Can you please tell me how deadlines and open enrollment have improved health insurance coverage in the United States?

It’s been like that for a very long time. It didn’t just start happening.

If you get hired and you pass the probation period, they will give you the health benefits at that time. If he had been working at a place who just started offering health insurance, I can see why they would wait. I’m not sure about the laws in your state. This is how it’s been here since I can remember.

We didn’t have this problem over a decade ago. Jon was able to get myself and our children enrolled very easily when we needed it.

Can you tell me why the deadline is helpful? How does it help the uninsured?

Things must be very different where you are then. I had that open enrollment and dealines thing for my entire civilian life. Ever since I got out of the Navy almost 20 years ago, I have only been able to change my plan either when first eligible for benefits, during open enrollment periods, or when I had a qualifying “life change” that warranted an exception to the above rules. And I had only a limited time to decide. Honestly, I am surprised that you’ve never seen this thing that has been going on everywhere else for decades.

Now, why were you and your daughter not on his plan to begin with? If it was because you had your own insurance and lost it, that would likely qualify as “life change”. I was able to add my wife to my plan on the occasions she lost her insurance despite it being outside of the open enrollment period. And having another child definitely qualifies, as do marriage and divorce.

But “just because I want to” is not a good enough reason to go through the red tape of changing your coverage. The insurer’s administrative costs are already ridiculously high without people making more work for them on a whim.

I don’t want this to be about me. I want to know why deadlines are helpful for the uninsured.

I didn’t have a waiting period or deadline to enroll my family members when I was working in the late 1990s. My husband didn’t have a problem enrolling his children during the same time period. Illinois must be an exception.

Deadlines and open enrollment aren’t helpful for the uninsured. They are helpful for employers and insurance companies.

@jonsblond “Illinois must be an exception.”

Pretty much. I mean, Vermont, New Hampshire, Massachusetts, Washington, and wherever @tinyfaery lives all operate differently from Illinois, so yes.

As for how the deadlines are helpful, I really don’t see how they hurt. I mean, if you’re uninsured, odds are that you will jump at insurance the first chance you get, or at least within the first month of eligibility, right? How long does it really take to decide? Most times I’ve had to make such a decision, the wife and I figured it out within a day or two. And unless there is something odd going on in Illinois, I would wager that you have considerably longer than 48 hours.

But @SavoirFaire is correct in that they are there to help the employers and insurance companies. It’s just that I don’t see how they are all that harmful. As I said, I’ve been able to amend my policy when life circumstances warranted, as there were rules in place for cases such as spouse losing their own coverage. They do allow for some “life happens” exceptions.

Maybe the reason you/Jon never had problems before is because you clearly fell under one of those exceptions, but this time the circumstances are more ambiguous?

Open enrollment and deadlines are bullshit in my opinion also. What you need to be aware of is there are exceptions by law that a lot of idiot HR people aren’t aware of. For instance, let’s say my husband and I use insurance through my job. If I lose my job his job has to let us enroll at the time we lose coverage no matter what their enrollment cycle is. If you get divorced, married, new child, lots of life changing events are federal exceptions mandated by law, sometimes companies go beyond these requirements.

When I had one of these sorts of things happen my husband told me to go to my company and get the forms and the HR person plus the assistant manager of the store, who is over HR, said I couldn’t do it. My husband happens to be HR himself and he told me to go above their heads. I pushed and they called HR at the central offices and they said I was right. Meanwhile, everyone thought I was a pain in the ass at work for pushing. For whatever reason that is my role in life, but that is another story.

As people have said above, the deadlines help the company. They can shuffle around all the paperwork necessary during one specific time period during the year.

My short answer is that they don’t.

The only positive I can come up with is that during open enrollment there is an emphasis on insurance options for the upcoming year – hopefully with marketing materials and educational sessions. This emphasis, hopefully, helps people (insured and uninsured) understand their insurance coverage/premium options.

For example, in the university where I work, here are some examples of the marketing about open enrollment:
– a banner across the employee intranet
– emails about deadlines with links to information
– a packet of information about policies, plans and premiums sent to my house
– a booth in the cafeteria with information and a person to answer questions
– a sign outside of HR about how to get your questions answered
– information sessions specific to our plan options
– sessions about different kinds of healthcare coverage, in general
– a popup in the online time management system

I guess I don’t understand what is so frustrating in your specific instance. For me, a major frustration with my husband’s last job was that their open enrollment period began after mine ended. We always had to assume that I would have better coverage and sign up for my insurance and then decline his… but we never had the full information by the end of my open enrollment.

But now he doesn’t get insurance through his employer, so I guess I would prefer the different open enrollment periods…

Everything depends on state laws. C.A. has laws for everything. My sister-in-law does employment law and she says they are so convoluted and at times contrary to each other.

Be glad you have insurance.

@Cupcake What’s frustrating is the fact that I’m still uninsured because we missed the deadline and I have a much needed echocardiogram that now needs to be put off. My heart and ascending aorta are enlarged and I’ve been experiencing SOB daily since the beginning of September and chest pains for two weeks. I can’t get the tests and help that I need.

@jonsblond You probably did this, but I’ll say it, did you ask how much the self pay echo is? It probably is around $300 hundred dollars on the inexpensive side if I were to guess and if you are lucky enough to live where they don’t gouge you. Maybe they will work with the price? The trick is you have to make sure to ask what the total price is including reading/interpreting it. I would bet the prices for an echo around the country vary by as much as $2,000 like so many diagnostic procedures. Call a bunch of diagnostic centers within an hour of you.

Also, did you ask the doctor if your treatment would change depending on the echo result? Sometimes a test just tells you, or confirms for you, what the doctor suspects and it doesn’t change anything. If that would be the case then maybe it would be helpful knowing, so you aren’t worried that not doing the test is causing you more harm.

Lastly, I assume you have tried looking into public assistance and maybe some charities. Don’t forget to try the American Heart Association. Maybe they know where you can go for inexpensive diagnostics near you.

@jonsblond That sucks so bad. I’m so sorry you’re going through that. I missed the deadline once, but they made a clerical mistake and reopened enrollment for one additional week for all staff, so I was able to fix it.

It’s a long shot… but has your husband or have you begged HR to have you added?

@jonsblond Congratulations. This is Obamacare. Depending on which side of the fence you’re on, Obamacare is worse than the other system; others say it’s better.

I’m sorry.

@snowberry I’ve noticed only three real differences between now and then. When insurance companies did this before, Conservatives didn’t bat an eyelash, but now that the ACA passed and made Romneycare a federal thing, anything and everything insurance companies do is now totally wrong, and it’s all the fault of a socialist Kenyan Muslim. Aside from that, being able to get individual coverage for under $100/week, and the fact that you can no longer be turned down for pre-existing conditions, things are pretty much as they’ve always been. OP would’ve faced the same issue in almost any other state back when either Bush were still in office, so it isn’t Obamacare doing this. OP just got lucky in the past.

@snowberry Deadlines and open enrollment predate both the signing and enactment of the ACA. They are a preexisting condition, if you will. The reason that Obamacare includes them is that the bill was severely watered down to appease insurance companies (which, again, were already employing these measures). So while it’s perfectly legitimate to complain about the Democrats being spineless wimps, let’s not pretend the ACA invented these things.

@SavoirFaire Apparently not in Illinois though, so it must be Obama’s fault. It’s also Obama’s fault that OP couldn’t figure out within 30 days things that most people figure out in a week or less… unless Illinois has shorter deadlines than I’ve ever seen.

@jerv I haven’t seen @jonsblond blame Obama once in this thread, so I don’t think it’s appropriate to draw her into this part of the discussion. Also, my impression is that @jonsblond‘s need for insurance didn’t arise until after the enrollment period had already ended. Her problem started in September. The open enrollment period for Illinois ended in March. So it’s not a matter of her being unable to figure things out in a timely fashion. It’s about the fact that people’s needs don’t operate on the calendar system.

Yes, one reason for deadlines and open enrollment is to prevent people from waiting until they need insurance to get insurance. That works just fine for me since my insurance is paid for by my employer and I get an email every year telling me it’s time to enroll. But not everyone is so lucky. Some people have no choice but to hold onto every dollar until it has to be spent. I know you are aware of this and sympathetic to people in such situations, so it doesn’t seem like the sort of thing to hold against @jonsblond insofar as she is presently in that situation.

@SavoirFaire That was actually in reference to @snowberry‘s post, combined with @jonsblond‘s assertion that Illinois never operated the way everyplace else does until now. Sorry if it came out wrong.
However, I admit I am puzzled as I’ve always sprung for insurance at the first chance I get even when I need the money for things like food though pretty much to avoid going down the road @jonsblond is on again. The puzzling part really is that @jonsblond seems to have issues with things working the way they’ve always worked elsewhere for many years, like it’s a new thing.

How does Obamacare have anything to do with an echocardiogram costing a gouging price? The government didn’t go far enough to control medical costs and still lets the private sector be thieves. Ugh, maybe the one really huge problem with Obamacare is now people can blame Obamacare and not look at the real problems that are in the system already and continue to be there. I still hold some hope Obamacare will eventually help address some of the issues, but I have my doubts. From my view Obamacare gave more people healthcare in the same shitty system we have had for years. The country talks about the uninsured, but we don’t talk enough about the insured and how we are all robbed. If we focused on that, then we could afford as a country to insure everyone. Check out my complaints about the costs of healthcare and access before Obama; all the same garbage we still hear today.

Right now, the same as ten years ago, @jonsblond can get emergency care so she does not (God forbid) die on the spot in an ER, but she cannot get tests and treatment for a chronic condition. This is typical of the American system. It has nothing to do with Obamacare.

My suggestion to shop around is really easy to say. When we are sick it is the time we have the least strength physically and mentally to shop around. The mental stress our system puts on a patient is really disgusting and if anything makes our health worse. Illness has enough difficult decisions without having to deal with a procedure or test costing $300 in one place and $2000 in another.

@JLeslie Plus ça change, plus c’est la même chose.

@jerv Yes, I definitely think it came out wrong. And I don’t think @jonsblond‘s issue is with things changing in Illinois. These practices are new to her—which is what’s behind her surprise—but her objection doesn’t seem to be about the recent local change or the surprise it caused her. It is to the practices themselves. They are objectionable to her, and the recent local changes have brought them to her attention. As for why she makes decisions differently than you do and prioritizes things differently, that’s what different people do—they make different decisions. Besides, her overall situation might not be the same as yours.

To clarify I was responding to @snowberry. I didn’t see @jonsblond blame Obama in any way.

I think probably previously @jonsblond had a life altering event that made it easy to enroll in insurance plans and she didn’t realize she was part of an exception. It isn’t intuitive to most people to think you have to enroll during a specific month. It wasn’t to me anyway.

@SavoirFaire I suppose that it’s that I never really knew any other way; what’s new to her is decades-old for me, and I’m having trouble wrapping my head around that. I would probably understand it better if Illinois were a different country.
As for making decisions differently, I’ve actually made that same decision for the same reason back when I was younger… and had it bite me in the ass the same way it’s biting her now. I could see someone in their early-20s doing that, but I can’t really grasp someone who has been bitten before making the same mistake twice, nor can I see how one could make it to 30 without having had any medical issues bad enough to make one prioritize health insurance right under food and rent.
Overall situation… not exactly, but I’ve had pretty heavy stuff happen to me while unemployed and uninsured; enough to have more sympathy than it may appear. I just don’t have the eloquence or tact to avoid coming across as totally heartless.

@JLeslie I figured that you were also addressing @snowberry. I just wrote plus ça change, plus c’est la même chose as I felt just giving you a GA wasn’t enough.
As for the other, no, it really isn’t intuitive. But after running through the process a few times due to an ever-changing life, you kind of get used to it. Unless one has zero changes in marital status, employment status, or number of children, most people will go through the process, quite likely a few times.

pretty much to avoid going down the road @jonsblond is on again. Going down what road again? This is the first time I’ve ever had trouble getting insurance for myself.

I must have been lucky in the past. I get it. When I needed to change insurance or add a family member in the past it must have been during open enrollment, so no mention of a deadline was needed. I learned something new. Other people have been helpful without the need to be snarky about it @jerv. Not once did I mention Obama. I don’t like the state of our healthcare system, but I’ve never criticized Obama. I’m a registered Democrat, btw.

The reason we missed the deadline @jerv was not my fault. It was due to incompetence in the front office of my husband’s workplace. He gave the office all of the information that was needed. A payment was even taken out of his paycheck two weeks ago and we thought the deal was finalized. I’ve been waiting for paperwork and insurance cards in the mail. We were informed the day that I asked this question that the deadline was missed and the money was refunded. Does my frustration make a little more sense to you now? It wasn’t because I was lazy, ignorant or a rabid hater of Obama. But you are going to believe these things anyway. I’m wasting my time with you. You are heartless

Thank you @SavoirFaire and @JLeslie for understanding and being helpful.

@jerv Yes, I understood you were just being supportive of me. My clarification was for the thread in general. I wasn’t directing it at you.

@jonsblond I think that scenario is enough for you to fight for coverage. Please don’t give up.

@jonsblond I would go as high as you need to to get it fixed. It sounds like it is the company’s fault. They can fix it.

I agree with @Cupcake.

@jonsblond The 30 day deadline is an effort to encourage communication within the family unit so their employees can weigh out the pros and cons of each plan and decide which coverage is best. In general, people respond better to a deadline rather than “submit whenever you want” policy and its saves time, hassle and money on the part of the HR department. Therefore, it has become a common in the workplace and has been taking place for many years. In many instances, if there is a birth, if you get married or if you change jobs, most companies consider that a “qualifying life event” and you can get added, provided you sign up in the appropriate time frame.This is the answer to the question asked
Now it seems the question you wanted answered is “I was unable to get on my husband’s insurance before the deadline. What do I do?”. Unfortunately, you also left out a vital bit of information, namely that your HR department screwed up the paperwork. Most of these answers are based on you simply missing the deadline. In this particular instance, you or your husband can file a complaint with HR and the insurance company to see if you can get added. Gross incompetence on the part of HR should also be seen as a “qualifying event”.