Looking for alternative to Obamacare

[joe8012]

Like many healthy senior American’s age 60 & 61, my wife and I are looking to purchase affordable health insurance. We will retire early on Jan 1, 2014. I planned for a high deductible catastrophic health insurance plan for $300-$500 a month. It looks like that is possible this year in Florida, but not next year. I guess my premium next year will be in the $1200-$1400 range. I won’t be eligible for a subsidy until 2015, as I have deferred compensation in 2014 that I will live on for more than a year. So I am looking for an alternative to Obamacare. I’ve been doing some research on medi-share. It’s not health insurance but works similar to it. They collect monthly payments from you and pay your medical bills. They’ve been around since 1993 and they are a legal substitute to the ACA. Does anyone here have experience with them or are considering them as an alternative to Obamacare?
My Christian Care

 

[MichaelB]

Preliminary info on premiums in Florida show some policies will be available for much less than the $1200 - $1400 you estimate. See here http://www.floir.com/siteDocuments/Avg_Costs_PPACA.pdf

 

[alaska55]

Those are nothing but averages. No mention of age in the premiums. I bet those are rates for 40 year olds. From 40 to 60 the rate will be about double. So take
Humana lowest rate of $315 x2 =630 x 2 for a couple = more than $1200. The next lowest premium is $366. So his guess of $1200-$1400 is close to what they'll pay. Unless your talking per person less than 1200 per couple of over 60 is a pipe dream.

 

[MichaelB]

The rates are for silver plan coverage. Bronze, with the higher deductible the OP wants, will be lower. In addition, if the rates are average the top cannot be more than 50% more, as there is a maximum spread between the lowest and highest cost of 3x. So, while we don't know what the real rates will be, it does look like there will be high deductible options for less than $1K for a couple in their 60's.

 

[joe8012]

Those are nothing but averages. No mention of age in the premiums. I bet those are rates for 40 year olds. From 40 to 60 the rate will be about double. So take
Humana lowest rate of $315 x2 =630 x 2 for a couple = more than $1200. The next lowest premium is $366. So his guess of $1200-$1400 is close to what they'll pay. Unless your talking per person less than 1200 per couple of over 60 is a pipe dream.

I was talking per couple. Has anyone had any experience with Medi-share?
My Christian Care

 

[Animorph]

My current, not very great, understanding was that insurers would still be able to offer underwritten individual policies outside of the ACA exchanges. Have you checked with a HI broker to see what's available in 2014 outside the exchanges?

 

[joe8012]

My current, not very great, understanding was that insurers would still be able to offer underwritten individual policies outside of the ACA exchanges. Have you checked with a HI broker to see what's available in 2014 outside the exchanges?

I checked with our employers broker. He thinks that I will be able to purchase a 10K/pp HSA plan for about $300/mo later this year and it should carry for 12 months into the end of next year. But he is not sure it will still be available after the exchanges open in October. It would be through United Health One.

 

[MichaelB]

My current, not very great, understanding was that insurers would still be able to offer underwritten individual policies outside of the ACA exchanges. Have you checked with a HI broker to see what's available in 2014 outside the exchanges?

Beginning next Jan 1 all new policies must be guaranteed issue - open to all takers. See here http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8327.pdf

The ACA requires significant changes to guaranteed issue laws. Beginning January 1, 2014, all individual and group health plans must guarantee issue policies to all applicants, regardless of health status or other factors. For children under the age of 19, beginning September 23, 2010, issuers were prohibited from imposing preexisting condition exclusionary riders (i.e., an insurance company cannot refuse to pay for chemotherapy for a child with cancer because the child had the cancer before obtaining insurance) and outright coverage denials (i.e., an insurance company cannot refuse to issue a policy to the child because of the child's cancer). The ACA’s guaranteed issue provision applies to all group plans and new plans on the individual market, but does not apply to grandfathered individual plans. Grandfathered plans are those that were in existence as of the date the ACA was enacted (March 23, 2010). These plans, which could be sold to individuals or groups, are exempt from most, but not all, of the ACA’s insurance market reforms.

 

[Bestwifeever]

Beginning next Jan 1 all new policies must be guaranteed issue - open to all takers. See here http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8327.pdf

Just want to comment that Michael has been so helpful with research--the links give so much info and will help DH and I figure out just what to do for the next 2 years with our retiree health care ending, one spouse becoming eligible for Medicare, a probably-pricey Cobra option in the picture, ACA policies, etc. My head has been spinning

 

[Animorph]

Beginning next Jan 1 all new policies must be guaranteed issue - open to all takers. See here http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8327.pdf

Thanks!

 

[samclem]

Do we have details yet on the availability of insurance after Jan 1, 2014 for those don't buy coverage on the exchanges in the 1 Oct - 31 Dec (subject to change, like other ACA features) "window"? Obviously, the exchanges will still be "open for business" since people will be coming off their employer's group plans every day and they'll need to buy individual policies. The tax/penalty for going uninsured in 2014 is low (less than $100 per adult or 1% of earnings, whichever is higher IIRC), and that is assuming the penalties are even one of those portions of the legislation that go into effect as written. Joe8012 says he's healthy now, if he can get a guaranteed issue insurance policy when/if he needs it (accident, sudden illness, etc), that might be a viable alternative for 2014. He won't be alone. In 2015, when he will qualify for the subsidy, he can go shopping for a policy if he didn't need/buy one in 2014.

 

[marko]

Just want to comment that Michael has been so helpful with research--

+1 !! I rely on Michael to provide clear, researched and unemotional information and links! Thank you MichaelB!

 

[MichaelB]

Thanks for the encouraging remarks. A former Moderator, Martha, was tireless in her helpful posting before the PPACA was passed and I found that to be quite inspiring. I also have a significant personal interest, as DW and I are able to pay full rate but still denied individual insurance due to mostly bogus reasons, and the PPACA offers us a path to the same health insurance coverage most others enjoy.

Health insurance has to be one of the most important issues that affect all of us early retirees.

Now, back on topic.

 

[MichaelB]

Do we have details yet on the availability of insurance after Jan 1, 2014 for those don't buy coverage on the exchanges in the 1 Oct - 31 Dec (subject to change, like other ACA features) "window"? Obviously, the exchanges will still be "open for business" since people will be coming off their employer's group plans every day and they'll need to buy individual policies. The tax/penalty for going uninsured in 2014 is low (less than $100 per adult or 1% of earnings, whichever is higher IIRC), and that is assuming the penalties are even one of those portions of the legislation that go into effect as written. Joe8012 says he's healthy now, if he can get a guaranteed issue insurance policy when/if he needs it (accident, sudden illness, etc), that might be a viable alternative for 2014. He won't be alone. In 2015, when he will qualify for the subsidy, he can go shopping for a policy if he didn't need/buy one in 2014.

I detect a question in there somewhere. Continuing coverage regulations under PPACA are similar to what they are today. People can only get new coverage during the enrollment period each year, and at other times if they meet specific conditions. Cornell law has a nice summary, you can read it here 45 CFR 155.420 - Special enrollment periods. | Title 45 - Public Welfare | Code of Federal Regulations | LII / Legal Information Institute

As a general comment not directed to anyone in particular, it is easier for all of us to answer specific PPACA questions when the snarky remarks are left out.

 

[samclem]

I detect a question in there somewhere.

Yep, it's the part ending with "?".

Thanks for the link. According to that info (section 155.420 (d)(6)) there's no doubt joe8012 can enroll if he becomes eligible for advance payment of the credit. Now, how an individual is supposed to know that is the next hurdle.

Joe, you might want to take a look at that same paragraph and see if it, considering the "affordability" of the retiree insurance offered by your former employer, offers you the flexibility you need to buy insurance sometime in 2014 if you actually need it.

As a general comment not directed to anyone in particular, it is easier for all of us to answer specific PPACA questions when the snarky remarks are left out.

That's a great policy for everyone to follow.

 

[joe8012]

Yep, it's the part ending with "?".

Thanks for the link. According to that info (section 155.420 (d)(6)) there's no doubt joe8012 can enroll if he becomes eligible for advance payment of the credit. Now, how an individual is supposed to know that is the next hurdle.

Joe, you might want to take a look at that same paragraph and see if it, considering the "affordability" of the retiree insurance offered by your former employer, offers you the flexibility you need to buy insurance sometime in 2014 if you actually need it.
That's a great policy for everyone to follow.

My wife and I will want insurance in 2014, but not a $1000 a month. I'm hoping I can buy a high deductible plan late this year, as we should have no penalty due to the fact the exchange premiums should be above 8% of 2014 income. UHC has a high ded. policy for $339 that would suffice for next year. I used a 10/18 start date (60 days out). I just don't know how long it will be available.

 

[alaska55]

Posted by MichaelB
Preliminary info on premiums in Florida show some policies will be available for much less than the $1200 - $1400 you estimate

I hope your right but i think you have rose colored glasses on. I have not seen any bronze plans much less than $200 for under 30 year olds. They can go 3x that for older people.

 

[travelover]

...........
I hope your right but i think you have rose colored glasses on. ...........

Michael, are you wearing your rose colored glasses again?

 

[scrinch]

I’ve been doing some research on medi-share. It’s not health insurance but works similar to it. They collect monthly payments from you and pay your medical bills. They’ve been around since 1993 and they are a legal substitute to the ACA. Does anyone here have experience with them or are considering them as an alternative to Obamacare?

No, I don't have any experience with it. But I just thought I would re-post your question to remind everyone what the original question was.

 

[brewer12345]

Medi-Share is not insurance. Medi-Share is a healthcare sharing program where Christians share their financial resources to pay each other’s medical expenses. Medi-Share isn’t insurance. Resources are shared directly between members. There is no pooling of funds as practiced by insurance groups. Christian Care Ministry and the Medi-Share program are not registered or licensed by any insurance entity, nor are we required to be. We do not collect premiums, make promise of payment, or guarantee that your medical bills will be paid. Sharing of medical bills is completely voluntary.

I think you would have to be on smack to trust this nonsense.

 

[Buckeye]

My wife and I will want insurance in 2014, but not a $1000 a month. I'm hoping I can buy a high deductible plan late this year, as we should have no penalty due to the fact the exchange premiums should be above 8% of 2014 income. UHC has a high ded. policy for $339 that would suffice for next year. I used a 10/18 start date (60 days out). I just don't know how long it will be available.

We are currently with Humana in the Tampa Bay area and they are offering to take our policy through 2014. Don't know if the option applies to new policyholders or whether Humana is a choice in your area. I have a very good broker if you want to have him investigate. You can PM me if you are interested.

 

[Katsmeow]

I think you would have to be on smack to trust this nonsense.

While I might not have quite that turn of phrase, after reading the disclaimers that brewer cites to, the phrase that comes to my mind is penny wise, pound foolish. I certainly understand the desire to save money on insurance, I question highly that not having insurance is the way to go. The voluntary nature of Medi-share wouldn't leave me feeling very confident. What if you have some serious health event that costs huge amounts of money? You have no guarantee it would be paid since payment is apparently voluntary.

Also, do you get physician and hospital discounts with Medi-share. With the PPO I use, discounts are often as much as 90% off the published rates. If you don't get discounts with Medi-share even minor events can end up costing thousands. Now, maybe you do get discounts with it some places (I don't know) but that is definitely something to look into.

 

[scrinch]

The voluntary nature of Medi-share wouldn't leave me feeling very confident. What if you have some serious health event that costs huge amounts of money? You have no guarantee it would be paid since payment is apparently voluntary.

Right. And that is when you absolutely need help paying the bills. Or what if a half dozen people in the group come down with terminal cancer one year and each voluntary member owes $50,000 to fund their share of the treatment? Are all the volunteers going to pay then? In my experience, people's good will only goes so far when a significant amount of money is concerned.

 

[joe8012]

Thank you all for you input. Early retirement is scary enough without the uncertainty of healthcare costs.