all insurances NOT in ACA subsidized plans

[wanaberetiree]

THAT'S whats not fair.

+1

 

[obgyn65]

This is my understanding also. I would wait until additional details emerge, specific to each state.

State exchanges will determine which plans are offered. So far, 18 states have firm plans for single state exchange, 7 will partner, and 26 (including DC) will default to a feredally run exchange. Until they actually start putting plans out there, we really don't know what they will offer.

 

[foxfirev5]

I intend to play by the rules. That's fair isn't it?

I also plan to play by the rules -whatever they may be. First it was the loss of my pension, now it's retiree medical coverage going away.

 

[bondi688]

I understand all the points. I think there is a very subtle difference between passive avoidence of having to do something and active acquiring of something. I am not really saying it is wrong and doing all that are still following the rules.

 

[frank]

I saved and was frugal all my working life and now I will continue to play by the rules to get the best deal possible for myself and my wife. If it means working the system then so be it. but if working the system is withdrawing less earnings than possible to get a subsidy, then why are tax deductions and lower withdrawal rates to avoid taxes also not working the system?

 

[harley]

It's just not in my genes to sip from the public pond when I have my own bucket of water.

If my bucket of water was left alone for me to use, I'd be right there with you. However, the gov't has a big siphon sticking in my bucket. When I follow THEIR rules to minimize the amount of the suction being applied, I don't feel anything other than slight satisfaction.

 

[Zantastic]

If California insurers mirror those in MA, it makes me wonder what the difference in benefits would be between a Medicaid plan and a subsidized one.

This CHART is adding to my confusion, with a minimum income for a subsidy that's much lower than what the calculator shows for Medi-Cal eligibility. My first thought was that the first column was for Medi-Cal, but I don't think that's correct.

 

[gerrym51]

One thing that will be to my benefit with Obamacare. assuming massachusettes will have to make adjustments for Obamacare income standards.

Massachusettes adds all forms of income to their income guidlines.I did not qualify.

under obamacare because MAGI can be manipulated i would qualify.

even both i and wife receive ss since its not a direct addition to income

i havefigured out we can have over 60,000 of total income and still qualify for a 1/2 to 2/3 subsidy.

thats is if mass is required to use federal guidline. this seems to be a big loophole for taking ss at 62 especially if one spouse is over 65.

good for me-not so good for the country

however i will only do this if it affects my silver plan i bought.,and can keep it-i,m not sure the mass. silver plan that already existed is the same as Obamacares.

 

[gerrym51]

If California insurers mirror those in MA, it makes me wonder what the difference in benefits would be between a Medicaid plan and a subsidized one.

This CHART is adding to my confusion, with a minimum income for a subsidy that's much lower than what the calculator shows for Medi-Cal eligibility. My first thought was that the first column was for Medi-Cal, but I don't think that's correct.

looking at the chart it appears that the 2 lower sections a almost copies of med-cal. the 2 highest subsidy sections are of the bronze,silver,gold platinum catagories.

in mass currently under ROMNEYCARE(i stress this because obamacare is simiiliar but not exact copy) all subsidized plans are same and restricted

 

[jollystomper]

While I understand your point, I have decided that I will structure my finances to optimize my taxes and benefits. The way I rationalize it is that I paid mucho taxes during my accumulation phase, many years I paid more in taxes than many people earn in a year and since my earnings were 99% wages, there wasn't much that I could do other than max out my 401k and suck it up. It's payback time.

+1

While I do not feel it is "payback time", I feel no guilt about optimizing my taxes and benefits when it is done legally. Goodness knows we paid a whole lot into taxes for many years and were eligible for very few credits.

This is why I favor a flat tax approach. The "gaming" of the system is taken out by the most objective mathematical means possible - a straight percentage. Otherwise, I don't blame folks going into retirement (like myself) who are trying to live as financially independent as possible to do what they call legally to ensure that it happens.

 

[gerrym51]

As an adjunct to this thread that i started.

I went and checked if my doctor was in the 5 plans that the state of massachusettes subsidized.

my doctor WAS NOT in any of the subsidized plans.

as i've stated before the subsidized plans a state will offer will most likely be in

medicaid networks-which fewer doctors take

 

[Live And Learn]

As an adjunct to this thread that i started.

I went and checked if my doctor was in the 5 plans that the state of massachusettes subsidized.

my doctor WAS NOT in any of the subsidized plans.

as i've stated before the subsidized plans a state will offer will most likely be in

medicaid networks-which fewer doctors take

thats what scares me most. While getting a $12k subsidy would be great, we need to think about the costs (in terms of medical care) that would offset it. Makes it impossible to budget for anything except full freight costs.

 

[samclem]

I too hold little respect for folks with huge financial resources tapping into public funds just because they're smart enough to work the system.

"The system" has no brain. It has no feelings. It has no logic (just look at what it has wrought!). All we have are rules, and any attempt to read logic into them is perverse.
I feel it is 100% proper to take advantage of every legal tax break and subsidy that is offered.
This isn't a private charity where well-meaning people have donated funds to help the less fortunate--any person who can afford to make their own way should properly feel ashamed at taking a free meal at the soup kitchen. Nope, this is tax money taken from people who had other good uses for it, and doled out by the government in a very arbitrary fashion. To fail to take the subsidy, or to structure your finances so as to be eligible for it, is just the same as failing to take a tax deduction you deserve.
In my opinion the "most right" thing to do is take every one of these obtuse tax breaks and subsidies and do something useful with the money--maybe give it to the truly needy. And also crow loud and long about how you are taking advantage of these giveaways so people get fed up with it and put pressure on their representatives to change the rules.
Failing to take these subsidies just serves as a tax on those with the biggest sense of misplaced guilt.

 

[REWahoo]

thats what scares me most. While getting a $12k subsidy would be great, we need to think about the costs (in terms of medical care) that would offset it. Makes it impossible to budget for anything except full freight costs.

Careful that you don't budget for "worst case" in every case leaving you a basket case...and still at work.

 

[kmt1972]

Given the cost of insurance in NY I am counting on the subsidized plans as being not too bad. My plan is to control my MAGI (but for sure not my withdraw) at $65K which would cap my premium around $6K given I will have a family of 3.

Just to show you what we in NY are up against, using

Health Insurance - Find Affordable Health Insurance Plans and Buy Medical Coverage Online

and doing a search on health plans for a family of 3, you can get an insurance policy from Empire Blue similar to the one from my mega-corp (is that the right terminology for this board?) for almost $60K a year, or one from EmblemHealth for about $24K. EmblemHealth has a much lower rating and I suspect that it will be the one that will be available on the exchange.

Looking at

New York Health Benefit Exchange | The Official Health Exchange for New York State

It does not even make clear which insurance providers will participate so this is one giant mystery until October when it when then somehow magically work which I doubt.

Anyhow, I did a search on EmblemHealth and it does have doctors and pediatrics that work out of here in Scarsdale. I figure if they work out my pretty good neighborhood, they cannot not be too bad. Right now my wife and I use our doctors in the New York City but that will change once we retire.

My plan is, while our health is good, keep using the subsidized plan, and then later in our life and since we will have the money for it, go to a non-subsidized plan when we need better care.

 

[MichaelB]

We lived under NY state guaranteed issue health care plans for quite some time. The best one could say is they are crappy. I suspect the state exchange PPACA based policies will differ in two ways: less expensive and substantially better coverage.

Edit to add: PPACA guidelines limit the maximum regional charge @ 1.5x avg. The max price for the best coverage is less than $30k for a family of 4.

 

[bondi688]

kmt1972
Was that a typo? Did you say your full freight health insurance premium in NY would be $60000 a year for a family of 3 unless you kept your income to $65000 a year?

 

[kmt1972]

kmt1972
Was that a typo? Did you say your full freight health insurance premium in NY would be $60000 a year for a family of 3 unless you kept your income to $65000 a year?

A qualified Yes. Of course the whole point is that the $60K plan would not be available on the exchange (I assume or else Obamacare subsidies will crush the system if everyone signs up for the $60K plan and then pay only $6K) so I could not even get that via subsidies so I would have to pay 60K to get it. So my choices are

a) Pay $60K for a very good plan
b) Pay $24K for a ok plan if my MAGI is above $78K
c) Pay $6K for a ok plan if my MAGI is below $78K

So if I want a good plan for my family if I retire I have to pay $60K a year. Under Obamacare it is claimed that this number might go down 12% so I guess it would be around $54K. As I mentioned before, reason this is so messed up in NY is because of Community Rating and Guaranteed Issue which led to a death spiral. BTW, Obamacare is doing exactly that (Community Rating and Guaranteed Issue) plus a "tax" to make sure people have to get healthcare to stop the death spiral.

Look, I have enough assets so I should not really have to game the system to get Obamacare subsidies. But if even a ok insurance is going to cost $24K unless I get subsidies, I will do it and game my investments so my MAGI is below $78K.

 

[kmt1972]

We lived under NY state guaranteed issue health care plans for quite some time. The best one could say is they are crappy. I suspect the state exchange PPACA based policies will differ in two ways: less expensive and substantially better coverage.

Edit to add: PPACA guidelines limit the maximum regional charge @ 1.5x avg. The max price for the best coverage is less than $30k for a family of 4.

That is nice to hear. But that makes it worse to some extent. I assume this just means NY state must cost only 50% more than the cheapest plan. There seems no rule to mean that number just be $30K. Also for insurance company to be able to charge so "little" is, as it was pointed out, they will have to pay the doctor less which makes the plan that much crappier. If anything this "rule" sounds like bad news because it might ensure that all plans on the exchange will not be that good and I will be forced to pay for the $60K plan which would be outside the exchange. This entire Obamacare is a disaster. Either it total disaster by pushing up costs for middle class or it goes bankrupt paying out all these subsidies with everyone trying to game the system, or both.

 

[bondi688]

If $60000 a year for health insurance premium is "affordable care" , I don't want to know what is defined as unaffordable.

 

[FinanceDude]

I have different philosophy, I fully intend to game ObamaCare and some years qualified for a health care subsidy, by shifting income from one year to another.

I am also getting an electric car, beside the silly $7,500 tax credit. I get several perks in Hawaii. All large private and all public parking are required to have charging stations, which are place right by handicap parking spaces.

Plus I don't have to pay for parking at any parking meters or public parking lots. Now I can make a tenuous case why charging stations are good public policy (why they have to be upfront I don't know). But I can't possibly make any case why me or my fellow wealthy electric car owners need free parking. So I will happily write a letter to the newspaper, post on Facebook, the forum. Suggesting that this perk that I receive is unneeded and should be eliminated.

I'll do the same thing about a multimillionaire getting a health insurance subsidy. Although in the case of ObamaCare I am pretty sure that additional cost of the insurance will more than make up for my small bi-annual subsidy.

It's not gaming the system, this new hi-faluting health care is FREE..........

 

[kmt1972]

I have different philosophy, I fully intend to game ObamaCare and some years qualified for a health care subsidy, by shifting income from one year to another.

I am also getting an electric car, beside the silly $7,500 tax credit. I get several perks in Hawaii. All large private and all public parking are required to have charging stations, which are place right by handicap parking spaces.

Plus I don't have to pay for parking at any parking meters or public parking lots. Now I can make a tenuous case why charging stations are good public policy (why they have to be upfront I don't know). But I can't possibly make any case why me or my fellow wealthy electric car owners need free parking. So I will happily write a letter to the newspaper, post on Facebook, the forum. Suggesting that this perk that I receive is unneeded and should be eliminated.

I'll do the same thing about a multimillionaire getting a health insurance subsidy. Although in the case of ObamaCare I am pretty sure that additional cost of the insurance will more than make up for my small bi-annual subsidy.

You are in luck. I believe the federal poverty level is higher in HI than mainland USA. So that gives you even more room to game the system for subsidies.

 

[MichaelB]

That is nice to hear. But that makes it worse to some extent. I assume this just means NY state must cost only 50% more than the cheapest plan. There seems no rule to mean that number just be $30K. Also for insurance company to be able to charge so "little" is, as it was pointed out, they will have to pay the doctor less which makes the plan that much crappier. If anything this "rule" sounds like bad news because it might ensure that all plans on the exchange will not be that good and I will be forced to pay for the $60K plan which would be outside the exchange. This entire Obamacare is a disaster. Either it total disaster by pushing up costs for middle class or it goes bankrupt paying out all these subsidies with everyone trying to game the system, or both.

It seems like you are committed to your view despite the evidence. The premium ceiling is a rule, period. The way cost regions break down across the states, you probably live in a medium cost area. High cost are rural and lower density areas along with the largest cities, such as NYC. Not your case.

Insurance companies do not pay doctors different fees for the same service across different plan or policy groups. Most state regulators might object to this. What they do is limit the service options, which describes the current NY state individual insurance market. This measure will do more to bring broad coverage to individuals and small groups in NY than all the previous efforts of the past 2 decades.

No comment on your last thoughts. A bit ironic, though, given your intro post.

 

[pb4uski]

It seems like you are committed to your view despite the evidence. The premium ceiling is a rule, period. ....

+1 I had the same thought while reading the thread.

 

[Felix Mulier]

Right now my wife and I use our doctors in the New York City but that will change once we retire.

Here are the questions I'm trying to get an answer on. What if you signed up with one state's exchange and move to another state that doesn't have one, or has a different one? Are these exchanges "portable"? Or must we choose the Federal Exchange for purposes of "taking it with you". I'll let y'all know what I find out.