My son will be taking a leave of absence from university for a year. He currently has his health insurance through his university. I cannot put him on my insurance because it is not available in Connecticut. He will definitely be filing his taxes as an independent in 2016. Should he make his permanent residence Connecticut as he will be living there 10 months of this year? Should he or can he apply for insurance on the exchange? Not quite sure how to do this.
If he is 25 or under check into Obamacare.
It may depend on what he is doing. If he will be working, he may be eligible under the company’s plan. If he will be doing something else, he should be able to get insurance on the ACA exchange. Can he get COBRA under the college’s policy as part of his leave? Are you sure your insurance does not include carriers in Connecticut? If worse comes to worse, I would cover him under your insurance and if something major happens he would have to use the out of network benefits and then come home to have treatment. I don’t think it matters if he files his own taxes; he can still stay under your plan.
Why do you say he has to be 25 or under to check into Obamacare Happy1? Losing coverage by leaving school would be a qualifying event and so he would be eligible to get coverage at any time through the marketplace.
Obamacare is just the Affordable Care Act – all health plans need to follow those rules now. I think one question is whether having his insurance plan end constitutes a life event. The easiest thing is probably to see if you can add him to your or his other parent’s insurance if he is 25 or younger and if you can. Or you can look into buying him an individual plan, either through a company (like your state’s BCBS, for example) or through whatever exchange your state has for the ACA.
His residency does matter, and he needs to be able to prove it (driver’s license is fine). Most kids away at school keep their primary residence as their home state. We just went through some issues with this when moving to a new state and proving to health insurance companies that my kid at college had moved too when she wasn’t there to get her new driver’s license yet. For what it is worth, in the state we are in (not CT and does not use the federal exchange) we ended up buying her plan through the exchange because they did not request as much proof of residency.
Prices vary by state, but right now we pay $205 per month for a Gold level BCBS plan with a $1000 deductible in our state. A similar plan was $192 per year last year in our previous state. My kid is 20. we picked BCBS because it travels well – my kid has the same coverage at home as at school. When you buy a plan, it is on a calendar year. So if he goes back to school starting on a fall semester, he will have to pay for it thru December of that year. You want a plan that will work in CT and at school for that reason, and has good enough coverage that his college will accept it instead of making you buy their plan for fall semester (resulting in paying for two plans for those months).
$205 per month for your kid only? If you sign up in January on the exchange and then get a job with qualifying coverage in March, you have to stay on the exchange thought the end of the year? did not know that.
If you get a job with qualifying coverage, you can get out of the plan (whether purchased from an ins co directly or via the exchange). But going to college isn’t a qualifying event… unless he changes his residency to the college state, then you might be able to get out of it. But that has its own set of hassles.
Yes,$205 per month for kid only. It is certainly cheaper than the COBRA option we had for her when her dad retired ($535 per month at that time). Since that was the only insurance at that time where you could be sure they wouldn’t kick you off if you get sick, we paid the COBRA until the ACA protections were available, then switched plans to the cheaper option. $205 per month may feel expensive to you, but it is almost $4,000 per year cheaper in premiums than the only reliable option we had a few years ago. CT insurance may be more or less expensive, though.
My daughter was in a similar position. Having your school insurance end is a qualifying event. You can sign up for on the exchange or buy insurance in the open market. In our case, we had to terminate our ACA policy and then had to take out a new policy with her on it for the balance of the year. We could even of have chosen a different policy if we wanted. I was told that once she returns to school and is eligible for insurance, she will have the option to drop the policy but that hasn’t happen yet. We are covered under the ACA so that might make a difference.
All policies are now ACA policies and have the same qualifying event rules, whether they come are purchased via the exchange or directly from the company. It may be that having the option to purchase school insurance in the fall is a qualifying event, that isn’t clear to me. (I just read over the rules for qualifying events – it still isn’t clear to me. Has anyone out here actually done this – terminated a plan purchased via exchange or on the open market mid-year for a kid enrolling in undergrad in the fall so they could go on the school insurance?)
You might want to look into whether your son is eligible for an subsidy. He might be. The rules are confusing at times but worth checking into. Also if he gets a job that offers insurance there is also a rule that it has to be affordable as define by the ACA. If it is not then he could be eligible for a subsidy on the exchange.
Also is he truly independent? Does he supply over 50% of his support. Note that scholarships do not count for determining support.
@intparent I have not done it yet. I know that the rep I talked to at healthcare.gov seem to indicate that I needed to inform them when my daughter returns to college. I did ask if she could return to her school policy instead of the exchange. I thought she said that was possible. She also indicated that she could remain on our plan even if she was eligible for the school plan since she is not an employee of the school. However this is the government and the OP needs to call and get clarification. Unlike the IRS, they are easy to contact and very helpful. The rules can get complicated. If you know differently how this works, please post since I also would like to find a written official source.
The other reality is that if the son get an individual policy what stops him from stopping paying and returning to the school policy? Every bill I get clearly states the policy is terminated the minute I stop paying. In this case, if you get a subsidy, you need to inform healthcare.gov to stop paying the subsidy.
If your son moves to a state with expanded medicaid and he is low income, he’ll probably qualify for that. Otherwise, he might get a subsidy if his income is within the guidelines.
Or you can add him to your policy. He might be out of network for services, but he’d be covered for emergencies.
Thanks for all the information. Losing coverage through his university is a qualifying event. Starting in the fall, he will be working part-time and living on a shoestring budget as his other commitment will be time-consuming and requires quite a bit of travel both domestically and internationally. My insurance really isn’t a good option as there is no coverage in Connecticut, nor internationally. While he should make a decent amount of money this summer, he will probably still qualify as low income. OTOH, with his scholarship income for this semester, he might get bumped into a higher income bracket. I do know that scholarship income is considered when it comes to subsidies for health care. I found that out the hard way the first year that I filed and had coverage through the exchange. I had to repay the entire subsidy that I received throughout the year because of my son’s scholarship income.
He will apply on the exchange when the date gets closer.
This year, he will definitely provide more than 50% of his support. I pay for his cell phone and car insurance and that is it. The incremental cost for his phone is low and car insurance is negligible because he is insured on a very old car that is parked in the driveway.
Since your user name is momofmusician, I am guessing he may have some kind of musical gig which will have him touring the country and the world! Hope this is a great opportunity for him.
Based on what you wrote, it sounds like you understand ACA. However (just in case), make sure he looks at silver plans. If he is low income, he is likely to qualify for “cost sharing reduction subsidies” which will great reduce his deductible and maximum out of pocket. This only applies if he purchases a silver plan. He might also be able to declare more of his scholarship as taxable in order to meet the income levels needed for ACA.
Coverage internationally can be tricky to find. He may need to buy supplemental insurance when he travels internationally (a whole different thread – we researched and did it for a vacation last year, as 2 of our 3 family members had plans with no international coverage).
If he will be a resident of CT, he can buy an individual health insurance plan directly from an insurance company. My DD had her individual plan which was purchased directly from Anthem. It was about $225 a month.
I also sent you a PM.
I’m just a parent…but I would suggest calling insurance companies in CT to discuss individual plans. See if you can get a PPO or POS Anthem Plan. They used to provide coverage in other states (my DD has an anthem POS plan from another state that also covers her when she travels here to CT).
I think Anthem is one of the brand name Blue Cross Blue Shield companies – so you probably get access to the whole nationwide BCBS network with an Anthem plan, although you have to (of course) ask a lot of questions and check carefully. I try to go through an example with their sales people on the phone – “Here is where my kid goes to school – if she needs an urgent care or a hospital when the campus health service is closed, where can she go nearby? If she breaks her arm and needs to see an orthopedic surgeon, is there something not too far away?” I always assume she can Uber or cab, but you want to make sure they have coverage in your kid’s location, AND that you know how to find it when you need it fast. Those search tools for the national BCBS network are tricky and buggy… 
I keep notes on what I learn so I can track down someone.
Now… in theory, just because their is a doctor in their national network nearby, they MIGHT not be take new patients. I have been warned about this, but so far have no issues (my kid has a BCBS plan she uses at school, and I have a BCBS plan from my previous state that I am keeping because my ex is a state retiree from there, and I have been using just this week in my new state and they seem to be taking it just fine, including for stuff like MRIs).
@intparent
You only get access to the whole anthem network if you have a policy that covers in other states. I think those are PPO and POs policies only…and not sure even all of those do.
We learned this lesson the hard way. DD had an Anthem policy…but it was an HMO…no out of state coverage except the ER.
Yes… like the other Blues, Anthem has plans that do and don’t include the national network. You have to ask for the ones that do, and make sure. My kid has a PPO plan. But most other insurance companies (non-Blues) have no out of state coverage, or it is limited with high costs. We used to find more that did, but in recent years they seem to have dwindled. Plans that provide some “out of network” coverage at a far away location aren’t always sufficient for a college to grant a waiver from their own insurance. Colleges have really cracked down in recent years on checking this, too.