Almost a million people are set to lose their health insurance coverage because the information in their applications didn’t match the data that the federal government had on file; however, that’s not the scary part.
Last year, during open enrollment people were encouraged to apply for federal subsidies without providing any type of documentation: income verification, tax returns, citizenship or immigration documentation.
The end result was the government was unable to accurately determine the income of almost Two million individuals of the touted eleven million who enrolled.
The Affordable Care Act (ACA), aka Obamacare was passed to provide access to affordable health Insurance for all uninsured and underinsured US citizens. In simple terms, the ACA is an expansion of Medicaid.
Obamacare is supposed to make it affordable for lower income households to be insured by providing a subsidy to help cover the cost of the insurance. In a nutshell, here’s how it works. If your household income is below a certain threshold, the government will write a check to the insurance company for the difference between what you pay and the actual price of your health insurance premium.
The old adage that nothing is free in this world is still true: not even Obamacare.
Reason # 1: You misstated your immigration status on your application
Knowingly or unknowingly making false statements on an application is a first degree felony, and is punishable by up to 5 years in prison. It also voids the entire insurance contract, all the way back to the effective date.
What the insurance company is going to do:
Any and all outstanding claims in process will not be covered, and the full financial responsibility of these medical bills will be placed on you.
– The insurance company will sue you for claims that they have previously paid, and they will request full reimbursement.
– Obtaining insurance in the future may be impossible, as fraud on your records will be seen by future insurance companies, and they may choose not to provide you with coverage.
REASON # 2: You misstated your income to obtain the subsidy and get a lower rate
What the IRS is going to do:
– It is estimated that 6,700 new IRS agent have been hired to enforce the individual mandate of Obamacare
– The IRS will flag your Social Security Number (SSN), along with other information on file, by matching your previous tax returns.
– If things don’t match up, they will cancel your subsidy, audit and/or fine you, and levy penalties and interest
– Also, you can face up to 5 years in prison
The IRS website states, “If advance payment of the premium tax credit was made but your income for the year turns out to be too high to receive the premium tax credit, you will have to repay all of the payments that were made on your behalf, with no limitation. Therefore, it is important that you report changes in circumstances that may have occurred since you signed up for your plan.”
REASON # 3: You unintentionally committed health care fraud
Health care fraud is the number one crime endangering the entire health care system. The IRS has recently made it clear that government’s key focus is on eliminating waste, abuse and cracking down on fraud everywhere. The federal government has informed insurance companies to terminate for those individuals who purchased their health insurance through HealthCare.gov, and have yet to provide the necessary documentation. Those terminations began as early as September 15, 2015.
Cancellation letters from various insurance carriers went out at the beginning of the month. This potentially leaves hundreds of thousands of individuals who were unable to provide the proper documentation in a far worse position than simply being uninsured.
What to do if you are in this situation
Federal officials are cracking down on individuals whose incomes cannot be verified. These people will lose their coverage, along with having to repay the government in full for all of the amounts paid by the government, including the subsidies. People whose coverage is terminated can apply to re-enroll for coverage at any point through platforms like www.jibehealth.com. Jibe health also has advocates on staff to help you sort out any issues free of charge. Jibe Health works with most insurance carriers such as Bluecrossbluesheild.com Atena.com, Humana.com, Unitedhealth.com, Coventry, Cigna and many others.
If you think any of these things may apply to you, don’t wait to be terminated by the insurance company. Call Jibe Health we will help you cancel your current coverage voluntarily, reapply with private insurance, and forgo the subsidy.
The moral of the story is simple: if you don’t really need the subsidy, don’t risk your liberty and freedom. It just isn’t worth it.
Jibe Health Inc. all rights reserved 2015