Poll of What is Your Health Insurance Choice for 2016

[NW-Bound]

I know this is an old thread but thought some might still read it...

Yes, I forgot about this thread. I am surprised that for an ER forum, the most votes went for "employer insurance".

With insurers dropping out like flies, who will be left for us to shop in the exchange next year?

For next year, I would change my vote to "Other", as I may have to go to Mexico or Thailand for healthcare.

 

[shotgunner]

I am single and in my late 50's. I have purchased my insurance through the Exchange starting in 2014. I am technically a HNWI (barely). With paid off vehicles and home my expenses are modest. I was working P/T in '14 and '15. Using my maximum contributions to an IRA and HSA I was able to pay nothing in taxes and still get a refund. Much of my taxable income is CGD's and dividends and although they count towards income for ACA purposes the CGD's are not taxed and the dividends are at 15% and are offset greatly by my personal and standard deduction. In 2015 I had a gross taxable income of about 40K, I paid no federal tax and received a refund for about $3200. This year I am not working so the trick is to have taxable income to put me into subsidy range, I turn 59 1/2 in October so I will take what I need out of a deferred account to get a decent subsidy (aka refundable tax credit). Does it make sense for the government to subsidize me, no, but in my mind when money is blowing down the street it would be stupid not to go catch some it. Odd as it is I will have to start paying taxes at age 65 again but for now I am enjoying the ride.

 

[Montecfo]

Is there any current situation where taxpayers are required to report all assets to the IRS? Can't imagine how complicated that would get - look at how complicated the tax code is now, mostly involved in determining what constitutes 'income'. And given unanticipated consequences, the next step after asset reporting would likely be using assets to means test Social Security.

Shortstop14-
The only situation I can think of there is for estate taxes, which of course exempts a lot of folks. I sincerely doubt this will happen, but it certainly would be easy for financial institutions to report account balances. The means testing of social security generally ends up being an income test, where social security is taxed more heavily as income grows.

With government finances careening toward some future debacle, I would be more worried about government trying to tax retirement assets such as Roths which are supposed to be tax-free.

Let's hope these things do not come to pass. In the meantime, as a low-taxable income person, subsidized ACA makes a lot of sense for me-when we get there. Not yet retired.

 

[pb4uski]

Is there any current situation where taxpayers are required to report all assets to the IRS? .....

Medicaid long-term care coverage is asset based as I recall.

If you are married, you are required to spend down assets to a certain level before long-term care coverage begins and once you die Medicaid can claim against any remaining assets up to the amount paid for your care (like a house, which is protected while you are alive).

 

[ivinsfan]

Medicaid long-term care coverage is asset based as I recall.

If you are married, you are required to spend down assets to a certain level before long-term care coverage begins and once you die Medicaid can claim against any remaining assets up to the amount paid for your care (like a house, which is protected while you are alive).

So in certain states including MN, you do not have to report all your assets to qualify for ACA Medicaid HEALTH INSURANCE COVERAGE, however if you are over 55 and have hard assets, IE real estate, a home, a business the state will file a lien against your estate for the entire cost of the coverage. It's payable when both you and a spouse are dead, or possibly at any sale of the assets.

I have no idea how many states do this, but it can be a pitfall for some. A few people in this state were complaining because there is a written disclosure signature page included, but apparently you are not told about it upfront and might not realize it not a standard sign up signature page.

 

[jim584672]

Medicaid long-term care coverage is asset based as I recall.

If you are married, you are required to spend down assets to a certain level before long-term care coverage begins and once you die Medicaid can claim against any remaining assets up to the amount paid for your care (like a house, which is protected while you are alive).

This is only true if you are 65+, disabled, or blind.

The ACA Medicaid "expanded group" are 18 through 64 yo and have no resource (asset) test. Each state decides on whether to make the "expanded group" eligible. Some states can claim estate recovery for benefits recd for 55 yo or greater depending on how they interpret the Federal law.

If one was under 65 and needed long term nursing home care they would be deemed to be disabled and come under the DAB (disable, aged, blind) group and its rules.

 

[LakeRat1]

Leaning more and more to that Healthcare Ministries and Selfpay .....

 

[ivinsfan]

Leaning more and more to that Healthcare Ministries and Selfpay .....

LakeRat..do you want to start a new thread so it's easier to follow and explain why you are leaning this way. There have been mentions of this in various threads but it gets buried in other subjects.

 

[gmshedd]

I know this is an old thread but thought some might still read it. For those of us without a retiree health plan from employer, it seems to make sense to manage your income so as to qualify for subsidy with ACA. Seems pretty doable for early retirees who are living off their taxable accounts anyway.

Do many folks use this strategy?

Variation on a theme: If you can work part time and participate in a 401k plan, then you can use the 401 and a traditional IRA to tune your taxable income to be in the sweet spot for the ACA subsidy. And if you do this, ALWAYS choose a Silver plan. At the lower MAGI levels, Silver plans come with cost-sharing (reduced deductibles and maximum OOP's). Other plans do not.

 

[LakeRat1]

LakeRat..do you want to start a new thread so it's easier to follow and explain why you are leaning this way. There have been mentions of this in various threads but it gets buried in other subjects.

GotRDone Looking forward to peoples thoughts

 

[shortstop14]

Shortstop14-
The only situation I can think of there is for estate taxes, which of course exempts a lot of folks. I sincerely doubt this will happen, but it certainly would be easy for financial institutions to report account balances. The means testing of social security generally ends up being an income test, where social security is taxed more heavily as income grows.

With government finances careening toward some future debacle, I would be more worried about government trying to tax retirement assets such as Roths which are supposed to be tax-free.

Let's hope these things do not come to pass. In the meantime, as a low-taxable income person, subsidized ACA makes a lot of sense for me-when we get there. Not yet retired.

Thanks, didn't think of estate tax - it's a bit out of the realm of anything I've expected to deal with. And the later-mentioned Medicaid spend-down situations, which I should have thought about having gone through it with my mother. The only asset-based disclosure that was coming to mind was in divorce situations, and I've seen how hairy those can be, with valuation of partnerships, small businesses and encumbered real estate holdings.

And I share the concern with Roth taxation - part of the reason I've prioritized ACA subsidy rather than Roth conversions.