Getting the Knack/Only in NJ: The federal tax penalty: rather Seuss-like

Just a comment today

I did my federal tax form, including the stuff associated with the line on the 1040 memo’d with “individual responsibility” for health insurance, and form 8965, which deals with an exemption from the tax penalty for not getting health insurance per the ACA. I worried about aspects of the penalty provisions in Part 2 of this series—it turns out, worried unnecessarily in some ways.

Fortunately, none of the tax forms asked for specific insurance-policy numbers, because it would be confusing to me which of the numbers I have (and for which insurance policy—i.e., which carrier) I would put down for 2014. All the 1040 and associated forms asked about was whether you had insurance, and if not for part of the year….

I filled out the worksheet that calculates what your penalty would be if you were not covered for part of the year. Indeed, I considered myself uncovered for part of the year, but the end result of all my tax prep stuff was different from what I’d envisioned, and I won’t say anything more about it other than that the end result didn’t leave me screaming.

But the big point to make here is that the worksheet you fill out to figure part-year penalty seems like it was designed by the Cat in the Hat, with help from Thing One and Thing Two.

Getting the Knack/Only in NJ: Bagging another “senior coffee”

[See “Sometimes it’s all in the hat” on my other blog, from January 2014, for an anecdote last winter that this one somewhat reprises. Edits 2/12/15. Edit 2/13/15.]

Case today: Getting a discounted cup of joe and showing some of the variety of moral and “instrumental” judgments and plans

I’ve joked with my mother (and with you, on my other blog) about managing to get a discounted coffee from such an esteemed establishment as McDonald’s because, on a given winter day, with my winter attire and momentary, somewhat haggard appearance, I passingly look like a senior citizen.

Before I took my mother to do her food-shopping trip (once a week at a Shop-Rite supermarket she prefers) today, I joked with her about perhaps getting the senior discount on coffee when I went to a McDonald’s a short walk away from the Shop-Rite. Actually, I dressed as I was apt to simply to be practical, and because it’s winter (and I haven’t shaved for days; and I wasn’t “going to work” yet). And I really wasn’t expressly trying to trigger some hapless McD’s clerk into charging me (out of sympathy or whatever) only the senior rate for coffee. But I knew it could possibly happen.

Again, so much is in the hat

Key to the way I look older (and perhaps a little more hapless) than I am, in the winter, is a grey knit hat that stands up high and makes me look like a garden gnome. It’s the sort of hat no twenty-something would be caught dead in (except maybe on a ski slope). I know from the almost-universal way that people—a range, including ones who know me well enough—seem to “give me a look” when I appear on the scene in this hat, as if I appear a bit goofy, that this hat has an efficient, reliable way of making me look like a real winter dipshit.

Add greyed whiskers that look rather like short bristles on a brush (for cleaning up your pet, or shoes), and the more extensive grey in my mustache….

Also add, by the sheer efficiency of nature and the winter day, a wrinkled, crow's-feet appearance about my eyes and perhaps a shadowy look there, due to short sleep and maybe my feeling a bit peaked (pronounced “pee-ked” [correction: the syllables have equal stress]), and we’re almost there. Instant 65-year-old. (Or maybe 60? What is the minimum age for what McD’s considers “senior”?)

What else? You never know who among fast-food wait staff is going to be triggered into thinking I’m older than I am, but often it’s younger (20-something, maybe late-teens) people. (Not always, but often. And it’s happened a couple times at a Dunkin Donuts, too.)

But today one thing that worked was that the wait person was a Hispanic woman, age maybe 50, and I think maybe she was generally a bit rough enough in assessing where we Anglos stood as to apparent age. (No big mystery: the same thing can happen among us Anglos regarding our Latino neighbors.) This, combined with hat and grey hair, was key to my securing the senior discount. And of course I didn’t have to say anything to make it happen. [Added 2/12/15: If you're wondering whether the presence of my mother helped trigger the age assessment, my mother wasn't there; I was on a solo sortie while my mother was in the supermarket.]

Analysis of the limits of devious activity here

It seems that, whatever the basis in particular cases, this assessment comes by sheer grace, or luck. It doesn’t seem you can calculate that it will happen based on (whatever combination of) goofy hat, unshaven face, short-sleep haggardness, etc. You only need go out of the house—all innocent in general intention—looking like a bit of a goofball, and maybe—when ordering some breakfast repast—encounter a McD’s worker who’s never seen you before….

So, no efficient decision to deceive here. Instead, going out on the road with the consciousness that you can possibly receive a “tricked” assessment of you. Devious? Not really. (And what does the discount cost McDonald’s? About 40 cents? The senior coffee in this case was about 70 cents.)

But if you were short of money, and were more apt to make the discount happen (and weren’t concerned about being devious), how could you add a bit to the possible misjudging of your age? Maybe humming a song “no young person would hum.” Sinatra, maybe. Maybe in a brief set of comments, some old-time idiom (maybe from 1950s movies), if you could think of it and not sound fake.

But in the hamming-up department, I wouldn’t make a passing remark about having been in a war, when you haven’t. So, if you’re considered 60 or 65, Vietnam might seem to be a good touchstone, but be serious (if you’re my age)—don’t ham it up and say, about something you allegedly saw outside, “I haven’t seen such craziness since Saigon. I was almost ready to jump flat to the ground as if enemy helicopters were coming.”

I mean, a famous TV news anchorman who developed his trademark tone of gravitas and senatorial bearing, all suited for delivery of the wealth of national-audience news (grave and fun), recently took a career fall for his previously suggesting he had received more risk from war-zone activity than he really had. Your honorableness should still come into play, when all that’s at stake is a discounted coffee. [Added 2/12/15: The unexpected senior discount happened again today, at a Dunkin Donuts over the state line in New York State, where it's happened before. No hat this time, but still with the grey whiskers that make my face look a little like a raccoon's rump.]

Getting the Knack/Only in NJ: Two wintertime issues: Double-insured?, and tax questions

1. What to do about a first insurer thinking it still covers me (while I’m covered by a new insurer)?

2. How to handle the ACA requirement in federal income tax

[See here for introductory information on this series. Edit 2/5/15.]

Case #1 today: Still getting mail from the first Medicaid insurer I was automatically assigned to, after having switched in December (per my doctor’s request) to a new insurer

This situation has an amusing aspect, which has to do with a mass-mailed letter I got on January 20 [added 2/5/15: it was dated Jan. 16; I received it on Jan. 20], informing me on what hospitals were and were no longer covered. But more on that later.

As I recounted in detail before, I signed up for ACA insurance—qualifying for the “Medicaid expansion” insurance—in December 2013. Then I got nothing in hand for many months, though starting in February 2014 I found out by phone call (to NJ FamilyCare, the entity handling the Medicaid expansion in the state, whose mechanized phone answering system was repeatedly, over weeks, unable to allow me to get many other questions answered) that there was a “policy number” for me, but I could find out nothing more about my Medicaid insurance, and got nothing mailed. That is, except for some survey-type invitations, mailed twice by a postcard, in late March–early April 2014.

In November and December 2014, I got the impasse-of-sorts ironed out: the reason I got nothing in the mail was that my Medicaid policy, effective on a date in March, had been mailed to an address that would not work for me, and not my P.O. box address (this despite the fact that on the federal ACA “Marketplace” Web site, I had put in my P.O. box address, and a printout shows this). So I got the address situation corrected, and got my state Medicaid card in the mail. I was also told by phone in November, by a state Medicaid worker, that my insurance was through the firm Amerigroup, which was the entity that had sent the postcards several months before.

Then, when I had a standing appointment with my usual doctor in December, his office told me they could take Medicaid patients, but they could not take Amerigroup insurance. They would take United Healthcare Community Plan. They said I should have had a choice about which insurer I would have when I was signed up (actually, I did not—not as far as I could see). They said I should be able to change insurers.

So I called the Medicaid office again, which referred me to a NJ FamilyCare number (this time with a live person, a rapidly-speaking but competent fellow). I got the insurer changed, and the effective date with the new insurer—according to a card I got in the mail—was January 1, 2015.

The problem

Meanwhile, I have still gotten occasional mail from Amerigroup. Now, all I’ve gotten from Amerigroup has been general-info stuff, including a glossy-paper newsletter (featuring, as is typical of their stuff and not offensive to me, both English and Spanish versions of the copy). There was also something saying I should take part in another survey (I had already taken part in one in December—online, very easy—and as a reward, they offered me the choice of a gift—and I asked for the water bottle, which I got).

What to do about Amerigroup’s mail that came, still in January? Just let it come (including in future months), for what info it gave that I might be able to use?

At first I thought that, because the Amerigroup mail I got was all stuff not predicated (as far as I knew) on expecting me to meet obligations of theirs, nor were there any bills (thank goodness), I didn’t have the need to alert them that I’m no longer covered by them. But then I thought, “Suppose Amerigroup was charging the federal government a certain premium based on the assumption that it covered me. If United Healthcare was already doing the same thing, that wasn’t right. So, I should tell Amerigroup to drop me as a client.”

Plan for a solution; what I did

At first I wondered, Write to Amerigroup myself? Or call the Medicaid office in Paterson? I debated a bit, and decided to write directly to Amerigroup, specifically to its office in Iselin, N.J. (The Amerigroup Web site also had a link by which you could get in touch with customer service, but I decided to write a letter. Call me a dinosaur. I also still like using Windows XP and a land-line phone.) I opted out of calling Medicaid because, first, they were indeed helpful in November but seemed to have their hands full, and would (more than once) refer me to another entity, like NJ FamilyCare. Then, when I was in touch with NJ FamilyCare on about December 18, they should have discontinued my coverage by Amerigroup while they set me up with United Healthcare.

Not that I was losing faith in the Medicaid office or in NJ FamilyCare, but it seemed worth a shot to send a letter to Amerigroup first, and see what happened.

Here is an edited version of the letter I sent by snail mail:

January 23, 2015

Amerigroup New Jersey Inc.

Attn: Customer Service Dept.

101 Woods Avenue

Iselin, NJ 08830

                                                                        Re: Gregory Ludwig,

                                                                        beneficiary

                                                                        CCN # [number redacted]

                                                                        ACA policy # [number redacted]

To Whom It May Concern:

I started signing up for Medicaid insurance (via the expansion program under the Affordable Care Act) through the federal Marketplace Web site in fall 2013. In winter 2014, in making phone calls to the NJ FamilyCare office, I found I had a policy number (see in caption above), but I got nothing in the mail then, or for months—not an ID card, mail specific to my policy, or anything else.

Then in November-December 2014, I started getting cleared up the apparent errors in handling of my policy—I never received an ID card (from the state) because it had been sent in winter 2014 to the wrong address.

So in November, I gave the Medicaid office in Paterson my correct mailing address, and I got my state ID card (see CCN number above). I got information on my more specific enrollment (with a named insurer) in November and December.

I was told I was enrolled in Amerigroup insurance (as the specific company handling my policy). (I was told the policy was effective March 1, 2014.) However, when I saw my regular primary care doctor (in [town], N.J.) in December (whom I’d seen for years and did not want to lose), his office told me they couldn’t take Amerigroup insurance, but they could take insurance from United Healthcare Community Plan. They said I could change insurers if I called the Medicaid office. I called Medicaid, and they referred me to a number with NJ FamilyCare, which readily switched me from Amerigroup to UHC.

I did this in December, and received my UHC ID card in the mail. (Note that I never received an Amerigroup ID card in the mail, though I’ve received other things from Amerigroup in the mail.)

It appears I am still signed up with Amerigroup, judging from the mail I still get, as recently as this week. As this may mean (I am guessing) that the Amerigroup company is able to get premium money from the federal and/or state government, while UHC is already able to do that with me, I think the Amerigroup policy for me should be terminated.

Please be advised that I appreciate the mail from Amerigroup that I have received so far, including a newsletter, some survey information, and a letter informing me that Amerigroup no longer covers care from Newton Medical Center (except for emergency care). If for some reason I need to change my Medicaid insurer from UHC back to Amerigroup, I have useful information based on which to choose Amerigroup.

Thank you for your attention to this matter, and if you need any other information from me, please contact me.

                                                            Sincerely,

                                                            [signoff]

So far, I’ve gotten no response from Amerigroup, but have gotten no more general-interest mail from them, either.

One reason it would have been nice to let the Amerigroup mail come is that it was informative in its own right, and I thought that as long as it doesn’t cost them much to send it to me, it didn’t hurt to receive this, in part because (as I noted in the above letter) if, for some reason, I had to switch to Amerigroup at some point, I would know what they’re about.

##

And actually, one of the bits of info I got, from the January 20 general-mailing letter, is very interesting. It said it would no longer cover service gotten at Newton Medical Center (formerly, Newton Memorial Hospital), except for emergency room care. But it would cover service at other local hospitals like two in neighboring Morris County (Saint Clare’s and Chilton, I believe), both of which I’d been to over the years for various reasons (but not as a patient).

It amused me that Newton was off their list. I have a mountain of stories to tell about that hospital, from many years of experience; perhaps most piquant in this context is that when I had a simple blood screen done in 2007, at the request of a doctor I was seeing in a particular division of the hospital, instead of a situation I used to get access to where Quest Diagnostics would do it, and they would charge a sliding-scale fee for someone in my shoes, now I had the hospital collect the sample, and I believe the hospital itself did the testing of the blood. The tech who happened to take my blood, at a local drop-in facility the hospital used to maintain in Vernon Township, was surprised I didn’t have a Quest Diagnostics form with me. (I had what the referring doctor had given me, which I think was just a prescription form with the request for the bloodwork written on it.)

Get ready for a shock: The hospital charged me $620.75, while the supposed actual fee was $955!! The reason I got the lower charge was that I was given a discount as an uninsured patient. Added to this was the fact that the venipuncture/testing was assigned a new patient account number for me, not my usual patient account number at Newton, connected with which latter (older) number I had a sliding-scale arrangement. (So the usual sliding-scale arrangement didn’t factor in with the blood screen, probably.)

I have a writing from 2007 detailing this situation more fully, but leave it at this. This is just one story of, oh, “how the Newton hospital could sometimes be” (negative implication).

Suffice it to say that when Amerigroup said they would not cover non-ER service at Newton, I was thinking, “I’m so willing to be cooperative in this decision! I can be very positive! And on this, I will work with you guys, believe me!” 

I could hoist my Amerigroup water bottle, blazened with its logo, to the sky: “[upside-down exclamation point] Me gusta Amerigroup! Si, si, si! [acute-accent marks over the i’s in si]”—and do a little dance, perhaps.

One reason why it’s unfortunate I had to cut off from Amerigroup.

Case #2 today: How to handle the ACA requirement in federal income tax (first chapter)

Here’s something I don’t have a full story on yet, because I haven’t gotten the instruction booklet for my 1040 form. I already printed out a pdf form of the tax-year 2014 1040, and from a cursory glance, I saw it has a line for what you may owe if you haven’t signed up for ACA insurance. There is also a box to check off for if you’ve been covered all year.

Here’s a question that occurred to me. Inasmuch as the tax form asks if you had coverage for all of 2014 or not, I know I cannot answer that I was covered all year (no problemo). But when it comes to the part-year situation (and I believe the instruction booklet will have stipulations about his, such as for prorating what your penalty will be), what can I answer? I supposedly had an Amerigroup policy effective March 1, 2014. But I had nothing in hand, no ID card, nothing. (I didn’t even receive an Amerigroup ID card when I got things straightened out in November, and I did get the state ID card.) So, have I been covered since March?

If I say I’ve been covered by ACA insurance since November, when I got the address mess straightened out, will that work for the tax form? I am thinking that that is when my “coverage start date” will be, to make things simplest for me. But in November I still had no Amerigroup ID card, and when I finally got a United Healthcare ID card, that insurance was effective January 1, 2015. So what to say about my coverage for 2014? It makes sense to say I had Amerigroup coverage in late November and all of December 2014. But will that fly with the IRS?

Frankly, this question may be a non-issue. I have budgeted into my estimated-tax payments enough to cover the $95 penalty for “not having coverage.” Thus, if I prorate it per supposedly having had insurance about five weeks in 2014, this will work for me. But not having seen the instruction booklet, I don’t know whether I have to specify what ID number I have for insurance, which would specify a little more exactly, for whomever, what my insurance situation was.

Here is another interesting thing. If I put on my tax-year 2014 1040 that, in effect, I wasn’t covered for about 11 months, hence I will have paid $88 or whatever prorated amount, the IRS may come back with a letter (weeks or months after I’ve filed) and say, “According to our files, you were covered by Amerigroup since March 2014.” What to do then? (Such a thing isn’t totally unlikely. The IRS has reviewed my forms and done something like say I was entitled to the Earned Income Credit when I hadn’t claimed it. They gave a simple form to fill out to show if you qualified, and if you did, you got a refund. And I did.)

Well, if they refund part of the ~$88 penalty I pay, depending on factors able to be considered at the time (like what options the IRS gives you to respond to their determination), I will decide what to do—keep the refund, or not.

##

Not to speculate about the coming year too much, but it will be interesting to see how 2015 pans out, which is more concerning, because the penalty will be much higher. When I file taxes for 2015 in 2016, I suppose I can say I was covered in 2015 (via United Healthcare). If something strange happens during the year, such as my UHC coverage is dropped (I don’t put anything past this screwy ACA system), then I’ll deal with that.

What if, in 2016, for tax year 2015, the IRS sends me correspondence after my 1040 is filed saying, “According to our files, you weren’t covered by United Healthcare in 2015 as you claim [assuming there was something within the 1040 forms in which to specify this], but by Amerigroup [based, per bureaucratic bungling, on the 2014 situation]”—what do I do then?

I think maybe it would be time to stock up on longjohns and move to Canada.