What PCVs and Recent RPCVs Need to Know about the Affordable Care Act (ACA)

Last month I spoke to both the Seattle and Portland RPCV groups on the ACA and New Health Insurance Options in 2014. The entire presentation is now available on the Resources section of the SEAPAX website, in the Health category. Because there are the unique issues for PCVs about to COS, and for RPCVs who completed service less than 18 months ago, this article addresses only this special topic.  More information for everyone and/or help to enroll is available online, by phone, and in person, from Washington Healthplanfinder, and locally from Coverage is Here of Public Health Seattle King County.

Thanks to the ACA, enrollment is now underway for new public and private health insurance plans that will start Jan. 1, 2014. (Dec. 23 is the deadline to sign up for coverage starting Jan. 1. Enrollment continues through March 31, 2014).  Those who are about to finish, or have just finished their Peace Corps service, will typically be among the majority of us required to have health insurance in 2014 or else pay an annual penalty. While about half of the US population now gets health insurance through employment, recent RPCVs may often be among the uninsured or underinsured.

At COS, the Peace Corps offers a volunteers temporary insurance plan called AfterCorps (sold by Seven Corners ) that can provide up to 3 months of coverage. Peace Corps pays the first month’s premium, after that the RPCV is responsible for the $253.44 monthly fee ( 2014 price) , plus any premiums for a spouse or dependent child.  For coverage beyond the first month, the RPCV must extend the policy, and pay the 2nd premium, within 30 days of their COS date. Now that ACA plans are available, PCVs and new RPCVs need to decide if they should buy AfterCorps insurance, or sign up for coverage through WA Healthplanfinder.  Before the ACA, the decision was easier, as many people were not able to purchase an individual health insurance policy simply due to exclusions for pre-existing conditions or because the price was too high.  The ACA is a major game-changer because pre-existing condition exclusions have been allowed even for conditions common among healthy young people like acne or near-sightedness.

The price tag alone may be the deciding factor, especially for new RPCVs under age 35. For them, Healthplanfinder private-sector plans (called Qualified Health Plans or QHPs) may be available with zero premiums, or priced under $50- $100/month. QHPs are ranked as Bronze, Silver, Gold plans based on the percentage of cost covered for a set of 10 Essential Health Benefits mandated by the ACA.  Some may be eligible for free coverage through WA’s Medicaid Expansion, called Washington Apple Health, available to individuals with annual income up to $15, 856.  In addition, there is some flexibility for new RPCVs to sign up for a QHP or Apple Health outside of the open enrollment period, based on a qualifying event which leaves her/him uninsured, including loss of a job and/or insurance (e.g. COS from Peace Corps) marriage, divorce, birth or adoption of a child; there is no deadline to enroll in WA Apple Health.

There are still some unknowns about the special situation of COS-ing PCVs and the ACA, such as if Peace Corps is planning any changes to the Post-Service Health Benefits program and/or to AfterCorps.  So far efforts to get information from the Peace Corps Office of Medical Services have not been successful, nor did a search of NPCA sites find anything on this topic. When details become available, SEAPAX will make a point of sharing the info. Meanwhile, here are some tips that may be helpful:

  • If you are under 26 and your parent has coverage through an employer’s group plan, you can be covered under their plan even if you live independently, are married, or have children. If your parent is now uninsured, they can get a family plan that includes you through WA Healthplanfinder
    • BUT first check prices very carefully– it may be much more economical to get your own individual plan through WA Healthplanfinder
      Consider how costs (premiums and out-of-pocket expenses) and benefits compare between AfterCorps and plans offered through Healthplanfinder
  • After the deadline to enroll following a qualifying event, you can only sign up during the annual open enrollment period.
  • Be sure to find out if you are eligible for premium tax credits or subsidies, which are only available through Healthplanfinder
  • Be aware that the plans that seem to be the lowest cost based on premiums, may cost you more in the long run because:
    • The lowest cost QHPs (Bronze plans) may actually cost more & offer less benefits than Silver-level plans
    • Insurers can still sell catastrophic plans to people under age 30. These plans often require high payments before benefits begin, and the benefits are usually limited in scope and only for major problems
    • QHPs must offer 10 core health benefits, but catastrophic plans do not have this requirement
    • Many colleges & universities require students to have health insurance, but you are not required to buy the plan offered by the school, which is often a catastrophic plan
    • The preferred method to enroll in a QHP  is online through Healthplanfinder, and the first premium payment must be made electronically. To sign up and pay before returning to the US, you will need to research how this can be done, such as any help available from your local PC office.
  • Remember that you only have 30 days after COS to continue with AfterCorps, but you have 60 days after COS to enroll in a Washington QHP, and no deadline to enroll in Washington Apple Health

And a special message for millennials: remember that by signing up for insurance you’ll not only be protecting yourself, but helping to ensure that all of us can get affordable coverage. Insurance works by spreading the risk among the largest possible pool of people.  While undoubtedly your Peace Corps services has made you more aware than most people your age about life’s challenges,  you might want to check out the Young Invincibles national website .which explains the why’s and how’s of getting insurance through the Affordable Care Act Marketplaces.

Joana Ramos
SEAPAX President