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Old 10-24-2013, 09:41 AM   #561
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I have a quote for my wife, straightforward process. I used IE7, clean install, no tools, widgets, clean logs and registries, no subsidy. I also went directly to BCBS of IL to double check and the two policies of interest were identical to my eye. Checked the networks, the principal "high end" providers and hospitals (Northwestern and U of C) are included as is Mayo, Anderson in Texas. Cost for same level of high deductable she now has from Mega Corp is less than her cost through Mega Corp. I fail to see the cause for belief that the world is ending.
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Old 10-24-2013, 09:46 AM   #562
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MRG,

Thanks! And you were right. My application eventually appeared.

Am still not seeing any mention of subsidies. I do however see a blurb that says "You're eligible for a plan with cost-sharing reduction. Select the box below to see plans with these savings."

Yet the box is not selectable and has a blurb that says "Health plans with cost-sharing reduction (0)".

I guess that means no subsidy for me
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Old 10-24-2013, 09:52 AM   #563
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Yet the box is not selectable and has a blurb that says "Health plans with cost-sharing reduction (0)".

I guess that means no subsidy for me
Cost sharing and subsidy are two different things here.

"Cost sharing" in this context means you have an income below 250% of FPL, which enables you to receive lower deductibles and/or OOP maximums with a Silver level policy. It's not the same thing as the premium subsidy.
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RIP to Reemy, my avatar dog (2003 - 9/16/2017)
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Old 10-24-2013, 09:55 AM   #564
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Healthcare.gov website 'didn't have a chance in hell' - Computerworld
" The folks developing the site never took the message of the mythical man month to heart. (Published in 1975). Among its lessons is that adding more bodies to a project just delays it.
Ahhh the "mythical man month"...
Back in my days of studing computer science we used to collect "bumper sticker" computer science axioms and I still have the list and have added to it over the last 30 years. Most of these were originally atributed to an individual, but unfortunately I do not still have the authors. Some of them are:
  • If one woman can have a baby in nine months, nine should be able to do it in one.
  • There are only 10 types of people in the world, those that understand binary and those that don't.
  • Adding more programmers to a late project make it later.
  • Testing can show the presence of bugs, but not their absence.
  • Always do the easy part first. What you think at first is the easy part often turns out to be the hard part. Once the easy part is done, you can concentrate all your efforts on the hard part.
  • Always do the hard part first. If the hard part is imposible, why waste time on the easy part? Once the hard part is done, you're home free.
  • The sooner you start to code, the longer the program will take.
  • Don't debug standing up. It cuts your patience in half.
  • The structure of a system reflects the structure of the organization that built it.
  • Furious activity is no substitute for understanding.
  • Keep it simple, stupid. (KISS Principle)
  • Putt's Law: Technology is dominated by two types of people - those who understand what they do not manage and those who manage what they do not understand.
  • I think it’s a new feature. Don’t tell anyone it was an accident.
  • In a room full of top software designers, if two agree on the same thing, that’s a majority.
  • The best way to get accurate information on Usenet is to post something wrong and wait for corrections.
  • The only truly secure system is one that is powered off, cast in a block of concrete and sealed in a lead-lined room with armed guards.
I still go through the list every now and then...
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Old 10-24-2013, 10:16 AM   #565
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No, as soon as I could see the plans the discount was shown. YMMV.

MRG
Let me ask this a different way -- The discount is shown how? As a blurb that says here's the amount of the discount, as an amount baked into the stated Monthly Premium, other? I'm not seeing a breakout of the discount.

I'm asking of course because I'm trying to budget for healthcare and it's not clear to me whether the stated "Monthly premium" for each plan is before or after the discount.
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Old 10-24-2013, 10:27 AM   #566
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Let me ask this a different way -- The discount is shown how? As a blurb that says here's the amount of the discount, as an amount baked into the stated Monthly Premium, other? I'm not seeing a breakout of the discount.

I'm asking of course because I'm trying to budget for healthcare and it's not clear to me whether the stated "Monthly premium" for each plan is before or after the discount.
If the system showed you were eligible for a subsidy, the first thing it would do is ask you how much of the tax credit you wanted to apply to reduce the premiums. Once you entered that, you could start seeing different plans where it would show your price and what would have been the unsubsidized price.

If you aren't seeing either of those, then presumably the system doesn't think you qualify for the tax credit to reduce premiums.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
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Old 10-24-2013, 10:45 AM   #567
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Hmmm, interesting. I'm referring to healthcare.gov and not a state-sponsored exchange. IIRC after getting the notification that my application was approved I logged in, could see the plans and the pricing but dont recall seeing any clear indication as to what the subsidies were.

I say "IIRC" because as I login now, my application seems to have gone missing. I'm so glad that the gub'mint thinks that my time isnt worth anything.
We learned in economics class that when things are 'free' (i.e. subsidized) we may then pay for them in other ways than money such as with our time waiting in line. So, yes, your time is worth something and you are using it to pay for the subsidy you are receiving.
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Old 10-24-2013, 10:50 AM   #568
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If the system showed you were eligible for a subsidy, the first thing it would do is ask you how much of the tax credit you wanted to apply to reduce the premiums. Once you entered that, you could start seeing different plans where it would show your price and what would have been the unsubsidized price.

If you aren't seeing either of those, then presumably the system doesn't think you qualify for the tax credit to reduce premiums.
Ah, thank you.

Never got the "how much of the tax credit ..." dialog.

Odd. Applying as married couple (hence 2 in household), only 1 seeking coverage as DW is on medicare, with projected household income of $44k.

Evidentally my parameters triggered an until now undiscovered feature of the system.
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Old 10-24-2013, 11:14 AM   #569
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Ah, thank you.

Never got the "how much of the tax credit ..." dialog.

Odd. Applying as married couple (hence 2 in household), only 1 seeking coverage as DW is on medicare, with projected household income of $44k.

Evidentally my parameters triggered an until now undiscovered feature of the system.
I think this system has problems with a situation where only one spouse in a couple needs coverage through the Exchange. We're in that situation too, and there are things I'm pretty sure it's still not properly handling.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
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Old 10-24-2013, 11:32 AM   #570
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I think this system has problems with a situation where only one spouse in a couple needs coverage through the Exchange. We're in that situation too, and there are things I'm pretty sure it's still not properly handling.
In this situation it's not even clear if one should apply as an individual or not. There are no policies for couples, so each buys individual coverage. Marriage (along with household income) only affects subsidy calculation.
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Old 10-24-2013, 11:38 AM   #571
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In this situation it's not even clear if one should apply as an individual or not. There are no policies for couples, so each buys individual coverage. Marriage (along with household income) only affects subsidy calculation.
I have two mostly completed applications out there: one for both of us and one for myself only. The one where we we both applying seems to be working fine; it asks for (and applies) my Indian status to eliminate out of pocket for me (in this case, they broke us into two separate individual policies with different cost sharing requirements and split the subsidy), and tells me to mail in proof of my Indian status (such as a copy of my tribal card).

When I am the only one seeking coverage, all else being identical in the application... it does not apply my Indian status even though I know I indicated it in the application. The "verdict" does not ask me to send a copy of my CDIB card. And the policies do not reflect any cost-sharing (i.e. they still list high deductibles and copays). This is something currently (they say) being investigated by an "advanced resolution" team, but I'm not holding my breath on it.

One thing that *might* be causing it problems is that the decision said I'd be eligible for Medicaid except that our state did not expand it. This I don't understand; while I will earn $2-3K per year on my current job, we plan a household income in the $35K range which is over 133% of FPL for a household of 2 (but below 300%). I don't see how this makes me eligible for Medicaid at all, expanded or otherwise. That said it still offers me a subsidy but doesn't reflect Indian status at all. I'm about 95% sure this is a bug. And I am essentially 100% sure that my income or lack thereof has nothing to do with not being told I can switch plans every month.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
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Old 10-24-2013, 12:02 PM   #572
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I think this system has problems with a situation where only one spouse in a couple needs coverage through the Exchange. We're in that situation too, and there are things I'm pretty sure it's still not properly handling.
We're in the same boat. While I see a discount, I'm getting more convinced I'm not seeing the subsidy i.e. the plans just list the standard copays and max oop.

Not sure my next steps.

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Old 10-24-2013, 12:10 PM   #573
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Ahhh the "mythical man month"...
Back in my days of studing computer science we used to collect "bumper sticker" computer science axioms and I still have the list and have added to it over the last 30 years.
Great stuff, Mythical Man Month was required reading.

One of my mentors used to say 'if they want it bad, we can give it to them, badly'. How true.

MRG
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Old 10-24-2013, 01:25 PM   #574
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And the policies do not reflect any cost-sharing (i.e. they still list high deductibles and copays). This is something currently (they say) being investigated by an "advanced resolution" team, but I'm not holding my breath on it.
.
Thanks, looks like what I'm seeing. The advanced resolution team, yea those guys.

Commited to 2 business day call backs. After my 3rd escalation I did get a call back, 7 business days later. I'll call too, can't hurt.

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Old 10-24-2013, 02:12 PM   #575
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I am not seeing any subsidy on the Hawaii website what is frustrating is that I don't know if that is A. because I don't understand how the subsidies work properly or B. the website isn't calculating them correctly.

For a 54 year old male. The cost of the second lowest silver plan is a surprisingly affordable $306 from Kaiser (I currently pay $337). It is conceivable, that I could get my income down to $35,000 with some tricks, which is 265% of the FPL in Hawaii (the FPL is higher than the mainland). The Kaiser calculator says I'd have to pay 8.47% or $2965 max for insurance. So I'd be eligible for a $707 subsidy. But on the Hawaii website even if I drop my income down to 25K I am not seeing a subsidy.

I am I understanding how the subsidy works properly?

Given the hoops I'd have to jump (setting up a charitable trust, prepaying property tax etc) through and the modest subsidy I am not going to bother. However I do wonder if there is anything wrong with electing to get a lower form of insurance Bronze in my case is ~$100/month cheaper and then if I end getting a chronic disease like diabetes, getting a gold or platinum plan?
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Old 10-24-2013, 02:29 PM   #576
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Given the hoops I'd have to jump (setting up a charitable trust, prepaying property tax etc) through and the modest subsidy I am not going to bother. However I do wonder if there is anything wrong with electing to get a lower form of insurance Bronze in my case is ~$100/month cheaper and then if I end getting a chronic disease like diabetes, getting a gold or platinum plan?
The downside is limited to having to wait until the next calendar year to upgrade the coverage and reduce the cost sharing. But beyond that, no, there's nothing to stop you from electing a higher-tier plan if your medical needs (and expected costs) change.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
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Old 10-24-2013, 02:34 PM   #577
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So I'd be eligible for a $707 subsidy. But on the Hawaii website even if I drop my income down to 25K I am not seeing a subsidy.

I am I understanding how the subsidy works properly?
I don't know the answer to your question.

But one thing I do want to mention is that it looks like subsidies often don't really amount to much if you aren't substantially below the cap.

I am not applying to ACA this year since I and kids have coverage through DH's retiree insurance (DH himself is on medicare). Premiums went way up this year (to $780 a month on the high-deductible plan) so I was curious about ACA costs even though I don't plan to jump to it this year.

I didn't want to go through the hassle of doing an actual app so I looked at

ValuePenguin | Insuring Your Decisions With Data

to see the cost of plans and to see how much difference a subsidy would make. There are unsubsidized plans that are about the same as or cheaper than the $770 we are paying now but the deductible is vastly different. The family deductible we have now is $3000 while these call for family deductibles of $12700 a year. Big difference. Only a few of the plans have family deductibles that are close to what we are paying so I was curious about subsidies.

I first put in what would happen if our income was about $2000 a year less than the cap. This resulted in a subsidy of about $360 a year. I then put in an income $10000 below the cap (this is for a family of 4). This resulted in a subsidy of about $1200 a year. Better, but I'm not sure it is enough to make it worthwhile to do all the gyrations that would be necessary to become subsidy eligible. Further it would probably be a thing where we load all the income in one year and so wouldn't be eligible that year but might be eligible the next.

The net is that the premiums are higher than the $780 a month we will be paying next year (an increase from $479) but are often not horribly higher. What is horribly different is that the deductibles for family coverage are astronomical.

For example, even a gold Blue Cross policy has a family deductible of $9000 with an individual deductible of $3000.

One thing that isn't clear in this material, btw, is how family deductibles work. The policies we used to have each individual had to meet the deductible for that person but if you collectively reached the "family" deductible then you didn't have to meet it for an individual. So if you had $1500 individual deductible and $3000 family deductible and there were 5 people in the family, once any combination of people met $3000 then no one else had to meet a deductible.

The high deductible policy we have now has those same limits on paper but the individual deductible doesn't apply at all for family policies. If I go in and have $2000 in health care costs there is no coverage for the $500 over the individual deductible. There is only coverage once $3000 is met.

I don't know how deductibles work on the exchange policies.

That is if a policy has a $3000 individual deductible and $9000 family deductible, what happens in a specific individual has $5000 work of costs. Are $2000 paid by the policy or is nothing paid because the $9000 hasn't been met yet?
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Old 10-24-2013, 03:00 PM   #578
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Cost sharing and subsidy are two different things here.

"Cost sharing" in this context means you have an income below 250% of FPL, which enables you to receive lower deductibles and/or OOP maximums with a Silver level policy. It's not the same thing as the premium subsidy.
I don't think it lowers the deductible. From my understanding it only can lower the OOP maximums. Are you sure on this point?
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Old 10-24-2013, 03:04 PM   #579
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I don't think it lowers the deductible. From my understanding it only can lower the OOP maximums. Are you sure on this point?
Yes, cost sharing which kicks in below 250% FPL (and to a greater extent below 200% and again below 150%) can lower both your deductible and out of pocket maximum substantially. I've never seen an sort of formula for this but I am sure it's true.
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Old 10-24-2013, 04:05 PM   #580
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I don't know how deductibles work on the exchange policies.

That is if a policy has a $3000 individual deductible and $9000 family deductible, what happens in a specific individual has $5000 work of costs. Are $2000 paid by the policy or is nothing paid because the $9000 hasn't been met yet?
I can't find a source to link but have read that once any member meets the individual deductible that member is only responsible for co-pays until the family individual TOOP is reached. This is mentioned in some insurers literature but I'm pretty sure it is now subject to ACA regulation.
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