to sell coverage or renew policies to anyone based on a pre-existing condition.

SEC. 2705 [42 U.S.C. 300gg–4]. PROHIBITING DISCRIMINATION AGAINST INDIVIDUAL PARTICIPANTS AND BENE- FICIARIES BASED ON HEALTH STATUS.

‘‘(a) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual:

‘‘(1) Health status.

‘‘(2) Medical condition (including both physical and mental illnesses).

‘‘(3) Claims experience.

‘‘(4) Receipt of health care.

‘‘(5) Medical history.

‘‘(6) Genetic information.

‘‘(7) Evidence of insurability (including conditions arising out of acts of domestic violence).

‘‘(8) Disability.

‘‘(9) Any other health status-related factor determined appropriate by the Secretary.

- See more at: Thanks, Obamacare: 7. No denial of coverage based on pre-existing conditions.

 

[Yagents]

Goal is to buy a short term Major medical plan now, and buy a new Obamacare plan on 1/1/14 as she is eligible for subsidies, and needs to keep her price way down between now and then.

The question is, will her pre-ex be covered under Obamacare on 1/1/14 if she buys a ST MM now?

 

[russelltw]

Do a conference call with client and call BCBS FL's customer service and get the answer. Likely she was given incorrect information, but having her on the phone will help reassure her that you are trying to help her. Good luck.
R

ps - take her to healthcare.gov
http://www.healthcare.gov/law/information-for-you/individuals.html

 

[Yagents]

thanks Dave for that link

 

[stuy119]

Goal is to buy a short term Major medical plan now, and buy a new Obamacare plan on 1/1/14 as she is eligible for subsidies, and needs to keep her price way down between now and then.

The question is, will her pre-ex be covered under Obamacare on 1/1/14 if she buys a ST MM now?

Yes, as long as the new policy is effective as of 1/1.

 

[bluediamond]

Ok guys & gals. I need your help.

I have a prospect that is hesitant to buy insurance from me because she was told by a BCBS FL agent that IF she buys insurance today, she will NOT be able to get on to Obamacare and have her pre-existing conditions covered.

She is currently 45 days without insurance, and doesn't want to get insured if that agent is correct. I told her that agent provided bad advice/guidance, and O'care will cover her pre-ex starting Jan 1st.

Who is correct? Me or the BCBS agent?

It doesn't matter what she is on now or leading up to Jan 1, if she purchases a policy between Oct1 - Dec 15th and is effective Jan 1 and all preex is covered. This is exactly what pisses me off about half of the BC agents don't know **** about PPACA.

I was at one of their seminars last week and my god you should have heard the questions, I commented to my boss that this is everyone's lively hood in this room and if by this time they haven't taken upon themselves to study and read what's going on they need to immediately get out of the business.

Another note I have been told if you purchase a plan Oct 1 for effective Jan 1 and in November you schedule a surgery for Jan 1 it's covered. Credible coverage will be a thing of the past.
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It doesn't matter what she is on now or leading up to Jan 1, if she purchases a policy between Oct1 - Dec 15th and is effective Jan 1 and all preex is covered. This is exactly what pisses me off about half of the BC agents don't know **** about PPACA.

I was at one of their seminars last week and my god you should have heard the questions, I commented to my boss that this is everyone's lively hood in this room and if by this time they haven't taken upon themselves to study and read what's going on they need to immediately get out of the business.

Another note I have been told if you purchase a plan Oct 1 for effective Jan 1 and in November you schedule a surgery for Jan 1 it's covered. Credible coverage will be a thing of the past.

I guess I need 20 characters more to post this, well that should take care of it.
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Ok guys & gals. I need your help.

I have a prospect that is hesitant to buy insurance from me because she was told by a BCBS FL agent that IF she buys insurance today, she will NOT be able to get on to Obamacare and have her pre-existing conditions covered.

She is currently 45 days without insurance, and doesn't want to get insured if that agent is correct. I told her that agent provided bad advice/guidance, and O'care will cover her pre-ex starting Jan 1st.

Who is correct? Me or the BCBS agent?

Oh, I went on a rant, you are correct.