How to Avoid Being Auto-Enrolled by the Federal Marketplace

Is There Anything I Can Do To Stop Healthcare.gov From Listing Fraudulent Insurance Companies?

Even though the deadline to enroll is January 15th, the federal health insurance marketplace takes it upon themselves to auto-enroll you into a plan without your permission if you haven’t signed up by a certain date. This has been documented on reddit multiple times.

advice with healthcare.gov and “auto-enrollment”
byu/catstone2 inlegaladvice

Healthcare.gov autoenrolled me for coverage even though I cancelled.
byu/averageboy24-7 inpersonalfinance

It happened to me this year. What the representatives SAY gives them permission to do this is a box at the end of the application that says:

” To make it easier to determine my eligibility for help paying for health coverage in future years, I agree to allow the Marketplace to use income data, including information from tax returns, for the next 5 years. The Marketplace will send me a notice, let me make any changes, and I can opt out at any time. “

Obviously, nowhere in that statement does it ask for permission to auto-enroll you. All it’s asking for is permission to view your income to determine the appropriate amount of advanced premium tax credit (APTC) you’ll receive upon re-enrollment. The representatives will tell you this allowed them to auto-enroll you. In my situation, I check that box “no” every year. It led to them completely dropping my advanced PTC on the renewal because they did not have my income information. If I checked that box yes, then they would’ve had all my information to maintain my APTC. I think this is something they’ve been told to say, but is not true in reality.

See also  Medical bill shock and imperfect moral hazard

The larger takeaway I had is that you should understand that most of these marketplace reps do not know what they are talking about. They are seasonal hires with minimal training. I spoke with 4 different ones and received 4 different answers over the course of two weeks before finally speaking with a supervisor who knew what they were talking about. At first, the rep simply cancelled the coverage, but only after January, so I was on the hook for the entire premium. Then they told me they couldn’t cancel January, but they could appeal for the PTC. Then they said they could only cancel part month. Finally I spoke to a supervisor who said: If you call and cancel your auto-enrolled coverage before the end of the year, they should cancel it entirely. Since I had attempted to do that and the representative did not do it correctly, it was “escalated” and took about a month before they cancelled Janaury.

So my takeaway is to understand that they will try to auto-enroll you. If you do not want the coverage, call to have it cancelled, make sure it is completely cancelled (healthcare.gov should say cancelled as of 12/31/20xx), and skip the reps and go straight to a supervisor if that isn’t the case. And if the supervisor tells you it cannot be done, keep calling back until you find one that knows what they are talking about and can properly “escalate” it for you.