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Old 10-26-2015, 07:13 AM   #41
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To answer your question, if a plan has a copay (first dollar benefit) for non-preventive services before the high deductible is met, it is not HSA compatible and you cannot contribute to an HSA.
That was more or less my understanding. I wasn't sure whether or not PPACA changed anything about the definition of HSA-eligible, but I didn't recall anything. At one point, you couldn't even provide first-dollar preventative care with an HSA-eligible HDHP, but that changed a couple years before ACA, IIRC.
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Old 10-26-2015, 09:27 AM   #42
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After getting over the shock of our price increase if we kept our current plan, I checked out why it went from HSA eligible to non-HSA eligible.

HSA plans for 2016 have a minimum deductible of $1350/person and a max out of pocket of $6550. Our current HSA plan has a max out of pocket of $6450 this year and that's going up to $6850 for 2016, making it higher than the max. So the plan not HSA eligible in 2016.

The link is titled HSA contribution limits but it also shows deductible and MOOP limits.

HSAcenter - Health Savings Accounts - Health Care and Savings for You and Your Family
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Old 10-26-2015, 09:39 AM   #43
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At one point, you couldn't even provide first-dollar preventative care with an HSA-eligible HDHP, but that changed a couple years before ACA, IIRC.
I think that is still the case. If any benefits are paid before the deductible is met it doesn't qualify. Mine didn't qualify because it paid for some generic drugs before the deductible. They can provide some preventive care but can only provide "first dollar coverage" after the deductible is met per this link...

HSA Health Insurance Plans - High Deductible Health Plans - HDHP - HSAConnect
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Old 10-26-2015, 09:41 AM   #44
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Checking the Florida BCBS plans, they also are no longer offering HSA on the exchange, but they offer 2 when bought directly from them. Apparently Humana and Aetna are doing the same thing.
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Old 10-26-2015, 09:48 AM   #45
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Couple of things I noticed with the increase for mine. One is age creep, I ran the numbers for different ages it went up for being a year older.

Main thing for mine is the cost of the second lowest silver plan actually went down while my bronze went up. Well that calculation makes the subsidy shrink so I'll be paying a good bit more because of that...
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Old 10-26-2015, 10:05 AM   #46
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I'm trying to reconcile why our subsidy dropped so much. I'm looking for the table that shows the income level used to determine your percentage to be used for premiums. Has anyone found the one for 2016?
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Old 10-26-2015, 10:41 AM   #47
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So your talking at least $200/mo for decent coverage. That may not be a great deal to you but not so much for people who are living on $1000/mo and are paying less than $100/mo thru ACA. Most of those people don't have the mental and/or physical ability to make any more money. I don't think they should have to pay 20%+ of their income for health insurance. There should be a cap of say 10% or maybe a little less.
I think for someone with limited income, Medicare Advantage with Medicaid paying part B premiums is the only option. That's net $0 monthly premium for health insurance and co-pays are $0 or very small. The PDF from MichaelB's post explains it pretty well.

Medigap policies are for people who can afford them.
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Old 10-26-2015, 10:41 AM   #48
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I'm trying to reconcile why our subsidy dropped so much. I'm looking for the table that shows the income level used to determine your percentage to be used for premiums. Has anyone found the one for 2016?
The 2015 FPL table is here 2015 Poverty Guidelines | ASPE

The cap limit table is here, Understanding the Affordable Care Act (ACA) Subsidies and another one from Kaiser, Explaining Health Care Reform: Questions About Health Insurance Subsidies | The Henry J. Kaiser Family Foundation

I think 2016 will use the 2015 tables , 2015 Federal Poverty Line (FPL) Charts
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Old 10-26-2015, 10:51 AM   #49
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And on top of that...now it's no longer HSA eligible!!
Not sure of your specific parameters, but I noticed the 2016 search filters in my case don't include HSA eligibility. Keeping same plan for instance, it doesn't become clear that it is still HSA eligible until drilling down and viewing plan specifics. Still not sure what's up with premiums though, it is showing much higher jump than what was requested (approved believed to be slightly lower), even if adjusting age back to last year.
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Old 10-26-2015, 11:11 AM   #50
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What I was looking for was the detailed table of what percentage is assigned to every incremental increase in income.

I found the specifics at the IRS site, in the instructions for Form 8962 which is the form to reconcile the Premium Tax Credit when you file.

https://www.irs.gov/pub/irs-pdf/i8962.pdf

The detailed table is on Page 6.

The reason that I wanted all the incremental details is that our 2016 income is just over 250% of FPL but that can be adjusted with Traditional IRA contributions.

Still not able to reconcile the subsidy shown on HealthCare.gov. Comparing our 8.10% of income vs the second lowest cost silver plan and the subsidy seems low by about $87/mo.
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Old 10-26-2015, 12:10 PM   #51
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Still not able to reconcile the subsidy shown on HealthCare.gov. Comparing our 8.10% of income vs the second lowest cost silver plan and the subsidy seems low by about $87/mo.
FWIW, I see the same thing with my hand calc vs their estimate. Backing out their multiplier it looks they used 9.9% instead of 9.56%

Here's the 2015 draft of the IRS table. It shows 8.1% for 250% and 9.56% 300% up.

https://www.irs.gov/pub/irs-dft/i8962--dft.pdf
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Old 10-26-2015, 12:22 PM   #52
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Yep, I'm testing this at a few different income levels, just to play with it and it looks to me like they are using 9.56% at 200% of FPL. At 250% of FPL they are using 10.69%.

I tried 150% of FPL and it's 8.33%

Well, somebody needs to correct this before the entire ACA population freaks out.
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Old 10-26-2015, 12:29 PM   #53
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Only one company in Maricopa County AZ with PPO plans. Everything else is HMO. Bleeecchhh! The alternative to BCBS here I was thinking was Healthnet but they've eliminated their PPO too. Looks like I'll be sticking with BCBS and adjusting my income to maximize my benefits.
Was looking at that as well. Looks like UHC is the only one left! Guess we'll take a look at BCBS and Cigna HMO's. On the other hand the prices for the Silver HMO's are about 30% cheaper at the same income level than the Silver PPO my GF has in Colorado.
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Old 10-26-2015, 12:40 PM   #54
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Was looking at that as well. Looks like UHC is the only one left! Guess we'll take a look at BCBS and Cigna HMO's. On the other hand the prices for the Silver HMO's are about 30% cheaper at the same income level than the Silver PPO my GF has in Colorado.
When was had my insurance through the Exchange it was a PPO. Here everything is an HMO now, so if you want an out-of-network doctor or don't want to need a referral to see a specialist, you're hosed. There is one other thing, though; for this zip code, anyway, it's the first time there has been a second insurer in the mix (it had been all BCBSTX before).

I wouldn't be happy about being forced into an HMO if I were still getting my insurance there, but at least Blue Cross tends to have a significantly larger "in network" provider list than most others.
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Old 10-26-2015, 12:46 PM   #55
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This site does seem to be working but I am having a hard time believing the subsidy amount, for couple 62 & 67 with one on medicare and income of 63k it says the tax credit is $693/mo. Does this sound right?
Had my healthcare insurance agent look at the website plugging my numbers in and she said healthcare.gov is not calculating the tax credit correctly. Having one spouse on Medicare should not give you double tax credits.
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Old 10-26-2015, 12:52 PM   #56
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Had my healthcare insurance agent look at the website plugging my numbers in and she said healthcare.gov is not calculating the tax credit correctly. Having one spouse on Medicare should not give you double tax credits.
I've also been playing around with covering myself only compared to both DW and me, factoring in the same level of income (about what I'd expect if I quit tomorrow). It looks like the subsidies they calculate show we'd pay LESS to cover both us instead of just myself, and not by just a couple bucks. Right now we could choose a silver plan that costs $254 for just me ($142 subsidy), or $163 for both of us ($580 subsidy)! It's like they would be paying us $91/mo to also cover my wife in addition to just me...
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Old 10-26-2015, 01:04 PM   #57
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I just got a rude awakening....

If I make LESS money, then my credit goes DOWN... yep, if you go below a certain point then your kids qualify for CHIPS or something and they will not give you credit for them....

Not sure if that is only for the monthly subsidy or you lose it when you fill out your tax return... now I have to worry if I make too much or not enough... I have to be Goldilocks and get it juuuuust right.....
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Old 10-26-2015, 01:58 PM   #58
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I just got a rude awakening....

If I make LESS money, then my credit goes DOWN... yep, if you go below a certain point then your kids qualify for CHIPS or something and they will not give you credit for them....

Not sure if that is only for the monthly subsidy or you lose it when you fill out your tax return... now I have to worry if I make too much or not enough... I have to be Goldilocks and get it juuuuust right.....
If you have room on your return for Roth conversions then between conversions and recharacterizations that is very easy to do... for 2014 my TI was exactly the top of the 15% tax bracket because I did our return and determined how much I needed to recharacterize to nail it on the head.
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Old 10-26-2015, 03:26 PM   #59
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Wow the plan we're on now (Humana Bronze National POS) is going up 23% next year (from $706 to $865/mo). And that's with a $12.9k family deductible/max OOP, they don't pay a dime until you hit that. Good thing we're going to be on their subsidized Silver POS plan next year - estimated premium is $138 a month for two people with $1k deductible and $1.5k max OOP (<150% FPL cost-shared plan). I think it also went up by the same percentage vs. this year, which is really excessive.
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Old 10-26-2015, 03:34 PM   #60
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Wow the plan we're on now (Humana Bronze National POS) is going up 23% next year (from $706 to $865/mo). And that's with a $12.9k family deductible/max OOP, they don't pay a dime until you hit that. Good thing we're going to be on their subsidized Silver POS plan next year - estimated premium is $138 a month for two people with $1k deductible and $1.5k max OOP (<150% FPL cost-shared plan). I think it also went up by the same percentage vs. this year, which is really excessive.
The plan Ive looked at a few times was $580. Its now $680. But dont worry, next year I will wish I could get it for $680.
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