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Old 08-08-2016, 10:58 AM   #61
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Originally Posted by socca View Post
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.
In a similar situation, my premiums are just over $450.

IIRC, I could have done a Kaiser plan where the premiums were about $100 more a month. But that included a number of doctor visits without meeting the deductible plus there's a new (about 5 years old) Kaiser facility about 3 miles from me.

The Anthem BC plan I have is a pain, because I have to search for network doctors and then they tell me to get the annual exam benefit, I have to make sure the provider uses the correct Diagnosis Codes for the blood tests so that I won't have to pay.

Plus their urgent care facility is like 7 miles away through traffic.

I don't see how I'd qualify for a subsidy. My dividends and cap gains distributions are well over the limit.
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Old 08-08-2016, 11:11 AM   #62
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Like the USA you can buy a rider from companies like Blue Cross (Canada) for drugs and better hospital services though right?
Yes, although usually drugs are subject to a copay.
Quote:
Also, Kcowan: what do you do for healthcare at Latitude 20?
We have an agent (Mediquote) who shops around each year based on our age and current medical condition. We end up with 2 policies, one for the 30 day repeat trips and another for the extended stay. Last year, these were different companies because of rates. Claims experiences have been good too.

The main value they add is to ensure that we answer the questionnaire accurately. One of the problems is that snowbirds are putting up with overcharges from local Mexican hospitals. This is increasing the rates for everyone.
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Old 08-08-2016, 11:30 AM   #63
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My wife and I are both on Medicare $2,517 per year, we have supplement plans for our Medicare through my pension fund $5,817 per year for drug and medical supplement. Out of pocket so far this year $1,979 for a total of $10,383, it will go a little higher with more co pays as the year goes.

We do not have dental or vision plans.
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Old 08-08-2016, 11:40 AM   #64
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My wife and I are both on Medicare $2,517 per year, we have supplement plans for our Medicare through my pension fund $5,817 per year for drug and medical supplement. Out of pocket so far this year $1,979 for a total of $10,383, it will go a little higher with more co pays as the year goes.

We do not have dental or vision plans.
So this is an interesting data point for the posters here with ACA subsidy money. When you hit 65 your expenses will go up instead of down.Those of us saying we can't wait to get on medicare are all complete private pay.

Though I have a question about your supplement. MY DH pays about 220 a month for a supplement that pays everything...no out of pocket expenses.How do you pay such a high premium and still have OOP of 2000+ per year.
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Old 08-08-2016, 12:56 PM   #65
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Originally Posted by burch64 View Post
My wife and I are both on Medicare $2,517 per year, we have supplement plans for our Medicare through my pension fund $5,817 per year for drug and medical supplement. Out of pocket so far this year $1,979 for a total of $10,383, it will go a little higher with more co pays as the year goes.

We do not have dental or vision plans.

In comparison to burch64 above, here's a little more of the breakdown for us. Not much different than an ACA plan. This is NOT a Medicare Advantage enrollment situation.

We are at (on Medicare also):

Combined costs, DW and I:

Medicare premium per year = $2520

Supplemental Plan Premium per year (Me, Plan G, her, Plan F) = $3896

Part D drug plan premium (plus deductible) per year = $1200

Out of pocket costs, if any = Drug costs not covered by Part D = $4000 (est) - Mostly DW as she hits the Donut hole and has some expensive meds.

So our total is roughly = $8,616 per year for both DW and I combined.

We also do not have dental, hearing or vision plans.
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Old 08-08-2016, 01:02 PM   #66
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It seems like there is quite a difference all things being equal from one state to another. That does not seem fair really as the numbers are so high. All things being equal shouldn't we all pay the same premiums, OOP Expenses, Drugs etc.?


In Canada there are slight differences between Provinces, but they are quite small.
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Old 08-08-2016, 01:06 PM   #67
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Medicare premiums are high but what about deductibles and OOP costs?
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Old 08-08-2016, 01:12 PM   #68
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Medicare looks great! $8616 for 2 people eh?

I'm at $6468 for just me. 4 more years -
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Old 08-08-2016, 01:22 PM   #69
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Medicare looks great! $8616 for 2 people eh?

I'm at $6468 for just me. 4 more years -
A good chunk of the OOP is for drug costs for DW who has some serious needs (about $4K over normal Plan D costs). But if you are healthy and choose a Medigap Supplemental plan that pays the majority (or all of) the Medicare deductibles, you should be able to be well under $4K per person per year.

This is why Medicare has become the "Holy Grail" of medical insurance now!
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Old 08-08-2016, 01:35 PM   #70
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So this is an interesting data point for the posters here with ACA subsidy money. When you hit 65 your expenses will go up instead of down.Those of us saying we can't wait to get on medicare are all complete private pay.

Though I have a question about your supplement. MY DH pays about 220 a month for a supplement that pays everything...no out of pocket expenses.How do you pay such a high premium and still have OOP of 2000+ per year.
Drug co-pay tiers $15 $50 $70 Also $500 deductible before supplement insurance pays what Medicare does not pay for DW. Lots of health issues and drug co-pays. Me, insurance make $$ from me so far 1 Doctor visit this year
Our drug insurance is $3,224 per year for the 2 of us.

Medical insurance supplement is $2,663 per year for 2 of us (our cost)

Health insurance through AARP United Health Care Drug Insurance through OptumRX
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Old 08-08-2016, 02:24 PM   #71
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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.
"non-ACA bronze" is an oxymoron. Perhaps you mean that you purchased an off-exchange ACA-compliant plan. If your plan is not ACA-compliant, you may have to pay a non-participation tax (AKA the 'shared responsibility payment').

Back when I was looking around for 2016 health insurance, I noticed that the plans available from the major carriers off-exchange and on-exchange were identical, so I went ahead and used healthcare.gov to sign up for a 2016 plan. I figured that I (along with millions of others) paid for this somewhat buggy website, so I might as well use it. In retrospect, this might have been a mistake, since I subsequently got to enjoy occasional recorded nuisance calls from the gov't reminding me to do this or that.

A third option I have for 2017 is to try to convince a reputable carrier to offer me a non-ACA compliant catastrophic coverage policy, and also pay the ACA non-participation tax. However, if the sum of these two costs is greater than or equal to an ACA-compliant policy premium, then this option won't work.
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Old 08-08-2016, 02:30 PM   #72
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Drug co-pay tiers $15 $50 $70 Also $500 deductible before supplement insurance pays what Medicare does not pay for DW. Lots of health issues and drug co-pays. Me, insurance make $$ from me so far 1 Doctor visit this year
Our drug insurance is $3,224 per year for the 2 of us.

Medical insurance supplement is $2,663 per year for 2 of us (our cost)

Health insurance through AARP United Health Care Drug Insurance through OptumRX
Do you ever shop this around,is this the best price for you? You each can have a policy that works for you. You might want to slant the better coverage to your spouse and do less for yourself. Some drug are covered without extra insurance, my DH takes a couple of generic type drugs and his supplemental knocks the 90 day co-pay down to around 10 bucks.Also zero deductible on anything medical.
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Old 08-08-2016, 02:32 PM   #73
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"non-ACA bronze" is an oxymoron. Perhaps you mean that you purchased an off-exchange ACA-compliant plan. If your plan is not ACA-compliant, you may have to pay a non-participation tax (AKA the 'shared responsibility payment').

Back when I was looking around for 2016 health insurance, I noticed that the plans available from the major carriers off-exchange and on-exchange were identical, so I went ahead and used healthcare.gov to sign up for a 2016 plan. I figured that I (along with millions of others) paid for this somewhat buggy website, so I might as well use it. In retrospect, this might have been a mistake, since I subsequently got to enjoy occasional recorded nuisance calls from the gov't reminding me to do this or that.

A third option I have for 2017 is to try convince a reputable carrier to offer me a non-ACA compliant catastrophic coverage policy, and also pay the ACA non-participation tax. However, if the sum of these two costs is greater than or equal to an ACA-compliant policy premium, then this option won't work.
Don't you need to have a waiver to buy the cat policy?
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Old 08-08-2016, 02:39 PM   #74
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Don't you need to have a waiver to buy the cat policy?
My understanding is that if I'm willing to pay the ACA non-participation tax, the companies who sell catastrophic coverage policies will be happy to sign me up. However, I've never investigated this option, so I could be wrong.
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Old 08-08-2016, 02:48 PM   #75
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My understanding is that if I'm willing to pay the ACA non-participation tax, the companies who sell catastrophic coverage policies will be happy to sign me up. However, I've never investigated this option, so I could be wrong.
Catastrophic plans are ACA compliant so the penalty is not applicable. However, to be eligible for a Cat plan you must either be under age 30 or live in an area where the lowest cost Bronze plan is more than 8.13% MAGI.

As explained in posts #38 and #40, the Cat plan premium will not be significantly different from a Bronze plan premium in FL.
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Old 08-08-2016, 03:03 PM   #76
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Catastrophic plans are ACA compliant so the penalty is not applicable. However, to be eligible for a Cat plan you must either be under age 30 or live in an area where the lowest cost Bronze plan is more than 8.13% MAGI.

As explained in posts #38 and #40, the Cat plan premium will not be significantly different from a Bronze plan premium in FL.
Thanks for the clarification. I guess there is no 'third option'. I was hoping that there was a 'shadow market' of reputable carriers offering non-ACA compliant insurance policies for people like me, who really only want/need catastrophic coverage but don't qualify under the ACA rules. Too bad.
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Old 08-08-2016, 03:21 PM   #77
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Annual premium: $6,500 for HDHP w/ HSA and a $11,000 max family deductible. Last year we spent ~$1,400 OOP. Purchased off exchange from BCBS - includes a letter from them saying it complies with current law. Obviously no subsidies.

This also includes annual physical and mammogram and it paid for our recent colonoscopies.

In 2013 we paid $4,300 for the same plan.
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Old 08-08-2016, 06:22 PM   #78
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I too am interested in this thread and suggestions:
Back Ground:
I am 54
DW 62
Income is all from Taxable IRA - we are drawing $110K per year, so we are not getting any credits
Medical Coverage is through Florida Blue for the two of us @$1132 Per Mo with a $6800 Deductible Each

Is there any better / cheaper coverage out there ??
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Old 08-08-2016, 07:06 PM   #79
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I too am interested in this thread and suggestions:
Back Ground:
I am 54
DW 62
Income is all from Taxable IRA - we are drawing $110K per year, so we are not getting any credits
Medical Coverage is through Florida Blue for the two of us @$1132 Per Mo with a $6800 Deductible Each

Is there any better / cheaper coverage out there ??
God lets hope so!
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Old 08-08-2016, 09:59 PM   #80
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I too am interested in this thread and suggestions:
Back Ground:
I am 54
DW 62
Income is all from Taxable IRA - we are drawing $110K per year, so we are not getting any credits
Medical Coverage is through Florida Blue for the two of us @$1132 Per Mo with a $6800 Deductible Each

Is there any better / cheaper coverage out there ??
Have you checked out healthsherpa.com?
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