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Report: #1473538

Complaint Review: New York State of Health Marketplace - New York

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  • Reported By: CelloDolly — Ridge United States
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  • New York State of Health Marketplace New York United States

New York State of Health Marketplace Misrepresented advance "tax credit" for monthly premium and caused my spouse and I to incur a penalty at the end of the tax year amounting to more than $8000. New York

*Consumer Suggestion: Advance

*Consumer Comment: You Should Have Consulted a Broker

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This is the state exchange for "affordable" health insurance.  If you live in New York State and your employer does not offer health insurance, this is pretty much your only option.  So  called "health markets" ultimately point you to the NYS marketplace plans --they are not an alternative.  Similarly, the so called "health share" programs are NOT an alternative to real health insurance. 

They are often more expensive with less coverage than what is offered on the exchange.  NYS of Health Marketplace  is clearly designed to benefit NY State of Health and their partners, NOT the insured.  In 2017 and 2018 they offered a so called "tax credit" toward your monthly premium but what they DON'T tell you is you still have to pay the balance on what the full monthly premium totals would be cumulatively at the end of the year.

You are NOT getting a reduced monthly premium.  In 2019, the tax laws changed so we did not have the option of deferring any portion of our premium. We would have had to pay the full monthly premium, which would have been more than $900 a month just to be enrolled, plus an $8000 yearly deductible, plus coinsurance payments IF you actually have to see a doctor or receive any medical services. 

My husband and I had to pay out of pocket more than $20,000 a year (fully a third of our gross combined income) before we received ANY coverage. This is NOT affordable health insurance.  This is a SCAM and a travesty of our government.  Then there is the issue of offering FREE health care to people who are not even citizens and NOT contributing anything to our economy, while NOT helping citizens who are truly sick, disabled and ARE ACTUALLY WORKING --actually contributing to the US economy. 

The sooner the working class of citizens defy this system and vote the people who perpetuate it out of office, the better off we will all be.  Until then, many of us will continue to suffer under a completely ineffective and unaffordable health insurance system.  

This report was posted on Ripoff Report on 02/14/2019 10:11 AM and is a permanent record located here: https://www.ripoffreport.com/reports/new-york-state-of-health-marketplace/new-york/new-york-state-of-health-marketplace-misrepresented-advance-tax-credit-for-monthly-premi-1473538. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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REBUTTALS & REPLIES:
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#2 Consumer Suggestion

Advance

AUTHOR: Flint - (Afghanistan)

POSTED: Tuesday, April 21, 2020

The way the ACA works is that you get the tax credit advanced to you to help pay for coverage.  You then have to claim it on your taxes, and if you are not eligible you pay it back.  The subsidy cut-off is right around $60k for two people, so if your pretax income is around $65k, you should have just contributed some money to an IRA to bring your taxable income down and qualify for the credit. 

Any half-decent tax pro could have explained it to you.  The way the ACA works is, if you make a dollar over the cutoff limit, you will lose the subsidy (which can be worth $10-20k).  And it has nothing to do with NY State, you can thank Nancy Pelosi and Obama for that law and especially the idiotic cutoff cliff.

 

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#1 Consumer Comment

You Should Have Consulted a Broker

AUTHOR: Jim - (United States)

POSTED: Friday, February 15, 2019

The idea you had to go out on your own to pursue something like this is idiotic.  If you weren't sure about whether you were getting a good deal or not, an insurance broker would have been able to consult with you and steer you thorugh the process more efficiently.  Brokers get payment from the insurance company, so you wouldn't pay anything to the broker.

Now, to the rest of it.

NYS of Health Marketplace  is clearly designed to benefit NY State of Health and their partners, NOT the insured.  In 2017 and 2018 they offered a so called "tax credit" toward your monthly premium but what they DON'T tell you is you still have to pay the balance on what the full monthly premium totals would be cumulatively at the end of the year.  Actually, the programs are, or were, designed to make certain participants were covered in compliance with the mandate most people refer to as Obamacare.  I mean if you were that rebellious, you could have decided not to comply with the mandate, but then you'd pay a penalty for the years in question.  Given you only purchased a Bronze plan, you may as well have not paid.

You are NOT getting a reduced monthly premium.  In 2019, the tax laws changed so we did not have the option of deferring any portion of our premium. We would have had to pay the full monthly premium, which would have been more than $900 a month just to be enrolled, plus an $8000 yearly deductible, plus coinsurance payments IF you actually have to see a doctor or receive any medical services.  I am pretty sure you meant the tax law changed in late 2017 to eliminate the tax credit.  However, let's also be clear:  You purchase insurance for the purpose of having insurance coverage - not for a tax credit.  Obviously, had the credit survived the 2017 Trump Tax Simplication Act, the credit would have occurred on the back end, which is how things like this generally work, not on the front end, which is what you thought was going to happen.  Tax credits also do NOT reduce the cost of your insurance.  In addition, you chose a bronze plan.  Bronze plans are generally for the young who don't see doctors often, except for the minor illnesses here and there.  It's not for people who have to spend significant amounts to see a doctor.  In such a case, you would have been far better off obtaining either a Gold or even a Platinum Plan.  Premiums are higher, but the back end costs are far less.

My husband and I had to pay out of pocket more than $20,000 a year (fully a third of our gross combined income) before we received ANY coverage.  Lady, you are an idiot.  First, this is exactly what catastrophic coverage is.  Second, the coverage would have kicked in the minute you begin seeing a doctor.  Insurance reduces down the out of pocket cost you would eventually have to pay by 30% in a bronze plan, 50% in a silver plan, 70% in a Gold Plan, and 90% in a Platinum Plan.  It isn't until you hit the $8,000 deductible that all of your out of pocket costs become zero.  I mean you seriously have no idea what you're talking about.  Perhaps the other thing you should consider is working for a company that ACTUALLY provides healthcare.  It seems idiotic to work for a company that doesn't provide it.  On the other hand, your comments seem to be consistent with your stupidity.

Then there is the issue of offering FREE health care to people who are not even citizens and NOT contributing anything to our economy, while NOT helping citizens who are truly sick, disabled and ARE ACTUALLY WORKING --actually contributing to the US economy.  Without engaging in politics, free or reduced health care is available to the poor who cannot afford coverage.  You just happen to be someone who makes too much money in order to qualify for the reduced cost.  You then become a complete IDIOT to then tie people who are not citizens to people who do not contribute to the economy.  How about people who legally obtained residency status - are you saying they aren't contributing to the economy when they work?  How about people with specific skills that obtained H1B visas to come here and perform work on behalf of an employer??  Are you sayiing they don't contribute to an economy??  Perhaps you don't like the fact that companies can hire foreign workers to work here and you simply liked it better when the KKK existed to keep them foreign people in line?  Perhaps you liked life better when people who were different than you, were simply lynched because you thought it was the right thing to do since they were different than you?  Perhaps you really meant to say that you didn't like the idea that people who aren't here legally can obtain free health coverage?  That's at least a debatable point.  The rest of your idiocy is not subject to debate.

Perhaps you should take your white hood off - clearly it's cutting off the circulation to your brain.  If you're only making $60,000 per year, I can assure you that you not only contribute very little to the economy, you should seriously consider moving out of NY.  It is obvious you can't afford to live there.  Perhaps you can live in a state where the people share your values - which right now, is nowhere.

The sooner the working class of citizens defy this system and vote the people who perpetuate it out of office, the better off we will all be.  Until then, many of us will continue to suffer under a completely ineffective and unaffordable health insurance system.  You have to be kidding.  You live in NY.    The working class of NY are pretty wealthy and like things the way they are.  You are not part of the working class if you only make $60K per year.  Insofar as an ineffective health insurance system, the issue has nothing to do with health insurance.  Health insurance companies are required BY LAW to take at least 80% of the premiums they receive and direct those premiums toward the delivery of healthcare.  Once you figure in overhead, a health insurance company essentially makes a profit of about 5%-7% pre-tax income.  So health insurance isn't the issue.  The real problem is the cost of delivering of healthcare to people here.  We do a great job of delivering healthcare to people, but it's expensive.  Other countries can deliver healthcare cheaper, but actually receiving healthcare is the issue.

 

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