I have a question about the new ACA for a friend of mine

[dsc]

Here is the deal. She and her husband both work for an employer, a NC school system, which provides insurance for its employees for free but requires full payment for dependents. Her son, who is currently on her policy, will turn 26 in March of next year. Now, we both assume he can get subsides and buy via exchanges after March since he would be dropped from her policy by aging out. The question is about the first three months. Can he buy via the exchange? If so, can he use the subsidy? She knows he qualifies for a subsidy post March and even knows what a plan will cost, she has done the whole application thing. But she is wondering about those first three months. She has to figure it out by 15 Nov, as her insurance will require her to either enroll or not enroll her son.

[pugetres]

1. A dependent losing or gaining insurance eligibility is a qualifying event

that would allow the son to purchase on the exchanges outside of the enrollment period.

But, why don't they just get him enrolled properly for coverage starting in January and just drop him from her policy?

[dsc]

2. she wants to do that

but one of the questions that is asked is are you eligible to be on someone else's policy, which he technically is for those three months. She would be willing to buy at full price for the first three months and then get the subsidy for the rest of the year but neither of us know if that is possible to do.

[pinto]

3. Not sure. Seems like there's three options at least.

He registers for ACA coverage, requests a March enrollment date. Or enrollment at the time of his removal from parents' plan, whichever comes first.

Buy an ACA plan and drop out of his parents' coverage. The end date for coverage may be a factor. If he isn't re-enrolled on Nov. 15th, when does coverage actually end?

Review the ACA situation with the employer HR rep and an ACA rep. That I would do ASAP.

[mazzarro]

4. Isn't there a toll-free number she can call to talk to a navigator?

I presume that she will be able to get some answers to her questions or be given direction as to where to go for more information/answers.

[dsc]

5. she tried that

and she was told that the site has glitches, and they are being fixed. She was able to nearly complete the enrollment process but fell into some sort of buggy loop. She also had answered no to the eligibility question when we now think that for Jan - Mar the answer should have been yes.