Affordable Care Act Scene 2 - Insurance Premiums

<p>Hanna,</p>

<p>if you do not qualify for subsidies, go directly to a provider. I said it before and I will say it again, your personal data is at risk when you shop at exchanges. </p>

<p>Is it at risk through provider? Yes, but the risk is lower and with exchange you add another point of failure.</p>

<p>Seriously, though - how does a dependent of a dependent get coverage for that kind of situation? </p>

<p>Not trying to be difficult. Really wondering.</p>

<p>I was one of those people without maternity coverage back in day, made too much to qualify for medii-cal and we had to get new insurance for me and baby before born. This is a little different though with new rules.</p>

<p>The baby’s eligible for CHIP, if he can’t get insurance.</p>

<p>I guess the baby has to go on the husband’s plan and they have to pay the premium out of pocket.</p>

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<p>The baby either qualifies through chip, expanded medicaid (starting 2014) or the parents buy baby’s health insurance.</p>

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<p>For California: [Hospital</a> Search - Rating Hospital Quality in California](<a href=“http://www.calhospitalcompare.org%5DHospital”>http://www.calhospitalcompare.org)</p>

<p>Medicare runs a site here: [Medicare</a> Hospital Compare Quality of Care](<a href=“Medicare.gov”>Medicare.gov)</p>

<p>Healthgrades: [Healthgrades</a> Quality Awards | Quality Center | Hospital Quality Ratings](<a href=“http://www.healthgrades.com/quality]Healthgrades”>Quality Matters | Find High Quality Health Care Near You - Healthgrades)</p>

<p>Keep in mind when comparing outcomes that they may be impacted by the type of services the hospital provides and the patients that the hospital accepts. In other words, a small community hospital might routinely send its highest risk patients out to other facilities – it’s mortality rates might seem lower, but only because many of its sickest patients were sent elsewhere to die.</p>

<p>How do you sign a baby up before they are born?</p>

<p>You don’t. You sign the kid up after he/she is born.</p>

<p>You don’t. You need to sign them up within 30 (I believe) days of birth.</p>

<p>ETA: XPed with GP.</p>

<p>I guess the parent’s policy pays for the maternity coverage for the mother. Is this right?</p>

<p>Will they be fully covered from day 1, then? How would you know what hospital or doctors to use if you needed care after baby born? My kid had a non-birth related issue 3 weeks after birth, and the insurance almost did not cover it. </p>

<p>They usually get seen by pediatrician or family care doc a few days and weeks after born.</p>

<p>Won’t the child need a social security number before parents can apply for coverage? They take some time to arrive, if I remember correctly.</p>

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<p>From what I understand yes, but there is a caveat. If you fail to sign up the baby after they are born within 30 days, insurance may refuse to pay baby portion of the hospital bill. I am not sure if this is true for all policies and in all states.</p>

<p>I do know that it happened to my friends. They did not realize that they had to add their daughter (assumed it was done automatically) and had to pay $3K to the hospital, because insurance refused to cover baby’s portion.</p>

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<p>Usually people add babies to their existing insurance, so they know in advance where to go. I guess it gets complicated with separate policies for mom and the baby.</p>

<p>A baby is covered if signed up within 30 days of birth. Because of the situation (father has employer-subsidized insurance, but would have to pay full cost to enroll wife and baby), the family will not be eligible for subsidies on the exchange.</p>

<p>What a headache! Maybe the navigator can figure it out :)</p>

<p>Isn’t CHIP disappearing in some states? </p>

<p>I thought the dad was on parent’s plan along with wife…maybe that was another post and getting them confused.</p>

<p>Edited to add - went back to original post. </p>

<p>Okay, so no subsidies for the wife or child - can buy on exchange. I guess you could always call carrier off exchange and buy a policy.</p>

<p>I had a $24,000 premie twin and it took a few phone calls but my lousy sub-standard plan did eventually pay the bill.
However, our family deductible went up a big chunk since our size had doubled.</p>

<p>So the wife can’t stay on the parent’s plan?</p>

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<p>It’s been a while, but I think you apply for SSN at the hospital and know the number right away. You don’t need the actual card to get the insurance, just the number.</p>