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Old 10-01-2013, 11:53 AM   #41
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Originally Posted by rec7 View Post
My income is below the federal poverty limit here in MO. Since MO did not expand medicaid my insurance will be going up even though I make under 11k a year. That is wild. I am learning that under 11.5k in many states you are in danger.
What happens if you estimate your income at just enough to stay out of medicaid and just make it into a subsidy? Then you can have insurance all year and when it gets reconciled it turns out you just didn't make enough.

Not implying fraud here, just thinking that when you estimate income you can try to be optimistic.
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Old 10-01-2013, 12:00 PM   #42
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Originally Posted by FIRE'd@51 View Post
Note she said COBRA conversion, not COBRA.
When we first went on COBRA, the premiums were ~1K a month for a bare bones plan. We are in our fifties with kids.

Last year megacorp dropped the bare bones policy so our only choice was to pay ~2.3K a month, but at least that included dental, vision, hearing and whatever else comprehensive plans cover.

When COBRA ended this summer, we looked at HIPAA, conversion, and small business policies. The HIPAA and conversion policies were all well over $2K+ a month for just medical. This does not include spa treatments. This is what people our age with kids have to pay to get guaranteed issue, not employer subsidized health insurance policies in our zip code.

The small business policies were somewhat cheaper premium-wise but they had very high deductibles and OOP maxes so this year we would not have come out ahead by taking them.

We called all the insurance companies and agents, looked at all our options, made spreadsheets, compared policies and this is the best we could do.

Middle aged and above households without employer insurance and pre-existing conditions in the U.S. prior to the ACA were simply screwed. We can afford it but prior to the ACA most middle or lower income families in our spot would simply have had to go without health insurance. I am not looking for sympathy for us, but before you complain about the ACA think about how maybe you or people you care about could easily end up in a spot like we did.
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Old 10-01-2013, 12:13 PM   #43
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The $30K has been commented on before. I have Cobra available at $830/mo for a $3,000 ded w/HSA. That's just under $10K. If I threw in kids, it would still be under $15K/yr. I can only assume that for $30K it includes spa treatments and on-call doctors that come to the house with no deductible. If not a super plan, they are really getting it stuck to them.
So because your COBRA payments are less you can't understand that an older couple with kids in a high COL might pay more for a COBRA conversion (not COBRA) policy?

Even COBRA rates are based on the insurance plans your former employer had in place, so the rates for someone who worked at Walmart might be totally different than someone who left Morgan Stanley. Then add in premium differences for age, kids, COL factors, etc.

My point is that pre-ACA, most households like us are in quite a pickle. For many, a bankruptcy or no health insurance or maybe both kind of pickle.
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Old 10-01-2013, 01:23 PM   #44
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When we first went on COBRA, the premiums were ~1K a month for a bare bones plan. We are in our fifties with kids.

Last year megacorp dropped the bare bones policy so our only choice was to pay ~2.3K a month, but at least that included dental, vision, hearing and whatever else comprehensive plans cover.

When COBRA ended this summer, we looked at HIPAA, conversion, and small business policies. The HIPAA and conversion policies were all well over $2K+ a month for just medical. This does not include spa treatments. This is what people our age with kids have to pay to get guaranteed issue, not employer subsidized health insurance policies in our zip code.

The small business policies were somewhat cheaper premium-wise but they had very high deductibles and OOP maxes so this year we would not have come out ahead by taking them.

We called all the insurance companies and agents, looked at all our options, made spreadsheets, compared policies and this is the best we could do.

Middle aged and above households without employer insurance and pre-existing conditions in the U.S. prior to the ACA were simply screwed. We can afford it but prior to the ACA most middle or lower income families in our spot would simply have had to go without health insurance. I am not looking for sympathy for us, but before you complain about the ACA think about how maybe you or people you care about could easily end up in a spot like we did.
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Old 10-01-2013, 01:49 PM   #45
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Originally Posted by Sue J View Post
What happens if you estimate your income at just enough to stay out of medicaid and just make it into a subsidy? Then you can have insurance all year and when it gets reconciled it turns out you just didn't make enough.

Not implying fraud here, just thinking that when you estimate income you can try to be optimistic.
A person could do that but would have to pay it all back at tax time. I know I will not make that much so it would be wrong also. I estimate a little but I know it down to a few hundred dollars which in my case will not help me. I am about 3k short of the level.
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Old 10-01-2013, 01:53 PM   #46
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In Texas everyone had been insurable if you kept your coverage active. That could involve switching to the Texas High Risk Pool. Similar high risk pools I thought were available in all 50 states. I've not known anyone in Texas over 50 that could get any other policy without substantial exceptions. Who wants HI that doesn't cover heart attacks and strokes?

The cost for a single individual age 62 was $7,500/yr with a $7,500 deductible. There were no family plans. A couple had to get two individual plans. The comparable costs for the new exchange plans are not drastically lower from the limited information I've seen. I'm waiting for the rush to settle down before looking at plans.
Risk pools are not available in every state. And for the states that have pools the variation in coverage, cost and limitations are huge.
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Old 10-01-2013, 01:54 PM   #47
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So much for "affordable"............
This reminds me of the friendly advice I got here several years ago when I was looking for coverage I could afford. Something about how I should just move... Gosh. Not the most practical advice for most folks.
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Old 10-01-2013, 01:54 PM   #48
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Risk pools are not available in every state. And for the states that have pools the variation in coverage, cost and limitations are huge.
Shouldn't that be "had" instead of "have"? Aren't all pools going away on Jan 1?
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Old 10-01-2013, 01:56 PM   #49
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Shouldn't that be "had" instead of "have"? Aren't all pools going away on Jan 1?
I thought about the verb use. It will be "had" as of the first of the year. Actually, in Minnesota they are keeping their pool going for another year to give people time to shop.
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Old 10-02-2013, 12:56 PM   #50
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Well, this obamacare cliff thing is going to crucify 60 year olds with a little over 62000 in income and no way to reduce.
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So ~ $500 per month for 2 people aged 60 with an income of $62,000, with no limitations for prexisting conditions, is being "crucified" ?
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Take the income up to 63k the premium is over twice $5,890 per year.
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Of course not, at least for the people in your example. But if you are either "stuck" with a pension that pays over 400% FPL (people who I am sure I will be busy shedding tears for) or you aren't smart enough to figure out a way to limbo under the 400% bar, you do take it is the pie hole.

Hey folks, sorry to take up more bandwidth, but I just want to apologize to ripper et al. -- I didn't realize the (steepness? is that a word?) of the Obamacare Cliff, and how making a small jump from $62,000 to $63,000 income makes such a large difference in the cost of premiums for a couple.

I'm learning a lot about the ins & outs of HI exchanges & such from this forum, so thank you all.

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Old 10-02-2013, 03:12 PM   #51
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I just looked at the plans available in MA for a 52 year old male.....they look pretty good to me. The premiums are a less than under the old MA system, but every plan has some co-insurance.

The plans range from a Platinum one from Fallon for $900/mth with 0 deductible, OOP max $2k to a Bronze from HealthNet Plan for $2626/mth with $2k deductible and OOP max of $6.35k.
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