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Old 11-05-2015, 07:14 AM   #41
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My question is, if I go from off market to marketplace, is there a chance I'd get a decline when applying saying that BCBS already has me enrolled by default?
For BCBSSC, if the enrollment system finds a match on personally identifiable information (SSN, birth date, etc.) the new policy automatically cancels the old one on the effective date.
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Old 11-05-2015, 08:57 AM   #42
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For BCBSSC, if the enrollment system finds a match on personally identifiable information (SSN, birth date, etc.) the new policy automatically cancels the old one on the effective date.

Thanks. The answer I like to read .
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Old 11-05-2015, 08:59 AM   #43
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Probably not. When I faced this situation I was concerned BCBS would continue the policy despite not renewing it, but that didn't happen.
Thanks. All these varibles to consider.
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Old 11-08-2015, 09:09 AM   #44
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I'm still on the fence about signing up with coverage from the marketplace or not.

Since FIRE'ing, I have so little income that paying insurance premiums definitely get me above the 10% limit for a tax deduction. For example, say one only makes $20,000 income a year. 10% of $20,000 is $2,000. A premium of $400 a month is already $4800. In otherwords, in my case is there a real benefit to get a premium tax credit through the markeplace, and then reconcile at tax time or does that just add more number crunching and possible hang ups with applying?
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Old 11-08-2015, 09:24 AM   #45
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Depends on how many dependents you have, but $20k may be too little to qualify for subsidies- you may be on Medicaid.

Check this out:

Health Insurance Marketplace Calculator | The Henry J. Kaiser Family Foundation
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Old 11-08-2015, 09:38 AM   #46
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Depends on how many dependents you have, but $20k may be too little to qualify for subsidies- you may be on Medicaid.
And if you're in a state that didn't expand Medicaid, you could be screwed on both ends.
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Old 11-08-2015, 09:46 AM   #47
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Depends on how many dependents you have, but $20k may be too little to qualify for subsidies- you may be on Medicaid.

Check this out:

Health Insurance Marketplace Calculator | The Henry J. Kaiser Family Foundation
I like that calculator site. Thanks.

$20K (remember, family of 1) at my state would qualify for a subsidy.
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Old 11-08-2015, 09:49 AM   #48
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And if you're in a state that didn't expand Medicaid, you could be screwed on both ends.
I feel for those folks.
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Old 11-08-2015, 10:10 AM   #49
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I like that calculator site. Thanks.

$20K (remember, family of 1) at my state would qualify for a subsidy.
Remember, it's not just a premium subsidy you get at that level of income but also cost sharing reduction subsidies if you buy a silver plan. This can result in dramatically lower out of pocket costs if you get sick e.g. deductible of $250 instead of $2500, lower coinsurance and lower maximum out of pocket. You really should check out the exchange plans for your income level.
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Old 11-08-2015, 10:18 AM   #50
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Remember, it's not just a premium subsidy you get at that level of income but also cost sharing reduction subsidies if you buy a silver plan. This can result in dramatically lower out of pocket costs if you get sick e.g. deductible of $250 instead of $2500, lower coinsurance and lower maximum out of pocket. You really should check out the exchange plans for your income level.
Thanks. The lazy part i me was kinda hoping you'd say not worth the effort .

Looks like more homework for me .
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Old 11-08-2015, 10:34 AM   #51
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I'm still on the fence about signing up with coverage from the marketplace or not.
You might consider running a few tax returns and see how it plays-out. My gut feeling is that tax deductions don't mean diddly, especially when you have low income anyway (much of your income is taxed at 0% and 10%). Tax credits, on the other hand, cha-ching! Cash money in your hand! My experience suggests you might need around 250% FPL to keep out of Medicaid territory, so if you can manage around $30K (not sure if you have any traditional IRA's to convert to Roth or not).

So when you open up the tax software (the 2014 version will be good enough), and you put-in the PTC numbers you got from the Kaiser site, you might be surprised at the check uncle sam is willing to send you (look at line 24 on form 8962).

Presuming you are not willing to go without coverage, and you're not a big user of healthcare services, I'd be very surprised if going with, say, a Bronze HSA eligible policy wouldn't be significantly better financially than buying off-exchange. And if you can afford to save some money, you can take $3350 off of your income by putting it into an HSA ($4350 if you're over 55).
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Old 11-08-2015, 02:08 PM   #52
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You might consider running a few tax returns and see how it plays-out. My gut feeling is that tax deductions don't mean diddly, especially when you have low income anyway (much of your income is taxed at 0% and 10%). Tax credits, on the other hand, cha-ching! Cash money in your hand! My experience suggests you might need around 250% FPL to keep out of Medicaid territory, so if you can manage around $30K (not sure if you have any traditional IRA's to convert to Roth or not).

So when you open up the tax software (the 2014 version will be good enough), and you put-in the PTC numbers you got from the Kaiser site, you might be surprised at the check uncle sam is willing to send you (look at line 24 on form 8962).

Presuming you are not willing to go without coverage, and you're not a big user of healthcare services, I'd be very surprised if going with, say, a Bronze HSA eligible policy wouldn't be significantly better financially than buying off-exchange. And if you can afford to save some money, you can take $3350 off of your income by putting it into an HSA ($4350 if you're over 55).
Points well taken. Thanks.
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Old 11-14-2015, 11:43 PM   #53
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So I went ahead and peeked over at the marketplace. Now I see there's an option to put in a doctor and see if the doc is covered as in-network or not for the plan. I went ahead and listed my doctor for the search. Looks like the way things are going, if I want HSA and my doctor, this leaves me with just one plan to choose from . So much for competition.

Well, at least this should make the decision process easier .
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Old 11-15-2015, 06:52 AM   #54
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So I went ahead and peeked over at the marketplace. Now I see there's an option to put in a doctor and see if the doc is covered as in-network or not for the plan. I went ahead and listed my doctor for the search. Looks like the way things are going, if I want HSA and my doctor, this leaves me with just one plan to choose from . So much for competition.

Well, at least this should make the decision process easier .
There are plenty of people who will have NO marketplace plans with their doctor in-network. And since they are HMOs they can't even get out-of-network benefits (at higher OOP cost to them); they are not covered at all.
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Old 11-15-2015, 07:13 AM   #55
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So I went ahead and peeked over at the marketplace. Now I see there's an option to put in a doctor and see if the doc is covered as in-network or not for the plan. I went ahead and listed my doctor for the search. Looks like the way things are going, if I want HSA and my doctor, this leaves me with just one plan to choose from.
Keep in mind that feature is still in 'beta-testing' and the disclaimer should be followed.

Quote:
In this early stage, some data may be missing or inaccurate. We'll be updating it regularly. Check with the insurance company to verify network coverage.
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Old 11-15-2015, 08:46 AM   #56
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Keep in mind that feature is still in 'beta-testing' and the disclaimer should be followed.
Thanks for the reminder about the "beta-testing".
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Old 11-15-2015, 11:55 PM   #57
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Anyone here know anything about a new plan called "Oscar?" It is available in only a few states including my home state of New York. Not wanting to remain with BCBS (premiums rising 14%, my recent fiasco with Express Scripts, their mail-order pharmacy), I have been looking elsewhere. Oscar has all of my doctors in their network, good coverage for my costly (Tier 2) prescription drug, and no mail-order requirement. Their Simple+Silver plan has free labwork at Quest Diagnostics, another plus.


As long as I can stay out of the hospital (I was in the hospital for nearly 2 weeks back in the summer) I won't come anywhere near $2,000 in OOP costs. And Oscar's premium will be 10-15% lower than BCBS for 2016. Looks like I'll switch to Oscar.


Question: Is there anything I should do with regard to canceling my BCBS policy at the end of the year? Or do I just simply not pay their January 2016 premium? I do have a doctor appt in late December which they will be obliged to cover fully (no cost to me because I have already exceeded my max OOP amount).


I don't seek any monthly premium assistance because I always owe federal income taxes so the subsidy I calculate at the end of the year will net out part of (or all) the taxes owed. The NY Marketplace website has always rejected my income verification attempts (annual brokerage statements) anyway, so what's the point?
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