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Old 03-31-2013, 11:21 PM   #41
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Reading about your complicated planned manipulations of MAGI in order to achieve the max subsidy for ObamaCare while still having a nice spendable cash flow makes me think that the methodology the gov't has planned to determine subsidy eligibility is poorly thought out. If having folks who unfortunately cross the subsidy barrier find themselves with an insurance bill that is a large percentage of their income isn't what the gov't intended, why did they write it that way? What were they thinking?
Political BS, obviously
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Old 04-01-2013, 08:14 AM   #42
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Originally Posted by ERhoosier View Post
Political BS, obviously
i have been researching MAGI for obamacare. appearently if a stat sets up an exchange they can configure magi as they want. untaxable ss in the federal governments magi.
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Old 04-01-2013, 08:37 AM   #43
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MAGI was defined when the PPACA was passed. The normal process of comments and changes was followed. The final clarification was released here http://www.gpo.gov/fdsys/pkg/FR-2012...2012-12421.pdf

There is only one definition of MAGI for the PPACa
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c. Modified Adjusted Gross Income
Under the proposed regulations, modified adjusted gross income is adjusted gross income increased by amounts excluded from gross income under section 911 and tax-exempt interest a taxpayer receives or accrues during the taxable year. The 3% Withholding Repeal and Job Creation Act, Public Law 112–56 (125 Stat. 711 (2011)), which was enacted after the proposed regulations were published, amended the definition of modified adjusted gross income to include Social Security benefits (as defined in section 86(d)) not included in gross income under section 86. The final regulations reflect this amendment.
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Old 04-01-2013, 08:38 AM   #44
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No. as others have stated, it's a lifestyle choice primarily. My DW has wanted to go to Ireland, but I have health issues in humid climates.
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International Federation of Health Plans 2012 Comparative Price Report
Old 04-01-2013, 02:15 PM   #45
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International Federation of Health Plans 2012 Comparative Price Report

For those interested in 'what it costs' overseas, the International Federation of Health Plans has just released their 2012 comparative price report.

(PDF document) http://www.ifhp.com/documents/2012iF...NALMarch25.pdf

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This year’s survey includes new prescription drug prices in response to increased interest in this area from plans in many countries. We have also added three new non-drug items to our survey: hip prosthesis, knee replacement, and colonoscopy.
Prices for each country are submitted by participating federation member plans, and are drawn from different sectors:
• Prices for Canada, New Zealand, Switzerland, and the United Kingdom are from the public sector, with data provided by one health plan in each country.
• Prices for Australia, Chile, the Netherlands, Spain, and South Africa are from the private sector and represent prices paid by one private health plan in each country.
• Prices for France and Argentina are a blend of public and private sector prices with the data provided by one health plan in each country.
• Prices for the United States are calculated from a database with over 100 million paid claims that reflect prices negotiated between thousands of providers and almost a hundred health plans.

Comparisons across different countries are complicated by differences in sectors, fee schedules, and systems. In addition, for some countries a single plan’s prices are real for that plan but may not be representative of prices paid by other plans in that market. The U.S. numbers are based on an aggregate of over a 100 million paid claims across multiple payers.
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Old 04-01-2013, 03:13 PM   #46
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although i am by no means an expert-the MAGI-is a catagory thats malleable-depending on how old you are when you retire. a couple ways around this-for most of the time anyways.

if your too young for ss-take 2-3 years withdrawals in the same year-then say in 2 od the 3 years you can get the subsidy. you could do this every 3 years until you reach 62.

then-take at 62. social security if done correctly does not go on the MAGI line.

if managed correctly you could have a 60,000 income only 15,000 -20,000
that would show up on AGI line.

i could not do this in mass because mass with Romneycare adds SS in as a straight line item but on federal its not. i suggest you look at a 1040 form and figure out ways to AGI down even if its not every year.

next year when mass has to adopt the Obamacare guidlines thats what i will be doing
Last time I checked, SS is counted as MAGI for O'care. Again, hope I"m wrong!
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Old 04-01-2013, 03:27 PM   #47
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I guess I'm a homebody. The idea of having to move abroad away from family and friends and my garden just to have (more) affordable health care is depressing to me. I'll figure it out here at home...
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Old 04-01-2013, 03:42 PM   #48
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Sengsational, I don't think you've explained why you think the ACA might push people toward retiring overseas. At present, retirees without health insurance through their former jobs either have to pay a lot for it, or they are unable to get health insurance. After the ACA goes fully in effect next year, at least early retirees who can't get health insurance at present will finally be able to get it. If anything, it seems to me it would reduce the number of retirees who would be inclined to move overseas mainly for health care reasons.
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Old 04-01-2013, 04:21 PM   #49
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Last time I checked, SS is counted as MAGI for O'care. Again, hope I"m wrong!
no you are right. it was at first not included then amended
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Old 04-01-2013, 06:53 PM   #50
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I agree that for many people, it WILL be a good deal to enable ER. But I'm coming to the conclusion that it's not universally a good deal for everyone. If you need to pull from traditional IRA's, for instance, and your income would be over the subsidy cliff, that would have you paying something like 30% of your income to cover the policy. I'm not claiming to be any kind of expert in this (have only just started to research it), but there also seems to be a suggestion that not all practices would even accept the insurance. Once we get prices, and see which practices accept the payment schedule, we will be able to answer with a higher level of confidence. I predict that fewer people in the group I selected in post 1 of this thread will think it's a good idea as time goes on. I even doubt that the 400% FPL will hold (yes, wild guess from someone that doesn't know shinola), pulling more people over the cliff.

--Dale--
I don't get it. Right now if you retire, you get no subsidy. How is this different with ACA?

It seems like with ACA, you should be better off, since you might be able to get a subsidy. If not every year, then every other year if you manage your income right.

I don't see how this can be any worse than what exists today, assuming that HI policies cost about the same. But maybe I'm missing something...
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Old 04-01-2013, 07:09 PM   #51
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I don't get it. Right now if you retire, you get no subsidy. How is this different with ACA?

It seems like with ACA, you should be better off, since you might be able to get a subsidy. If not every year, then every other year if you manage your income right.

I don't see how this can be any worse than what exists today, assuming that HI policies cost about the same. But maybe I'm missing something...
I think what he is saying is that health insurance premiums will be more expensive than today (which is probably true) and if you don't qualify for the subsidy then you are worse off.

But you're right in that it might be best to take enough out of tax deferred accounts to cover multiple years of living expenses as long as the tax bite is not too much and then get the benefit of the subsidy for the years you live off that stash.
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Old 04-02-2013, 05:19 PM   #52
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Sengsational, I don't think you've explained why you think the ACA might push people toward retiring overseas. At present, retirees without health insurance through their former jobs either have to pay a lot for it, or they are unable to get health insurance. After the ACA goes fully in effect next year, at least early retirees who can't get health insurance at present will finally be able to get it. If anything, it seems to me it would reduce the number of retirees who would be inclined to move overseas mainly for health care reasons.
Precisely. Because of the ACA, I'm not bothering to chase down paperwork to demonstrate Swiss family ties any more. That was one of the plans when I couldn't qualify for individual medical insurance back when I was on the COBRA group coverage continuation. I was also exploring becoming a very small business to get group coverage for the three of us.

This isn't a problem with the 'guaranteed issue' nature of coverage under the Affordable Care Act. In addition, the strict restrictions on recession (now only allowed for actual fraudulent applications) mean that I don't have to worry about losing coverage from some omission of a childhood problem should I be diagnosed with some expensive serious problem and have an eager loss mitigation specialist claims agent processing my paperwork.
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Old 04-02-2013, 05:24 PM   #53
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I think what he is saying is that health insurance premiums will be more expensive than today (which is probably true) and if you don't qualify for the subsidy then you are worse off.
I suspect that with the ACA health insurance premiums will be more expensive next year than this year. I also suspect that without the ACA, health insurance premiums would be more expensive next year than this year.

I'm not sure why I might possibly suspect such a thing, though...
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Old 04-02-2013, 05:38 PM   #54
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I suspect that with the ACA health insurance premiums will be more expensive next year than this year. I also suspect that without the ACA, health insurance premiums would be more expensive next year than this year.

I'm not sure why I might possibly suspect such a thing, though...
I think that what pb4 was saying is that some people can currently buy cheaper policies than what will be offered under ACA. For example, I can currently get an Anthem PPO insurance policy in California for DW and me for $600 a month (0% co-insurance, $5,500 deductible). Covered California says that under ACA we can expect to pay $1,149 a month with a $12,800 out-of-pocket maximum.
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Old 04-02-2013, 06:18 PM   #55
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I think that ACA would make it more likely that people wouldn't retire overseas. That is, currently, some people under Medicare age may feel that they have to retire overseas because they can't get insurance in the US. Under ACA, they will now be able to obtain insurance that they couldn't obtain before so might be able to stay in the US.
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Old 04-04-2013, 06:24 PM   #56
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Sengsational, I don't think you've explained why you think the ACA might push people toward retiring overseas. At present, retirees without health insurance through their former jobs either have to pay a lot for it, or they are unable to get health insurance. After the ACA goes fully in effect next year, at least early retirees who can't get health insurance at present will finally be able to get it. If anything, it seems to me it would reduce the number of retirees who would be inclined to move overseas mainly for health care reasons.
From what I understand, there are plenty of folks who moved overseas after retiring early in order to live a more affordable (and more adventuresome) life. Part of the cost equation is health care. Most of the discussion is about where to get world class health care, but not pay US prices for it.

I didn't go back and read post 1, but I think I said that if someone had no plans for living overseas, I didn't expect this topic to tip the scales. Also, I think I said something about not just needing a year or two in order to get to Medicare. And if I didn't say it, I meant to say too that your lifestyle and your asset profile might make it hard to manipulate under the subsidy cliff.

Imagine a 55 year old couple that's already sort of adventuresome and likes to travel. No pre-existing condition issue, so could get HI overseas for really cheap. They would be spending a lot and pulling from accounts that will show as income, so might not be able to juggle the subsidy manipulation as easily as those with a more favorable asset layout and a lower spending rate. It just seems to me that a couple like that might look at the (likely) higher cost of HI next year and just say, "FIREOS!"

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Old 04-04-2013, 06:35 PM   #57
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I just scanned through and picked out France to compare to the US. I'm wondering if they have an axe to grind because the US is the only country that has 25th percentile, average, and 95the percentile shown. So, looking only at average for the US, it looked like the US was twice to three times France, in general. From what I understand, you get good healthcare in France, as good as the US.

One thing I noticed...there was one procedure where the US was less than twice France: colonoscopy! Maybe they figure the other procedures do that financially
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Old 04-05-2013, 06:38 AM   #58
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Originally Posted by sengsational View Post
From what I understand, there are plenty of folks who moved overseas after retiring early in order to live a more affordable (and more adventuresome) life. Part of the cost equation is health care. Most of the discussion is about where to get world class health care, but not pay US prices for it.

I didn't go back and read post 1, but I think I said that if someone had no plans for living overseas, I didn't expect this topic to tip the scales. Also, I think I said something about not just needing a year or two in order to get to Medicare. And if I didn't say it, I meant to say too that your lifestyle and your asset profile might make it hard to manipulate under the subsidy cliff.

Imagine a 55 year old couple that's already sort of adventuresome and likes to travel. No pre-existing condition issue, so could get HI overseas for really cheap. They would be spending a lot and pulling from accounts that will show as income, so might not be able to juggle the subsidy manipulation as easily as those with a more favorable asset layout and a lower spending rate. It just seems to me that a couple like that might look at the (likely) higher cost of HI next year and just say, "FIREOS!"

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You have just described a situation that does NOT add to the reasons to move overseas. The couple you described would not get affordable, world-class insurance in the US before ACA and might, or might not get affordable, world-class insurance in the US after ACA. In the search for affordable, world-class insurance ACA does nothing but improve their odds. They may qualify for subsidy and, if not, HI may cost more than a cheapo, limited policy today but it is more likely to at least approach that world-class caveat you posited than today's limited policy. And, even more important, it will definitely be available regardless of the individual's health status.

Now, if you believe that ER'd individuals making too much for a meaningful subsidy are better off with limited, but cheaper policies than more comprehensive but potentially more expensive policies under ACA, then maybe you have a point. But in that case forget the affordable, world-class alternative for pre-ACA in the US.
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Old 04-06-2013, 05:51 PM   #59
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The couple you described would not get affordable, world-class insurance in the US before ACA...
Affordable is relative to means. I'd rather go with "reasonably priced". Yes, most everyone in the US fails in the reasonably priced category (just look at that PDF of procedure costs by country posted earlier).

From what I can gather, it looks like the example couple would pay about 50% more for similar coverage next year under ACA (not currently grandfathered). That, compared to reducing insurance cost by 50% (probably more), by living overseas and getting an international policy. If the location is chosen wisely, they could get health care, should they even need it, at world-class facilities. So if they were already thinking about going the expat route, this might get them off the fence.
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Old 04-06-2013, 07:59 PM   #60
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From what I can gather, it looks like the example couple would pay about 50% more for similar coverage next year under ACA (not currently grandfathered).
I have not read anything that shows that a typical ER age couple will pay double for what they get now. More for a more comprehensive policy, yes but not more for a similar policy. Please tell us where your info comes from.
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