ACA / Early Retirement / How is it working for you?
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John Galt III
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Not sure I would call myself ER, but yes, I was able to enroll in a plan, and have used it successfully. It paid for a blood test, and for a routine annual physical so far. Everything worked, with the usual headaches of trying to figure out ahead of time what your out of pocket costs will be. I'm happy with my new plan, since it is subsidized 
I want to add that I spent at least 80 hours back in 2013 figuring out how to avoid the quicksand traps in the enrollment process.
I want to add that I spent at least 80 hours back in 2013 figuring out how to avoid the quicksand traps in the enrollment process.
walkinwood
Thinks s/he gets paid by the post
We signed up through the colorado exchange.
It had some hiccups, but was pretty easy. The lack of "will they accept me?" stress made up for the hiccups.
For the most part, it works just like it did last year. Our ins. company is a little behind on online conveniences - mainly ebills & benefit statements.
It had some hiccups, but was pretty easy. The lack of "will they accept me?" stress made up for the hiccups.
For the most part, it works just like it did last year. Our ins. company is a little behind on online conveniences - mainly ebills & benefit statements.
daylatedollarshort
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We are on an ACA plan. We had some sign up glitches, but so far so good. We picked a network with the local hospital and doctors we have used for years so no issue there. One kiddo away at college so far found a network doctor close by for a minor illness.
We have had a couple of bills submitted so far and everything is working as advertised, only our premiums went down over $2K a month. Last year on a COBRA conversion plan we had premiums and medical bills of around $50K total. This year our worst case max out of pocket + premiums is much more affordable under a Bronze plan. If we had a Bronze plan last year our total medical expenses + premiums would have been ~$10K. Still high compared to every other developed country in the world, but it beats $50K.
We had friends who tried to ER several years ago but went back to work when they found out they were both uninsurable, even though they thought they were reasonably healthy for their ages. I do think this will help the unemployment rate long term the Congressional Budget Office predicted as people no longer have to keep full time jobs just for the health insurance.
So far I give our ACA plan 5 stars, especially for price!
We have had a couple of bills submitted so far and everything is working as advertised, only our premiums went down over $2K a month. Last year on a COBRA conversion plan we had premiums and medical bills of around $50K total. This year our worst case max out of pocket + premiums is much more affordable under a Bronze plan. If we had a Bronze plan last year our total medical expenses + premiums would have been ~$10K. Still high compared to every other developed country in the world, but it beats $50K.
We had friends who tried to ER several years ago but went back to work when they found out they were both uninsurable, even though they thought they were reasonably healthy for their ages. I do think this will help the unemployment rate long term the Congressional Budget Office predicted as people no longer have to keep full time jobs just for the health insurance.
So far I give our ACA plan 5 stars, especially for price!
I was an early enrollee, I somehow got through Healthcare.gov in mid Oct and was enrolled in a plan and paid by early Nov.
DH had a Drs appointment and blood work last week and claims are showing up on the insurance company website. So far, so good. We stayed with our previous insurer so the negotiated rates are very close to previous years. All our providers are still in network and in our area our network is huge. We should have plenty of options if we need additional providers.
We picked a low cost/high deductible Bronze plan with an HSA and I'm glad we did. I opened an HSA and partially funded it and it's invested in a Vanguard acct.
Our insurance covers Rxs but I am not using the insurance Rx (Express Scripts) plan as the prices are much lower if I go locally and use coupons from Prices, Coupons and Information - GoodRx . For both of us (DH 2 Rx, me 3 Rx) 90 days has cost us $108. Through Express Scripts it would have been $249.
The only awkward part has been the monthly premium bill. The insurer had a link to pay online but it never worked and now they removed it and they send a monthly bill in the mail. I can send a check back to them or use my bank's bill pay.
DH had a Drs appointment and blood work last week and claims are showing up on the insurance company website. So far, so good. We stayed with our previous insurer so the negotiated rates are very close to previous years. All our providers are still in network and in our area our network is huge. We should have plenty of options if we need additional providers.
We picked a low cost/high deductible Bronze plan with an HSA and I'm glad we did. I opened an HSA and partially funded it and it's invested in a Vanguard acct.
Our insurance covers Rxs but I am not using the insurance Rx (Express Scripts) plan as the prices are much lower if I go locally and use coupons from Prices, Coupons and Information - GoodRx . For both of us (DH 2 Rx, me 3 Rx) 90 days has cost us $108. Through Express Scripts it would have been $249.
The only awkward part has been the monthly premium bill. The insurer had a link to pay online but it never worked and now they removed it and they send a monthly bill in the mail. I can send a check back to them or use my bank's bill pay.
rbmrtn
Thinks s/he gets paid by the post
I'm signed up, got insurance cards and make premium payments. I rarely use medical service so it is there just in case.
TimSF
Recycles dryer sheets
Signed up last month and now we are in the system. Using same healthcare providers we have had for 10 years. Saving $1000 a month on premiums over Cobra.
tomz
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After a few problems with healthcare.gov, we got signed up for a Silver Blue Cross plan with the same network as our old BC plan. The new plan costs $500 a month less (thanks to subsidies) than the old plan and is much, much better. Monthly billing is now automatic from our checking account. Very happy with the new plan. IMHO, the ACA was designed for early retirees who live off their investments and have a low adjusted gross income.
It took some work and a bunch of phone calls in December and January, but well worth the effort. After all, I'm retired. What else do I have to do?
It took some work and a bunch of phone calls in December and January, but well worth the effort. After all, I'm retired. What else do I have to do?
scrabbler1
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Same here, and as I posted in the other lengthy thread on this topic, they finally got the premium notices and balances due straightened out. They have also been cashing my checks in a more timely manner.
Chuckanut
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I know several people who have signed up for ACA through their state exchange. Their only 'use' so far has been to pay the monthly premium.
MRG
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Signed up December 6. Premium is less than half of what COBRA was. I've had an ongoing medical issue that started last October, so I've already met my deductible. My scripts are $5.00 copays, less than half of what I used to spend.
MRG
MRG
As with any big change in any major program- we know there are some winners & some losers. YMMV.
FWIW- Unlike Timsf, ACA was poor option for me. I'm still COBRA due to much wider provider network & much lower (no subsidy) premiums, deductible, & OOP max vs ACA options in my region.
We signed up for Jan 1st and it's been working fine. My biggest complaint is my auto payment didn't go through the first month and I got a pretty negative/threatening sounding letter 2 days BEFORE the due date saying I was late. Then the second month the auto payment did go through fine but STILL got the letter. I guess you need to be sure the auto pay goes through a full week before the due date to avoid this letter. So now that that new earlier auto pay date is set, now I hope to not get any more of those letters.
We have child dental on the plan, though, and it's been 6 weeks since my son's appointment and still they haven't paid .... not sure what's up with that.
We have child dental on the plan, though, and it's been 6 weeks since my son's appointment and still they haven't paid .... not sure what's up with that.
No problem signing up, no problem using it. Our OOP went up $5K, but our yearly (unsubsidized) premiums went down $5K vs. last year's COBRA. If we stay healthy, we win.
We were able to start browsing the exchange last July. There were so many choices that we didn't make a decision until November. The medical group that we use sent out a letter listing which plans they were accepting which helped narrow it down.
We were able to start browsing the exchange last July. There were so many choices that we didn't make a decision until November. The medical group that we use sent out a letter listing which plans they were accepting which helped narrow it down.
ACA is great for our family
Signed up with no problem. Saving over $1,000 vs COBRA. Had a terrific pain with my neck and shoulder. Went to doctor and he wanted me to get 2 MRI's. Insurance required 30 days of Physical Therapy to be taken first. Doctor was pissed and ran down Obamacare. After just two Physical Therapy my neck feels great. As long as I continue the stretching it should be great. I learned a lot. So happy someone limited the wasteful spending of my doctor and probably saved me a surgery and over $3,000 in deductible. I am going to find a new doctor.
Signed up with no problem. Saving over $1,000 vs COBRA. Had a terrific pain with my neck and shoulder. Went to doctor and he wanted me to get 2 MRI's. Insurance required 30 days of Physical Therapy to be taken first. Doctor was pissed and ran down Obamacare. After just two Physical Therapy my neck feels great. As long as I continue the stretching it should be great. I learned a lot. So happy someone limited the wasteful spending of my doctor and probably saved me a surgery and over $3,000 in deductible. I am going to find a new doctor.
In 20 some years as a physician, I never once saw an MRI cure pain. Physical therapy, OTOH, has a lot of potential to work. Your insurance plan undoubtedly had criterion that you needed to meet for an ASAP MRI. They had them 5 years ago and they'll have them 5 years from now -- ACA or no ACA. I'd look for someone who is a bit more up to date.
Four years ago I felt cruddy for about 24 hours and then noticed a teeny, tiny little pain right where my appendix lived. After a few hours I developed a fever and so I shuffled myself off to the ER. I must have had 6 people explain to me why I did not need a CT in accordance with their new CT reduction program. I was fine with not getting a big load of ionizing radiation, but, boy, did they want to make sure that I understood it.
CyclingInvestor
Thinks s/he gets paid by the post
Finally successfully signed up. Very painful. Took 3 months to get them to accept my money. AnthemBC kept telling me (after a 1 hour or so wait each time) that I was accepted, but not quite completely yet. Finally CoveredCA escalated it a level so that they talked directly with Anthem and I got my customer# (no card yet, "on the way") and the initial payment went thru.
Costwise I like it. Platinum coverage this year (no subsidy) cost about the same as my insurance last year, which was about silver level and would have probably gone up another 10%.
Costwise I like it. Platinum coverage this year (no subsidy) cost about the same as my insurance last year, which was about silver level and would have probably gone up another 10%.
Our case as well.
We have a state exchange, and though the signup took a couple tries, all seems to be working. Chose a platinum plan and we are saving $113 a month from the plan we had and that is before this years increases. We will also be eligible for a subsidy this year and next, but will claim that at tax. time.
My annual physical fully covered. Non covered item (eye exam) was submitted and we were able to get the reduced negotiated rate- an unexpected bonus. DH had some doctor appointments, and everything went really well and the insurance company does a great job communicating.
Our old plan had a $1000 deductible for each of us, and the new plan is $750 deductible each, non-embedded. (so essentially a $1500 deductible max for each/and or both) But after that everything, including prescriptions are 100% covered in network. Old plan had a 20% copay for prescriptions with no cap. DH has one monthly expensive prescription- so this is a win for us.
Only thing I do not like is the payment system. If you auto pay, they draw on the 10th. So I opt to send checks, and they do not cash them until the 10th. Feels late and drives me crazy.....
My annual physical fully covered. Non covered item (eye exam) was submitted and we were able to get the reduced negotiated rate- an unexpected bonus. DH had some doctor appointments, and everything went really well and the insurance company does a great job communicating.
Our old plan had a $1000 deductible for each of us, and the new plan is $750 deductible each, non-embedded. (so essentially a $1500 deductible max for each/and or both) But after that everything, including prescriptions are 100% covered in network. Old plan had a 20% copay for prescriptions with no cap. DH has one monthly expensive prescription- so this is a win for us.
Only thing I do not like is the payment system. If you auto pay, they draw on the 10th. So I opt to send checks, and they do not cash them until the 10th. Feels late and drives me crazy.....
golftrek
Recycles dryer sheets
Husband and I signed up under the ACA, got very good policies. We were able to keep our doctors. Both of us have already used the policies and our claims went through with no problem.
Husband has a preexisting condition that made him uninsurable. This is the first time he has been able to get a decent individual policy (his previous policy had had a low lifetime maximum). My husband takes medication for his condition. His new policy covers the medication, his old policy did not and had a $5000 per year cap on drugs.
The ACA is a life saver for people with preexisting conditions. Before the ACA we constantly worried that if my husband had a major illness or accident we would be put into bankruptcy.
We are grateful to have good health insurance thanks to the ACA.
Husband has a preexisting condition that made him uninsurable. This is the first time he has been able to get a decent individual policy (his previous policy had had a low lifetime maximum). My husband takes medication for his condition. His new policy covers the medication, his old policy did not and had a $5000 per year cap on drugs.
The ACA is a life saver for people with preexisting conditions. Before the ACA we constantly worried that if my husband had a major illness or accident we would be put into bankruptcy.
We are grateful to have good health insurance thanks to the ACA.
I signed up in October, and have used the new insurance alot already. Got a colonoscopy (polyp biopsies benign), had two basal cell cancers (on my back) removed, and have had many costly prescriptions filled. And I've resumed seeing my therapist (dx: GAD and MDD.) As of this week, I've met my out-of-pocket max ($500) and deductible, so I'm "home free" for the rest of the year, confirmed by BCBSKC. Just for an example, an $800 Rx that I paid $20 for in February will now be a zero-copay.
My situation may be atypical, though, for at least two reasons. I had cancer at age 27 and again at age 43, so my medical needs are higher than most. The ACA brought my premiums way down after many years (retired in 2007) of paying very high rates -- not to mention no more preexisting conditions worries.
But also, I am lucky because almost all of my assets are, by design, in IRA's, so my MAGI is very low -- I'll have to do a modest Roth conversion each year just to qualify for the subsidies. But obviously it is a no-brainer to do so, and I am very grateful. Having added up the EOBs so far, I've easily saved over $10,000 already, while the Roth conversion will only increase my income taxes a few hundred dollars.
My situation may be atypical, though, for at least two reasons. I had cancer at age 27 and again at age 43, so my medical needs are higher than most. The ACA brought my premiums way down after many years (retired in 2007) of paying very high rates -- not to mention no more preexisting conditions worries.
But also, I am lucky because almost all of my assets are, by design, in IRA's, so my MAGI is very low -- I'll have to do a modest Roth conversion each year just to qualify for the subsidies. But obviously it is a no-brainer to do so, and I am very grateful. Having added up the EOBs so far, I've easily saved over $10,000 already, while the Roth conversion will only increase my income taxes a few hundred dollars.
fisherman
Full time employment: Posting here.
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- Jul 7, 2007
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Yes. Tried to sign up to early and had lots of problems but all worked out late in December. We have used it for physicals, and minor doctors visits with no problem. All our doctors are in network and many more that were not before. Kids have also used the dental they get with it which was really nice and the vision. Our premiums are about half what they use to be and our OOP max is a third of what it use to be. It has been a very good change and a tremendous cost savings for us! Very Happy with it!
M Paquette
Moderator Emeritus
Works just fine. We signed up last November, made the initial payment last December, and got our new cards and whatnot in January. We're with a large HMO, and it works just like it always did. Same doctor, same specialists, same pharmacy and medications.
The biggest impact item was from the HMO switching it's payment processor as of January. THAT is just now starting to work properly.
The biggest impact item was from the HMO switching it's payment processor as of January. THAT is just now starting to work properly.
I signed up directly with an insurer for an ACA-compliant policy since my state exchange was DOA. Signup was simple, but the insurer completely screwed up my first payment. I eventually got it corrected. My premium is a few dollars less than my COBRA policy's premium for last year, for a policy which is almost identical. Since my new policy is for 2014 and COBRA was ending in 2013, I figure I'm definitely paying less than I would have if the ACA didn't exist. I am not getting a subsidy. Instead, I am doing capital gains harvesting and Roth conversions until I'm eligible for Medicare and most likely later sign up for Social Security.
My state had a high-risk pool I could automatically get insurance from after COBRA exhausted (even though I'm not high-risk), but not surprisingly, my ACA premium is lower than it would have been in that pool. I like knowing that I can move anywhere in the country and be assured of getting a policy at a fair price, and also that some preventive care must now be covered with no deductible.
My state had a high-risk pool I could automatically get insurance from after COBRA exhausted (even though I'm not high-risk), but not surprisingly, my ACA premium is lower than it would have been in that pool. I like knowing that I can move anywhere in the country and be assured of getting a policy at a fair price, and also that some preventive care must now be covered with no deductible.
pb4uski
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
What's the difference? The same amount comes out of your bank ~ the 10th either way. Or am I misunderstanding you?
I prefer auto-pay only because if for some reason the premium doesn't get taken when it should its their fault and responsibility and not mine. I just need to make sure there is enough in the account (which is not a problem).
