Hardship Exemptions Can Be There Own Hardship


My wife and I (retired, too much income for subsidies, not eligible for medicare etc) apparently qualify for exemptions because last year’s ‘grandfathered’ policy was cancelled and the cheapest bronze is in excess of 8% of our AGI/MAGI. finding someone at healthcare.gov or at the two insurance providers in our area who understood how to help us was impossible.

We are supposed to be eligible to purchase a catastrophic policy due to the 8% rule, but it took a week on the phone with each of the healthcare providers to convince them of this. Once convinced, we had the problem that their software was not set up to give a quote for catastrophic for anyone over 30. never got any quotes.

Apparently, if you have an ECN (not supposed to need one for the ‘cancellation/unaffordable’ exemption) you can get the marketplace to quote catastrophic, but good luck with that, too.

We filled out and sent in the exemption form back in November (at the time. it was a 4 page form – now it has grown to 12 pages) – we do everything jointly (taxes, insurance coverage), yet they granted an ECN to my wife but said they ‘needed more information’ for me.

Nowhere did they say what the additional info was or where to send it. healthcare.gov was of no help here either.

So here we are paying an ADDITIONAL $500/month (about $840 total) for what is effectively catastrophic coverage (it is a ‘bronze’ plan, has $10k deductible and covers the minimum up until that point).

I could go on with my adventures with the NC state insurance commissioner’s office, etc, but you get the drift

Author: User Generated

Content generated by our users

Leave a comment

We'll never share your email with anyone else.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

I am looking for a financial hardship exemption. Same story as I’ve seen here. I am paying the premiums but am falling into debt. I would like to find out how to apply for the financial hardship qualification and purchase a lower priced catastrophic plan. Don’t want to be without health insurance but the premiums have gone up so much I can’t afford to continue paying the monthly payments. Can’t imagine what I’ll do if my 9 year old truck or the heater at the house needs to be replaced. The roof had to be replaced this year. Savings are all but gone.

I know this has helped some people, but it has been a disaster for me.

Reply

This is exactly the same situation that I and my husband are faced with. (my husband retired and me, self employed and making too much income for subsidies, not eligible for medicare etc) I applied for the hardship exemption November 16, 2015,(11 pages) based on the fact that the least expensive “Affordable” plan available in Wyoming was over 16% of our income. It took until March 31, 2016 to finally receive the exemptions. Then, when I called to get catastrophic coverage finding someone at healthcare.gov or at the ONE insurance provider, Blue Cross Blue Shield) in our area who understood how to help us was impossible.

We are supposed to be eligible to purchase a catastrophic policy due to the 8% rule, but I can’t find anyone at healthcare.gov or at our ONE insurance provider who gets this???? I was told since we were over 30 that we were not eligible, period.

Also, when I discussed purchasing the catastrophic plan with my provider, they stated that now I am past the open enrollment period???. Since it took the Marketplace 5 month to review and approve the exemption, March 31, 2016 I am now well past the open enrollment period. The provider said my hardship exemption isn’t a “qualifying event”. But, I think my “qualifying event” is receiving the hardship exemption!
This is indeed a huge runaround.

Reply

This is really unfortunate. Some people’s situations get really complex under the ACA, for all it’s good, that aspect I think has been universally frustrating.

I think the complexity is meant to be fair to every person, group, and agency in America… but the repercussions point toward there being more elegant solutions for sure.

Reply

This is exactly the same situation that I and my husband are faced with. (my husband retired and me, self employed and making too much income for subsidies, not eligible for medicare etc) I applied for the hardship exemption November 16, 2015,(11 pages) based on the fact that the least expensive “Affordable” plan available in Wyoming was over 16% of our income. It took until March 31, 2016 to finally receive the exemptions. Then, when I called to get catastrophic coverage finding someone at healthcare.gov or at the ONE insurance provider in our area who understood how to help us was impossible.

We are supposed to be eligible to purchase a catastrophic policy due to the 8% rule, but I can’t find anyone at healthcare.gov or at our ONE insurance provider who gets this???? I was told since we were over 30 that we were not eligible, period.

Reply

I got a hardship exemption but I haven’t been able to buy catastrophic coverage anyway.
I live in NY State, which has its own marketplace.
But, I received the hardship exemption after the end of the open enrollment period.
So the state marketplace told me I should apply for catastrophic insurance directly to the insurance company. I did, but so far they have kept refusing, giving various reasons that don’t make much sense. They said my hardship doesn’t have a “qualifying event”. But, I’ve been told my “qualifying event” is receiving the hardship exemption!
It’s been a huge runaround.

Reply

Umm, that is very confusing. The marketplace is supposed to give you approval and then you are supposed to be able to get catastrophic coverage. It is unclear what the problem is to us. Let us know if you find a solution.

Reply

You can always reapply for an exemption(read instructions carefully). You’ll mail your application and any supporting documents to the same address. I had to re apply because I did not get my supporting documentation in on time and my name had to be on those supporting documentation. If you ever get a phone call from them, answer it.

Health Insurance Marketplace – Exemption Processing
465 Industrial Blvd.
London, KY 40741

to get the forms https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/

Reply

Health Care Sharing Ministries are a viable option. It’s important to note that not all services will be covered.

Since these are groups that gather around a religion you can expect rules like:

You can’t use tobacco or drugs
You can’t have premarital sex
You can’t use contraception
You may not be able to use certain drugs or immunizations
etc.

If this sort of thing meets your belief system, then health care sharing ministries may be a viable option.

Learn more about how they work here: https://obamacarefacts.com/healthcare-sharing-ministry-exemptions/

The only thing we ask our readers is that they take the time to understand the pros and cons before enrolling.

Reply

I’m sorry to hear your troubles trying to apply for your insurance. Seems to me like if you are considering a catastrophic plan, then you both must be in good health at the moment, or is that mainly because of cost?

I only ask because I want to suggest that you also look at Health Sharing programs where thousands of members share their health costs and are also excempt from the ACA penalty. I am an independent agent in NC, but I am suggesting this as an option to many of the people I meet as an option if insurance is too costly for them at the moment. These options would cost you less than half of what you would pay for insurance now, and only have small deductibles. I suggest you do look at them as a good alternative.

There are four big options you have:

http://www.chministries.org

http://www.samaritanministries.org

https://mychristiancare.org

http://www.libertyhealthshare.org/

Personally I think the last one is the best option, but you can look at what fits you better.

I hope that helps

Reply
ObamaCareFacts is a free informational site. It's privately owned, and is not owned, operated, or endorsed by the US federal government or state governments. Our contributors have over a decade of experience writing about health insurance. However, we do not offer professional official legal, tax, or medical advice. See: Legal Information and Cookie Policy. For more on our company, learn About ObamaCareFacts.com or Contact us.