Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
ACA and retiree coverage
Old 08-20-2016, 10:38 PM   #1
Full time employment: Posting here.
GalaxyBoy's Avatar
 
Join Date: Jul 2009
Location: The Beautiful Blue Ridge Mountains
Posts: 614
ACA and retiree coverage

Sorry if this has been covered here before. I searched and didn't find it.

The government ACA web site at https://www.healthcare.gov/retirees/ states the following regarding early retirees who are covered by insurance from the former employer and choose to drop that plan in favor of a plan from the exchange.

Quote:
If you have retiree coverage and want to buy a Marketplace plan instead, you can. But:

You can’t get premium tax credits and other savings based on your income. This is true only if you’re actually enrolled in retiree coverage. If you’re eligible for but not enrolled in retiree coverage, you may qualify for premium tax credits and lower out-of-pocket costs based on your household size and income.
This is the case with my DW, who is not yet 65 and is covered by retiree health insurance from her former employer (state government). When I retire hopefully at the first of the year, I could either be added to her plan or I could purchase one on the exchange. If I do that, I would consider purchasing a family plan and dropping her current policy. I'm thinking it'll be much cheaper if I can get a subsidy since I won't have much income in 2017 save for mainly Roth conversions, her very modest pension (barely covers the health insurance premiums) and capital gains distributions.

But what I'm reading is that because she chose to buy insurance from the retirement system, we can't get a subsidy for her? That just doesn't sound right.
__________________

__________________
GalaxyBoy is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 08-21-2016, 08:12 AM   #2
Full time employment: Posting here.
 
Join Date: Jan 2014
Posts: 617
As long as your DW is enrolled in the retiree medical plan she is not eligible to receive subsidies if she also has an exchange plan. That is a double coverage situation. If she voluntarily drops the retiree medical plan during the ACA annual Open Enrollment Period (OEP) and selects an exchange plan, then she is eligible for subsidies.

Price should not be the only reason to select a plan. Exchange plans usually have smaller provider networks so make sure they meet your needs.
__________________

__________________
MBSC is offline   Reply With Quote
Old 08-21-2016, 08:41 AM   #3
Full time employment: Posting here.
GalaxyBoy's Avatar
 
Join Date: Jul 2009
Location: The Beautiful Blue Ridge Mountains
Posts: 614
Now that makes sense.

Yes, we will consider all factors. Right now, I'm determining what all my options are.

Thanks!
__________________
GalaxyBoy is offline   Reply With Quote
Old 08-21-2016, 01:22 PM   #4
Thinks s/he gets paid by the post
ivinsfan's Avatar
 
Join Date: Feb 2007
Posts: 1,746
Quote:
Originally Posted by MBSC View Post
As long as your DW is enrolled in the retiree medical plan she is not eligible to receive subsidies if she also has an exchange plan. That is a double coverage situation. If she voluntarily drops the retiree medical plan during the ACA annual Open Enrollment Period (OEP) and selects an exchange plan, then she is eligible for subsidies.

Price should not be the only reason to select a plan. Exchange plans usually have smaller provider networks so make sure they meet your needs.
Are you certain of this? If you have a regular employee plan that doesn't exceed the 10% income threshold(this is household income) you can't just drop it and get a subsidy for your premium. Are you certain the rules are different just because you are retired.
__________________
ivinsfan is offline   Reply With Quote
Old 08-21-2016, 02:01 PM   #5
Full time employment: Posting here.
 
Join Date: Jan 2014
Posts: 617
Retiree plans are considered optional.

Quote:
We have health insurance through my previous employer’s retiree-only plan.
Is there any way that one or both of us can opt out of my retiree-only plan and get subsidized insurance on the exchange?

A. The short answer is yes, you can opt out of your retiree-only plan and shop for subsidized coverage on the health insurance marketplace.

In general, people who have employer-sponsored insurance that meets the definition of “minimum essential coverage” are eligible for exchange subsidies only if the employer plan is considered unaffordable or inadequate under the health law.

However, the law treats people with retiree coverage differently than those in the workforce with job-based insurance.

In other words, if you opt out of your retiree plan to choose a policy on the health marketplace instead, you may qualify for premium tax credits that are available to people with incomes between 100 and 400 percent of the federal poverty level.

Keep in mind, however, that even though the premiums may be more affordable on the exchange, it’s important to carefully compare the benefits in your retiree plan with those in the exchange plans to make sure a new policy provides the coverage you need.
Reference: A Reader Asks: Can I Opt Out Of My Retiree Plan To Get Subsidized Insurance? | Kaiser Health News
__________________
MBSC is offline   Reply With Quote
Old 08-21-2016, 04:10 PM   #6
Thinks s/he gets paid by the post
 
Join Date: Feb 2007
Posts: 2,340
In our case, and I suspect it may work this way for you too, if DH stayed with his retiree plan and I went through the exchanges our subsidy (for just me) was less than half of the subsidy if both of us went through the exchange.

In other words, the subsidy was based on our total household income and only one of us needing insurance compared with the same total household income and both of us needing insurance through the exchange. You still have to use your total income even though only one of you is buying insurance.

Anyway, it worked out better for us if DH opted out of his retiree insurance and we both bought through the exchange. For us to both stay on his retiree insurance would have been more than 20% of our income.
__________________
Married, both 62. DH retired June, 2010. I have a pleasant little part time job.
Sue J is online now   Reply With Quote
Old 08-23-2016, 07:44 AM   #7
Full time employment: Posting here.
GTFan's Avatar
 
Join Date: Apr 2013
Location: Atlanta
Posts: 586
My retiree plan has no employer subsidy so it's a no-brainer to go with the exchange + subsidies for me (retirees pay full cost in other words). Saves me something like $800 a month, and the network is no worse than what I could get with the employer plan. Cost-shared Silver plans are better than the employer plan too (lower deductible and max OOP).

As mentioned retiree coverage is optional and as long as you don't use it you're a full participant on the exchange with subsidies, cost-sharing etc.
__________________

__________________
GTFan is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Retiree Health Plan After Death of Retiree-Spouse Coverage? Youngster Health and Early Retirement 11 12-12-2015 08:24 PM
Retiree Medical Coverage/Medicare Question(s) frayne FIRE and Money 21 07-14-2015 11:23 AM
Parting Ways With the Megacorp and the ACA - Coverage Gap? sengsational Health and Early Retirement 16 11-05-2013 11:58 AM
HC Exchange Eligibility if Retiree Coverage Available GalaxyBoy Health and Early Retirement 6 10-02-2013 08:18 AM
Retiree Dependant coverage after age 65 Katsmeow Health and Early Retirement 3 12-02-2009 07:12 PM

 

 
All times are GMT -6. The time now is 06:46 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.