Healthcare Marketplace Qualifying Event

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Hello! I am trying to determine if my father, who has stage 4 lung cancer, will qualify to enroll next year when this change happens or if he should make the change now.

The situation is that he is on Cobra insurance now that is affordable because the employer he had when he was diagnosed and determined to be permanently disabled pays a subsidy that covers 2/3 of the cost of coverage. I am looking at Marketplace plans for him and there aren’t many good options that cover his Oncologist and much of his current medication. My preference would be that he stay with what he has and, realistically if he is still alive when the subsidy runs out, switch at that time. I want to make sure that is a qualifying event before moving forward with that plan.

We are in Missouri. He does qualify for a government subsidy so the cost of both plans is comparable, I’m just scared about a change in plans making it difficult to continue on with his care as it is now. It would be difficult to make big changes at this point. The other issue with switching mid-year is that he will meet his deductible for the old plan and then have to meet it again with the new plan. I’m sure there are points I am not considering here. He cannot afford his care out of pocket. His income is very minimal but just high enough that he doesn’t qualify for Medicaid and he is only 60 so no medicare.

TIA for any insights!

ETA: His current plan does have dental and he has some dental problems from chemo he will probably never see a dentist for. The marketplace plan that most closely meets his needs does not have dental.

submitted by /u/overwhelmedunder
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Hello! I am trying to determine if my father, who has stage 4 lung cancer, will qualify to enroll next year when this change happens or if he should make the change now. The situation is that he is on Cobra insurance now that is affordable because the employer he had when he was diagnosed and determined to be permanently disabled pays a subsidy that covers 2/3 of the cost of coverage. I am looking at Marketplace plans for him and there aren’t many good options that cover his Oncologist and much of his current medication. My preference would be that he stay with what he has and, realistically if he is still alive when the subsidy runs out, switch at that time. I want to make sure that is a qualifying event before moving forward with that plan. We are in Missouri. He does qualify for a government subsidy so the cost of both plans is comparable, I’m just scared about a change in plans making it difficult to continue on with his care as it is now. It would be difficult to make big changes at this point. The other issue with switching mid-year is that he will meet his deductible for the old plan and then have to meet it again with the new plan. I’m sure there are points I am not considering here. He cannot afford his care out of pocket. His income is very minimal but just high enough that he doesn’t qualify for Medicaid and he is only 60 so no medicare. TIA for any insights! ETA: His current plan does have dental and he has some dental problems from chemo he will probably never see a dentist for. The marketplace plan that most closely meets his needs does not have dental.
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