I tried the “local help” places listed on the healthcare marketplace site — three times, and did not receive a response so I hope you can answer my question. My husband will not pay the bill for the family care signed up for through the marketplace. The reason is because I called the number as mandated on December 15th but because the number obviously was so busy, there was a message saying leave your phone number and we will use your phone number as proof that you called by the necessary date (I’m paraphrasing of course. In retrospect I wish I would have taped the call myself for “quality control purposes”.)
I enrolled in Amerihealth, which we already had from my husband’s employer. The employer would no longer pay for the insurance because of Obamacare. Because we already originally had Amerihealth it rolled over automatically, and came in at a higher price than quoted through the marketplace.
When I tried to straighten it out through the marketplace, they would not adjust the January invoice because they claimed they knew nothing about the automated message in regard to all who called on 12/15 and received the message I spoke of. This made my husband decide since they would not adjust the bill we simply would not have insurance. This was the final straw that broke the camel’s back to me and I am in the process of finding out how I separate from my husband.
I do not want to be married to someone who will not pay for his family’s healthcare because the bill came in a few hundred dollars higher. My question is how do I end the family care marketplace insurance and get individual insurance from the marketplace? As mentioned, I tried to ask this question of CamCare twice and also a doctor’s office designated on the healthcare marketplace site as “receive local help” but what a shock, received no response. Thank you for your response. If you give one anyway. I’m not getting help anywhere so far that was designated to be able to help. Also, I do not want to speak to anyone by phone. I prefer email so I have a record. That’s how I got screwed by the marketplace originally and I won’t make that mistake again. I am in New Jersey.
To switch to an individual plan from a family plan outside of open enrollment you need to have a qualifying life event that triggers a special enrollment period. Qualifying life events include losing access to employer based coverage, moving out of state, and getting a divorce. Also exceptions can be made in the case of the Marketplace making an error that resulted in you not getting a plan or getting the wrong plan. You can also appeal any Marketplace decision.
During open enrollment it's easier (although we strongly suggest having the Marketplace help or double-check your work). You simply have to enroll in a new plan and cancel your old plan. The new plan will start when your old plan ends the following month, after you pay your premium. (Keep in mind only plans purchased before the 15th of the month during open enrollment start on the 1st of the next month.)
One thing that doesn't trigger a special enrollment period is non-payment. So the problem you may run into is that if your husband refuses to pay the premium and your coverage lapses you will not have enrollment opportunities and will instead face the fee (based on claimed household income for each family member without coverage for each month).
Not sure if there is a specific solution beyond continuing to pay, appealing, and getting on the phone with the Marketplace outside of triggering one of those special enrollment periods. Sorry for the frustration.
Lastly, we just want to make it clear that we are an independent grassroots website and don't offer professional tax, medical, or health insurance advice. Just friendly consumer to consumer education and a place for us all to voice our questions and have the community address them.