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Old 08-07-2016, 07:09 AM   #41
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I did some Research in British Columbia Canada, as it is the only Provice we would consider moving to. These are directly off their web site:

These are the 2017 Monthly Premiums for BASIC BS, MSP (Medical Service Plan) Even if we had a system the tripled or quadrupled these premiums it would be a good deal. Remember No Copays or Deductibles for the most part. Any BC Residents please feel free to comment.


Effective January 1, 2017

  • There are no premiums for children under the age of 19.
  • MSP premium rates will be determined by the number of adults on an MSP account (the MSP account holder and, if applicable, a spouse.)
Adjusted Net Income is the BOLD Number, One Adult is the first number below that, and Two Adults in a Family is the number below that. (The columns did nor come through with the Paste.


$0 - $24,000 - Net Income
$0.00 - One Adult
$0.00 - 2 Adult Family
$24,001 - $26,000
$12.00
$24.00
$26,001 - $28,000
$24.00
$48.00
$28,001 - $30,000
$36.00
$72.00
$30,001 - $34,000
$48.00
$96.00
$34,001 - $38,000
$58.00
$116.00
$38,001 - $42,000
$68.00
$136.00
Over $42,000
$78.00
$156.00

When determining premium rates, B.C. residents may claim allowable MSP deductions to their net income to determine their adjusted net income. Individuals may claim $3,000 for every person on their MSP account that is age 65 or older this year, and $3,000 for each child on their account. In addition, if you claimed a disability on your tax return for yourself, spouse or child included on your MSP account, you may claim $3,000 for each disabled person. To determine if you qualify for deductions, please refer to the Application for Regular Premium Assistance Form for more information.
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Old 08-07-2016, 07:23 AM   #42
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Are you a U.S. citizen or Canadian citizen? If U.S., how can you qualify for that program?
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Old 08-07-2016, 07:34 AM   #43
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Are you a U.S. citizen or Canadian citizen? If U.S., how can you qualify for that program?
I have Tri Citizenship, my wife is dual. Canada and USA are common. We both paid our fair share into the system in our early years too but rarely used it, I did have one hospital stay and it was excellent.
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Old 08-07-2016, 08:45 AM   #44
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The monthly premium for my ACA HMO is $580. But I only have to pay $36 per month thanks to massive subsidy. $500 deductible, $2,250 max oop. I feel sorry for those worker bees with the $6,000 deductibles and large premiums, who are not getting a large subsidy! I used to be one of them.
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Old 08-07-2016, 09:16 AM   #45
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It can cost more to buy health insurance than to rent a condo in Canada and never live in it simply to get health care. For those of Xpats with dual citizenship who can do so. Who do not like the cold.....
This thought had occurred to me as well but it remains a backup plan as I really don't want to go back to -20 to -30 degree winters. Also I really hate flying out of Pearson.

Right now, we're paying 200-300 under ACA for monthly premiums (with tax credit) for mid 40s couple. Which in my view is an exceptional deal. Still we've allocated way more than that in our budget due to lumpiness of expenses and uncertainty.
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Old 08-07-2016, 09:52 AM   #46
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Controlling your MAGI / moving is the best way to control the expense. In NY 0-150 FPL is free, 150-200 FPL is $20 a month. Also NY is cheaper for older people since age is not allowed in premium pricing.

My back up plan is to move to the UK for NHS if worst case happens in the US.
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Old 08-07-2016, 09:55 AM   #47
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DH and I have the same policy so I'll just combine the numbers. It's an ACA Bronze plan with $6650 deductible each, $6850 OOP Max each. $40/$80 copay for PCP/Specialist. We use the Rx plan (CVS Caremark) for some Rxs, for a few we don't use the insurance and use GoodRX coupons instead.

The cost of this plan is $776/mo but we get a subsidy of $650 so our cost is $126/mo.

The first two years of ACA we had Bronze HSA plans. For 2016 all the HSA plans in our area were several hundred dollars more than the Bronze non HSA plans with a co-pay.

When I estimated our income for 2016 for the ACA subsidy I included DH's taxable pension, our taxable interest and my small part time income. By the end of the year my entire part time income will be in a traditional IRA so our ACA MAGI will be smaller than I estimated and we will be getting back a portion of what we already paid in premiums.

Every year I've looked at Silver plans, too. The monthly cost is so much higher than Bronze and at the top tier (200-250% FPL) the cost sharing benefits are not that attractive.

Our only alternative to using ACA insurance is DH's retiree insurance. It offers much better coverage but would have cost us around $800/mo which makes it higher than the limit of "affordable" by the ACA. DH's retiree plan is eliminating any subsidies for spouses so next year I would have to pay the full premium of $959/mo just for me.

We both have about 3.5 years left until Medicare. Just hanging on until then.
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Old 08-07-2016, 10:21 AM   #48
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For those of us with ACA premium tax credits (whether taken in the form of premium subsidy, or at tax time).... Do you budget for the full cost?

When I was getting ready to retire I looked at the COBRA prices for my employer insurance (Kaiser Permanente, HMO, no deductible, $20/copay). It was $1100/month. I used COBRA for the remainder of the year I retired. I budgeted for $1400/month figuring that my large employer had negotiated a better deal than I could get. That's only a little higher than what the plan I have now is - but my plan now is a HDHP - so a lot more out of pocket.

Tax laws can change - and the ACA premium tax credits are a tax credit I plan to take advantage of while I can... if it changes, then health insurance will go to the highest line item BY FAR. Higher even that paying for groceries for 2 teenagers (which is a lot of groceries - especially now that they're playing water polo.)

My budget is for the worst case - but I am happy to take any tax credits coming my way.
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Old 08-07-2016, 10:31 AM   #49
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For those of us with ACA premium tax credits (whether taken in the form of premium subsidy, or at tax time).... Do you budget for the full cost?

...
For me, any subsidy is calculated at tax time. I budget for the full cost. Any $ I get back, I'll deposit (no splurging ) in my checking account for premium payments the following year.
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Old 08-07-2016, 10:58 AM   #50
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For us we have a joint plan too. We only pay Florida Blue our portion they look after claiming the subsidy from the government. If I underestimated out income it will be adjusted at tax time.


We are just so scared that ACA will be repealed if things go pear shaped, that we do not know what to do. Hopefully we will still be able to use ACA for 2017 regardless as we will sign up ASAP in November.
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Old 08-07-2016, 11:00 AM   #51
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Quote:
Originally Posted by ShokWaveRider View Post
I did some Research in British Columbia Canada, as it is the only Provice we would consider moving to. These are directly off their web site:
...Remember No Copays or Deductibles for the most part. Any BC Residents please feel free to comment.
...
When determining premium rates, B.C. residents may claim allowable MSP deductions to their net income to determine their adjusted net income. Individuals may claim $3,000 for every person on their MSP account that is age 65 or older this year, and $3,000 for each child on their account. In addition, if you claimed a disability on your tax return for yourself, spouse or child included on your MSP account, you may claim $3,000 for each disabled person. To determine if you qualify for deductions, please refer to the Application for Regular Premium Assistance Form for more information.
No coverage for drugs. Anything normally covered by Blue Cross not covered. Deductions are subject to a means test i.e. must be below net $30000. 90 days waiting period for coverage for qualified residents.
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Old 08-07-2016, 11:13 AM   #52
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No coverage for drugs. Anything normally covered by Blue Cross not covered. Deductions are subject to a means test i.e. must be below net $30000. 90 days waiting period for coverage for qualified residents.
Like the USA you can buy a rider from companies like Blue Cross (Canada) for drugs and better hospital services though right?


Also, Kcowan: what do you do for healthcare at Latitude 20?
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Old 08-07-2016, 11:23 AM   #53
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For those of us with ACA premium tax credits (whether taken in the form of premium subsidy, or at tax time).... Do you budget for the full cost?
I estimate our income as accurately as possible. Then we budget for the premium amount after our subsidy. Then if something can be sheltered into non-taxable, I decide if it's worth it or not and get the extra subsidy back at tax time.

So for 2014 and 2015 our HSA contribution lowered our income and increased our subsidy at tax time. For 2016 putting all my part time income into a Traditional IRA will do the same thing. For 2017 our income will be the pension, some taxable interest, my part time income and an RMD from an inherited IRA. The only thing that can be sheltered is my part time income unless we have an option for an HSA next year.

I don't know about other ACA users but for us every year has been a different insurance company, premium prices jumping all over the place and deductibles going higher. For 2016 we both had to change doctors as keeping our same plan/same doctors would have more than doubled our cost. My doctor's office dropped the plan I was on, a large local insurer with narrow network, but kept the same insurers plan with the larger network.

So while I hugely appreciate coverage of pre-existing conditions, access to a large choice of plans and generous subsidies at our income level, it's a whole new ball game every year.

We are happy to have the ACA, but it's not perfect.

I'm glad that subsidies are based on taxable income and not assets. I have a little bit of control over that.
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Old 08-07-2016, 11:54 AM   #54
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For those of us with ACA premium tax credits (whether taken in the form of premium subsidy, or at tax time).... Do you budget for the full cost?
In 2014 and 2015, I paid the full cost and took the subsidy at tax time. The subsidy was pretty small, about $220 in 2014 and $450 in 2015. I was expecting to do the same for this year, but when I applied my new insurance company told me my monthly premium would be net of the subsidy, about $480 per ($40 per month). This means, for 2016, that I will have to declare both subsidies as either tax credits or offsets to medical expense deductions.

My annual federal tax bill is pretty low, so I don't make any estimated federal income tax payments (I do make an estimated state income tax payment, though). For 2014 and 2015, I used the tax subsidy as a backhanded income tax withholding, as it partially reduced my federal income tax bill. With my investment income projected to be lower this year than I anticipated, the overall projected subsidy (much higher than the $480) will end up being lower but still higher than the $480, so it will still offset some of my tax bill.

As for how I budget from month to month, I budget whatever premium amount I have to pay. For 2014 and 2015 it was the full cost but for this year it will be reduced by the advanced subsidy ($40 per month).
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Old 08-07-2016, 12:04 PM   #55
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ACA is not looking like it will change much at all for at least the next four years, so no, we don't budget for the full ACA cost.
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Old 08-07-2016, 12:29 PM   #56
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ACA silver plan costs me $250, $1200 deductible, $1200 oop, first 4 doc visits, of any type, free. One trip to the ER and I'm at oop, sure didn't pay in $1200 either more like 250.

I was unable to buy insurance prior to ACA, five and a half years to Medicare. Maybe CO passes single payer.
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Old 08-08-2016, 06:07 AM   #57
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Male, Single, 53

2015 situation:
+ grandfathered non-ACA compliant plan
+ BCBS of FL
+ $174 / mo = $2,088 / yr
+ $12k deductible
+ out-of-network covered at 50%

BCBS of FL terminated this policy, so ...

2016 situation:
+ ACA-compliant Bronze plan
+ Aetna
+ $398 / mo = $4,776 / yr
(the lowest ACA-compliant premium I could find)
+ $6k deductible
+ out-of-network covered at 0%
+ no subsidy

In 2017, it appears that I will have two choices:
(1) sign up for an ACA-compliant plan that is unaffordable according to Obamacare's own definition for what constitutes 'affordable' (annual premium less than 8% of MAGI), or
(2) self-insure and (perhaps) pay the non-participation tax penalty.
I don't like either of these two options.
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Old 08-08-2016, 08:27 AM   #58
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Originally Posted by socca View Post
Male, Single, 53

2015 situation:
+ grandfathered non-ACA compliant plan
+ BCBS of FL
+ $174 / mo = $2,088 / yr
+ $12k deductible
+ out-of-network covered at 50%

BCBS of FL terminated this policy, so ...

2016 situation:
+ ACA-compliant Bronze plan
+ Aetna
+ $398 / mo = $4,776 / yr
(the lowest ACA-compliant premium I could find)
+ $6k deductible
+ out-of-network covered at 0%
+ no subsidy

In 2017, it appears that I will have two choices:
(1) sign up for an ACA-compliant plan that is unaffordable according to Obamacare's own definition for what constitutes 'affordable' (annual premium less than 8% of MAGI), or
(2) self-insure and (perhaps) pay the non-participation tax penalty.
I don't like either of these two options.
Those of us in your position, including myself are suffering the most negative outcome of the ACA. ACA incomes limits actually encourage some people to stop working. Every mainstream media report about ACA says premium will rise this year, but the good news is so will the subsidies, forgetting about those of us who don't get one. MY DH is one medicare and I'n 63 so we'll just plod along for a couple of years. someone who is 53 has my complete sympathy,because in my book "self-insure" is not an option.I believe that being charged rack rate for medical procedures is the road to ruin.
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Old 08-08-2016, 08:36 AM   #59
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Originally Posted by socca View Post
Male, Single, 53

2015 situation:
+ grandfathered non-ACA compliant plan
+ BCBS of FL
+ $174 / mo = $2,088 / yr
+ $12k deductible
+ out-of-network covered at 50%

BCBS of FL terminated this policy, so ...

2016 situation:
+ ACA-compliant Bronze plan
+ Aetna
+ $398 / mo = $4,776 / yr
(the lowest ACA-compliant premium I could find)
+ $6k deductible
+ out-of-network covered at 0%
+ no subsidy

In 2017, it appears that I will have two choices:
(1) sign up for an ACA-compliant plan that is unaffordable according to Obamacare's own definition for what constitutes 'affordable' (annual premium less than 8% of MAGI), or
(2) self-insure and (perhaps) pay the non-participation tax penalty.
I don't like either of these two options.
Another argument for single payer. With such a system EVERYONE will contribute. A Medicare for all would work too. At the moment, although it does not apply to all, those over 65 are "more" prone to use more services as they get older, so it really needs to cover younger people too. It just makes so much sense. Go Figure. Currently Medicare is like a "High risk" Pool for the demographic.

The other thing that just grinds my gears (Thanks Family Guy for the quote), is the amount of people that are against single payer for whatever reason. YET they ALL yearn to be eligible for Medicare.


Seems like all the common sense is going by the wayside in this country. We are actually seeing it being played out real time as I type.
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Old 08-08-2016, 08:55 AM   #60
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Single guy here, mid-40s, living in Georgia, paying ~ $330/month for a non-ACA bronze high-deductible plan. Not eligible for ACA cost sharing or premium subsidies, unfortunately (or fortunately, depending on how you look at it). I set up an HSA this year, so that lowers my overall medical costs somewhat. And since I have some self-employment income, I'm able to take the health insurance premium deduction when filing my 1040, which reduces my AGI by nearly $4K. All in all, things could be worse.
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