Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Old 06-16-2015, 08:31 PM   #21
Thinks s/he gets paid by the post
 
Join Date: Dec 2014
Location: Florence, AL/Helen, GA
Posts: 2,093
This subject makes me glad I just turned 65--and I'm now saving $250 per month with Medicare and a Supplement--over my ex-employer's old healthcare plan.

I'd hate to think I had to go on Medicaid. We have great physicians, however they barely take any new Medicare patients even with a Supplement. They refuse to see any Medicaid patient under any circumstances. We still see physicians in our community leaving the medical world before retirement--one of which opened a coffee shop and two farming full time.
__________________

__________________
Bamaman 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 06-16-2015, 09:36 PM   #22
Thinks s/he gets paid by the post
 
Join Date: Feb 2011
Posts: 1,629
Quote:
Originally Posted by MichaelB View Post

Medicaid is a State plan, coverage may not be available for out of state health care. The same may hold true for some of the lower cost ACA exchange plans......
You might want to familiarize yourself with the policies available at your state ACA exchange.
Very true. Best to study your HI plan options VERY carefully before pulling the FIRE trigger. Since Medicaid is state-based program, most do not generally provide out of state coverage. In many regions most ACA plans, not just the cheaper ones, have limited networks which often do not include out of area coverage except for true emergencies. Main reason I'm still w#rking is for access to decent HI, IOW a reasonably broad network & true nation-wide coverage. Under most any ACA Plan offered in my region, if I were to need urgent but not "emergency" care while traveling/visiting I would be stuck paying 100% of the bill. Almost all ACA plans in my region offer NO out of network coverage, and the few that do have OON OOPmax (HSA family plans) of $40-60K!!! One goal of ACA was to offer a choice of nationwide plans in each region, but that is sadly still not the case for many. Wish that changes in my region for 2016 but I'm not hopeful based on early press from state insurance commission
__________________

__________________
ERhoosier is offline   Reply With Quote
Old 06-16-2015, 10:17 PM   #23
Recycles dryer sheets
 
Join Date: Jan 2015
Posts: 170
Anyone know if the nationwide network Bluecross Blueshield health insurance policies are any good? I too am trying to figure out how to juggle our money to get an ACA subsidy, though I think our MAGI will naturally fall somewhere between 25K & 50K before income tweaks.
__________________
Dreaming of Freedom is offline   Reply With Quote
Old 06-16-2015, 10:30 PM   #24
Thinks s/he gets paid by the post
 
Join Date: Dec 2014
Posts: 1,664
Quote:
Originally Posted by Dreaming of Freedom View Post
Anyone know if the nationwide network Bluecross Blueshield health insurance policies are any good? I too am trying to figure out how to juggle our money to get an ACA subsidy, though I think our MAGI will naturally fall somewhere between 25K & 50K before income tweaks.
From what I seen, BCBS has a good network if they are offering the whole network. However, I have seen on the ACA where they strip down the network. In the latter case it is often not as good. Really need to look at the overall network offered on the plan you are looking at. If you don't select the correct plan to look at, you may see the wrong network.

This is true of more than just BCBS. Get one of the lawyers on this forum who can't talk themselves into retiring to check the plan out for you!
__________________
bingybear is online now   Reply With Quote
Old 06-16-2015, 10:44 PM   #25
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
pb4uski's Avatar
 
Join Date: Nov 2010
Location: Vermont & Sarasota, FL
Posts: 16,474
Quote:
Originally Posted by DonL View Post
.....It doesn't really matter if I spend the money withdraw from the 401k instead of using cash savings or put it into Roth IRA far as this topic is concerned....
Perhaps as far as health insurance that is true, but it is an important retirement strategy that you seem to not understand or are totally overlooking.

A Roth conversion is where you rollover 401k money to a tIRA (which is not a taxable event) and then convert it to a Roth IRA (which is a taxable event). You want to convert as much as you can while you are in early retirement and in a low tax bracket. Once pensions, SS and RMDs start you'll be in a higher tax bracket so doing Roth conversions makes you money go farther because you pay less in taxes and therefore have more to spend.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
pb4uski is online now   Reply With Quote
Old 06-16-2015, 10:56 PM   #26
Thinks s/he gets paid by the post
 
Join Date: Jul 2005
Posts: 3,862
Quote:
Originally Posted by DonL View Post
I've figured out the answer and will post it (BTW turns out this is a typical forum)

We withdraw $22000 from our 401ks, which counts as income (don't think I will pay a penalty but even if I do it is a savings).

...

It doesn't really matter if I spend the money withdraw from the 401k instead of using cash savings or put it into Roth IRA far as this topic is concerned.

Thanks to those who helped in the question!!!
Just to add my weight to the Roth conversion side:

As far as getting the subsidy, a 401k withdrawal or a 401k to Roth IRA conversion will both generate income.

You pay the same tax either way also.

However, with a simple 401k withdrawal you may pay a significant penalty (if you don't qualify for the rule of 55). The Roth conversion can be performed at any age without a penalty. Plus a simple 401k withdrawal removes value from your tax-privileged 401k account and moves it into your taxable account. A Roth conversion keeps your money in a tax-privileged account.

Reducing the value of your 401k now may help your tax situation when you turn 70 and have to start RMD's, as pb4uski has pointed out.
__________________
Animorph is offline   Reply With Quote
Old 06-16-2015, 11:02 PM   #27
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2005
Posts: 13,290
Quote:
Originally Posted by bingybear View Post
From what I seen, BCBS has a good network if they are offering the whole network. However, I have seen on the ACA where they strip down the network. In the latter case it is often not as good. Really need to look at the overall network offered on the plan you are looking at. If you don't select the correct plan to look at, you may see the wrong network.

This is true of more than just BCBS. Get one of the lawyers on this forum who can't talk themselves into retiring to check the plan out for you!
My problems is you do not know the network is good or bad until it is too late... in theory you can look at docs in your network, but in reality it is quite hard... also, you usually only look local... so you do not know anything about farther away....


Healthcare is still broken... and getting more so... and it is expensive.... and getting more so....
__________________
Texas Proud is offline   Reply With Quote
Old 06-16-2015, 11:15 PM   #28
Thinks s/he gets paid by the post
 
Join Date: Dec 2014
Posts: 1,664
Quote:
Originally Posted by Texas Proud View Post
My problems is you do not know the network is good or bad until it is too late... in theory you can look at docs in your network, but in reality it is quite hard... also, you usually only look local... so you do not know anything about farther away....


Healthcare is still broken... and getting more so... and it is expensive.... and getting more so....
you know, in many ways it STILL IS. there are a couple items here. one, people working for companies don't see the full cost because the company pays most of it in many cases. This causes a false concept of cost in much of the public.
Next, age on the exchange is a variable, but preexisting conditions are not (I guess not in a company either). But companies still are trying to play games to make more money... part of the general game of business.

The subsidy issue is more governmental. I think ER was missed in the process. Likely good for ER.
__________________
bingybear is online now   Reply With Quote
Old 06-17-2015, 12:04 AM   #29
Confused about dryer sheets
 
Join Date: Jun 2015
Posts: 1
Quote:
Originally Posted by pb4uski View Post
If you have no income then in most cases you'll be eligible for Medicaid. You don't need to be disabled.

It might be a good time for you to do Roth conversions to create just enough income to qualify for subsidies and pay minimal taxes on the Roth conversions and avoid a tax torpedo later in life when SS and RMDs kick in.

One thing though... depending on where you are sailing Medicaid or an ACA policy might not do you any good so look into it.
Unlike ACA, Medicaid has tight limits on assets in most, if not all states. I'm in Texas, and you're talking impoverishment to qualify. So the other posters are right to advise simply managing AGI to qualify for an ACA subsidy. And great point about the partial Roth conversion. If you've got to show some income for ACA, definitely use the conversion to provide it and still keep the tax preference. Regarding the question about networks, BCBS Texas has a good PPO network but a very limited HMO network. I suspect other Blues are similar.
__________________
Surfer60 is offline   Reply With Quote
Old 06-17-2015, 05:26 AM   #30
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
Quote:
Originally Posted by Surfer60 View Post
Unlike ACA, Medicaid has tight limits on assets in most, if not all states. I'm in Texas, and you're talking impoverishment to qualify. So the other posters are right to advise simply managing AGI to qualify for an ACA subsidy. And great point about the partial Roth conversion. If you've got to show some income for ACA, definitely use the conversion to provide it and still keep the tax preference. Regarding the question about networks, BCBS Texas has a good PPO network but a very limited HMO network. I suspect other Blues are similar.
Not even impoverishment will get you care in Texas if you are a childless adult 18-64 (the undeserving poor), since Texas did not expand Medicaid. Texas doesn't even have a "medically needy" exception for this group. So if a 52 year old spends down all assets to $0, Texas will pay nothing for care. The person would have to be deemed "disabled" and have income under 15% FPL with almost no assets to get coverage. In the 30 states that expanded, the only test is a <138 FPL income test for childless adults 18-64.
__________________
jim584672 is offline   Reply With Quote
Old 06-17-2015, 06:02 AM   #31
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,492
Quote:
Originally Posted by Dreaming of Freedom View Post
Anyone know if the nationwide network Bluecross Blueshield health insurance policies are any good? I too am trying to figure out how to juggle our money to get an ACA subsidy, though I think our MAGI will naturally fall somewhere between 25K & 50K before income tweaks.
Quote:
Originally Posted by bingybear View Post
From what I seen, BCBS has a good network if they are offering the whole network. However, I have seen on the ACA where they strip down the network. In the latter case it is often not as good. Really need to look at the overall network offered on the plan you are looking at. If you don't select the correct plan to look at, you may see the wrong network.

This is true of more than just BCBS. Get one of the lawyers on this forum who can't talk themselves into retiring to check the plan out for you!
In many states BCBS offers three types of plan on the marketplace exchanges: HMO, limited network, and national network (Bluecard). They appear to be rolling out this approach across the country. Humana and Aetna also offer plans with national networks.

Health insurance is regulated by each state, and insurers offer different plans (with much different prices) around the country.
__________________
MichaelB is offline   Reply With Quote
Old 06-17-2015, 06:04 AM   #32
Full time employment: Posting here.
 
Join Date: Jan 2014
Posts: 663
Quote:
Originally Posted by jim584672 View Post
Not even impoverishment will get you care in Texas if you are a childless adult 18-64 (the undeserving poor), since Texas did not expand Medicaid. Texas doesn't even have a "medically needy" exception for this group. So if a 52 year old spends down all assets to $0, Texas will pay nothing for care. The person would have to be deemed "disabled" and have income under 15% FPL with almost no assets to get coverage. In the 30 states that expanded, the only test is a <138 FPL income test for childless adults 18-64.
Your statements have been put into graphic form in Figures #2 and #3 of the article below.

Link: Where Are States Today? Medicaid and CHIP Eligibility Levels for Adults, Children, and Pregnant Women | The Henry J. Kaiser Family Foundation
__________________
MBSC is offline   Reply With Quote
Old 06-17-2015, 07:39 AM   #33
Thinks s/he gets paid by the post
 
Join Date: Jul 2012
Location: Mississippi
Posts: 1,878
Many states have now restricted balance billing. HMOs seem to be better in this respect as almost all states restrict balance billing for HMOs, but PPOs vary. Only AK seems to have no restriction. Here's the table from Kaiser

State Restriction Against Providers Balance Billing Managed Care Enrollees | The Henry J. Kaiser Family Foundation
__________________
rbmrtn is online now   Reply With Quote
Old 06-17-2015, 08:23 AM   #34
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
pb4uski's Avatar
 
Join Date: Nov 2010
Location: Vermont & Sarasota, FL
Posts: 16,474
Quote:
Originally Posted by Surfer60 View Post
Unlike ACA, Medicaid has tight limits on assets in most, if not all states. I'm in Texas, and you're talking impoverishment to qualify. ....
Quote:
Originally Posted by jim584672 View Post
Not even impoverishment will get you care in Texas if you are a childless adult 18-64 (the undeserving poor), since Texas did not expand Medicaid. Texas doesn't even have a "medically needy" exception for this group. So if a 52 year old spends down all assets to $0, Texas will pay nothing for care. The person would have to be deemed "disabled" and have income under 15% FPL with almost no assets to get coverage. In the 30 states that expanded, the only test is a <138 FPL income test for childless adults 18-64.
Good to know. I'm in a state that expanded Medicaid so there is no assets test.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
pb4uski is online now   Reply With Quote
Old 06-17-2015, 02:48 PM   #35
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
Actually the DAB (Disabled, Blind, or Elderly) group still has a resource / income test, just not the 18-64 expanded group.
__________________
jim584672 is offline   Reply With Quote
Old 06-17-2015, 09:34 PM   #36
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
brewer12345's Avatar
 
Join Date: Mar 2003
Posts: 16,391
Quote:
Originally Posted by ERhoosier View Post
Very true. Best to study your HI plan options VERY carefully before pulling the FIRE trigger. Since Medicaid is state-based program, most do not generally provide out of state coverage. In many regions most ACA plans, not just the cheaper ones, have limited networks which often do not include out of area coverage except for true emergencies. Main reason I'm still w#rking is for access to decent HI, IOW a reasonably broad network & true nation-wide coverage. Under most any ACA Plan offered in my region, if I were to need urgent but not "emergency" care while traveling/visiting I would be stuck paying 100% of the bill. Almost all ACA plans in my region offer NO out of network coverage, and the few that do have OON OOPmax (HSA family plans) of $40-60K!!! One goal of ACA was to offer a choice of nationwide plans in each region, but that is sadly still not the case for many. Wish that changes in my region for 2016 but I'm not hopeful based on early press from state insurance commission
Perhaps you could stop with the scaremongering? I am sorry you live in a benighted state that has decided that access to healthcare for everyone is a horrible thing to be disencouraged at all costs. Some of us live in more enlightened states where the gubmint either has decided not to crap on its citizens or is at least less competent at getting in the way. There are lots of places where the dire stuff you spew regularly is not the case.

I am in year two of ACA coverage. Last year we had low income and got a generous subsidy with cost sharing. We had excellent coverage and care from a healthcare organization I had not previously dealt with, but am mightily impressed by. This year is a high income year so we have no subsidy. The premiums are spicy and the deductible is caliente, but the care and coverage are from the same excellent organization.
__________________
"There are three kinds of men. The one that learns by reading. The few who learn by observation. The rest have to pee on the electric fence for themselves."



- Will Rogers
brewer12345 is offline   Reply With Quote
Old 06-17-2015, 09:46 PM   #37
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Feb 2013
Posts: 5,327
We have mainly the same doctors we've had for years and the same highly rated local hospital with our ACA plan. We had to change eye doctors so far and that is all. We have expanded Medicaid here in California (no asset test), though we are on a Bronze plan ourselves. We're quite happy and apparently our experience is not unique -

"More than 80% of U.S. residents who obtained health insurance through the Affordable Care Act's exchanges say they are satisfied with their coverage, according to a new Commonwealth Fund survey, The Hill reports (Sullivan, The Hill, 6/12)"

"Further, 93% of Medicaid beneficiaries who enrolled in the program through an ACA exchange said they were satisfied with their plans, according to the survey....In addition, 91% of residents with ACA coverage who have used their plans reported they are satisfied with their provider network...The survey also found that 53% of individuals with exchange coverage previously had been uninsured. "

Survey Finds 81% of U.S. Residents Satisfied With ACA Coverage - California Healthline
__________________
Even clouds seem bright and breezy, 'Cause the livin' is free and easy, See the rat race in a new way, Like you're wakin' up to a new day (Dr. Tarr and Professor Fether lyrics, Alan Parsons Project, based on an EA Poe story)
daylatedollarshort is offline   Reply With Quote
Old 06-17-2015, 10:02 PM   #38
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Apr 2013
Posts: 5,599
I went from Megacorp's COBRA gold plated plan to a wide network with national coverage platinum exchange plan for 50% less money.

This state is not enlightened, my selections were from 3 decent insurers. I went with what is considered in this area to be the best. I know YMMV.
__________________
MRG is offline   Reply With Quote
Old 06-17-2015, 11:12 PM   #39
Thinks s/he gets paid by the post
 
Join Date: Feb 2011
Posts: 1,629
Quote:
Originally Posted by brewer12345 View Post
Perhaps you could stop with the scaremongering? I am sorry you live in a benighted state that has decided that access to healthcare for everyone is a horrible thing to be disencouraged at all costs. Some of us live in more enlightened states where the gubmint either has decided not to crap on its citizens or is at least less competent at getting in the way. There are lots of places where the dire stuff you spew regularly is not the case.

I am in year two of ACA coverage. Last year we had low income and got a generous subsidy with cost sharing. We had excellent coverage and care from a healthcare organization I had not previously dealt with, but am mightily impressed by. This year is a high income year so we have no subsidy. The premiums are spicy and the deductible is caliente, but the care and coverage are from the same excellent organization.
Pointing out fact is not "scaremongering". My comments clearly did NOT refer to the situation in all regions or for all ACA plans. Fact is that there are potential pitfalls in HI for FIREs. It is prudent to use due care in understanding the features of any HI plan before signing up. And vast majority of HI options are region specific.

BTW- the state I reside in has a lower % of uninsured than ave, as it did pre-ACA (at least according to data from Kaiser).
Rates of Uninsured by State Before & After Obamacare | WalletHub®
Better than ave rate of uninsured is not the best, but the state has clearly not "decided that access to healthcare for everyone is a horrible thing to be disencouraged at all costs". In fact, earlier this year the Feds granted the state a waiver for a longstanding and fairly successful (hopefully sustainable) program of expanded HI and HC services for low income folks not well served by traditional Medicaid. Again, not perfect but hardly "crapping" on its citizens.
__________________
ERhoosier is offline   Reply With Quote
Old 06-17-2015, 11:17 PM   #40
Recycles dryer sheets
 
Join Date: Jan 2015
Posts: 170
My state only has 2 providers, Coventry & BCBS. Coventry only has plans with local providers, so going with a BCBS nationwide plan is my only option if I want in-network access to healthcare services outside of my metro area. We plan to travel the US quite a bit in retirement, so having in-network access to doctors in .other cities in the US is important to us.
__________________

__________________
Dreaming of Freedom 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
Planning to receive a ACA subsidy? Malcolm2 Health and Early Retirement 21 10-24-2013 10:29 PM
Why did I get rejected for ACA Subsidy? scrabbler1 Health and Early Retirement 26 10-06-2013 05:24 PM
TurboTax has a ACA subsidy calculator if you need an estimate. grasshopper Health and Early Retirement 5 10-05-2013 06:45 AM
ACA Subsidy Calculator By Zip Code tomz Health and Early Retirement 11 09-26-2013 10:19 PM
ACA/Obamacare Subsidy Calculation Gresh FIRE and Money 14 06-20-2013 08:24 AM

 

 
All times are GMT -6. The time now is 01:55 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.