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Old 10-30-2013, 02:17 PM   #1
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We can sign up for 2014 plans now (effective Jan.) directly with BCBS, Aetna etc.
What downside may there be?

If we choose an exchange plan I would think we can work the subsidy in at some point in 2014.
And if we choose silver probably cost sharing as well.

Any opinions?
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Old 10-30-2013, 02:23 PM   #2
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Originally Posted by Refresher View Post
We can sign up for 2014 plans now (effective Jan.) directly with BCBS, Aetna etc.
What downside may there be?
You might want to investigate this:

Quote:
New tax credits, available to individuals earning less than 400 percent of the federal poverty level, or about $46,000 per year, can only be accessed through new ACA insurance marketplaces. Those who purchase coverage outside the exchanges cannot claim subsidies, even if they qualify for them, according to the Centers for Medicare and Medicaid Services, the agency overseeing implementation of the ACA.
How Some Americans Could Miss Out On Obamacare Subsidies In 2014 | TIME.com
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Old 10-30-2013, 02:34 PM   #3
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That certainly is a good reason to wait.

I'm wondering if enrollment is not possible by Jan 1
If we can buy a plan on our own then cancel it and enroll when the Federal website is able to enroll everyone.
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Old 10-31-2013, 06:24 AM   #4
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The more I think about this the more it appears as a real issue. I was under the (obviously mistaken) belief that tax credits would flow as long as the policy was offered on the exchange, even if it was not purchased there. This is not the case. I see two options right now. One is to identify another exchange that is authorized to enroll subsidy-eligible candidates and enroll there. The other is to find a local navigator team and ask them for help. The navigator's will be swamped, so if this is the options, the sooner the better...


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That certainly is a good reason to wait.

I'm wondering if enrollment is not possible by Jan 1
If we can buy a plan on our own then cancel it and enroll when the Federal website is able to enroll everyone.
No reason why not. The first month premium must be paid by 12/15. I wouldn't pay it 'til the 14th anyway , by then the problems may be fixed or not, but at least we'll have a better idea of what the options are.
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Old 10-31-2013, 06:51 AM   #5
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We can sign up for 2014 plans now (effective Jan.) directly with BCBS, Aetna etc. What downside may there be? If we choose an exchange plan I would think we can work the subsidy in at some point in 2014. And if we choose silver probably cost sharing as well. Any opinions?
Not sure if it's widespread but you can buy subsidized coverage on the Blue Cross of Florida website. You register with BCBS, they then shoot you directly to the exchange to get qualified for subsidy, after which the Exchange shoots you back to the BCBS website for direct enrollment in one of their plans. Believe it or not, THIS one actually works!
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Old 10-31-2013, 07:11 AM   #6
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Not sure if it's widespread but you can buy subsidized coverage on the Blue Cross of Florida website. You register with BCBS, they then shoot you directly to the exchange to get qualified for subsidy, after which the Exchange shoots you back to the BCBS website for direct enrollment in one of their plans. Believe it or not, THIS one actually works!
Good point, and helpful.
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Old 10-31-2013, 07:40 AM   #7
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I'm not sure if this applies anywhere but Texas....

The ehealthinsurance site has no active Aetna policies but there is a note that says Aetna does not offer policies that won't go into effect more than 60 days in the future. If so, Aetna policies should show up in the next few days.

The ehealthinsurance site also has a link to apply for the subsidy. I haven't followed the link but this probably works like the Fl BCBS link described earlier.

Of the policies offerred, I can't see the value of buying the silver or gold plans. The OOP seems to be about the same as the bronze plans when you adjust for the higher premiums. The mucho higher premiums overwhelm any savings you might get in having a copay for doctors and meds unless you really live at the doctor's office.

My bottom line is that now DW and I will pay about $12,000/yr for a $6,000 joint deductible/max OOP versus the no longer available Texas High Risk Pool of $15,000/yr - $7,500 individual deductible.
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Old 10-31-2013, 07:51 AM   #8
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I just check out Blue Cross of Texas and they tell you that you do not get a credit if you do not do something up front...

This seems that it is not following the little that I know of the law.... I would think that if I qualified when I fill out my tax return I would get it.... if not, this is really stupid...


As an example.... if you asked me at the beginning of this year if I would qualify I would have said 'no way'.... but now that I lost my job I WILL qualify.... if I was buying my own insurance I would not have signed up with a tax credit option at the beginning of the year so I would lose out..... REALLY STUPID....


I also bet that when I do sign up, it will tell me that I do not qualify as my income that is probably checked does not qualify.... not a big deal for me if I got the credit on the tax return, but still....
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Old 10-31-2013, 08:25 AM   #9
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This seems that it is not following the little that I know of the law.... I would think that if I qualified when I fill out my tax return I would get it.... if not, this is really stupid...
Be careful. Anytime I have pointed out anything about the ACA or how it was created that is less than perfect I have received a message from a moderator.
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Old 10-31-2013, 09:42 AM   #10
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Be careful. Anytime I have pointed out anything about the ACA or how it was created that is less than perfect I have received a message from a moderator.

I know.... I have received some also.... but this was not a political statement.... at least it was not intended as one....


Just checked ehealthcare as someone else had put it down.... and guess what.... two low cost bronze plans from BCBS that are almost similar.... and then a $200 jump to the next bronze plan... so I guess the credit is based on that low cost plan that is an HMO that does not have any of my docs....


However, it does look like I can get a plan that is similar to my old company that is a bit cheaper than I have under COBRA.... so that is a good thing....
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Old 10-31-2013, 09:46 AM   #11
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The more I think about this the more it appears as a real issue. I was under the (obviously mistaken) belief that tax credits would flow as long as the policy was offered on the exchange, even if it was not purchased there. This is not the case. I see two options right now. One is to identify another exchange that is authorized to enroll subsidy-eligible candidates and enroll there. The other is to find a local navigator team and ask them for help. The navigator's will be swamped, so if this is the options, the sooner the better...
Yeah, the problem is that the tax credit (subsidy) and cost-sharing (if any) are *only* available through the exchange. Which means that households that know they will be eligible for neither don't have to go near healthcare.gov, but everyone else pretty much does.

Another danger, of course, is that people with coverage ending on December 31 (including yours truly, DW is being covered by a Gold-level plan by her employer but not me) need to actually complete the process by December 15 -- with all the glitches out of the system -- or risk being hung out to dry and starting 2014 uninsured. I do have some worst-case options that can be invoked if I still can't get anything done by November 22, but would rather not go there.
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Old 10-31-2013, 09:55 AM   #12
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Just checked ehealthcare as someone else had put it down.... and guess what.... two low cost bronze plans from BCBS that are almost similar.... and then a $200 jump to the next bronze plan... so I guess the credit is based on that low cost plan that is an HMO that does not have any of my docs....


However, it does look like I can get a plan that is similar to my old company that is a bit cheaper than I have under COBRA.... so that is a good thing....
I can get a policy that's less than my COBRA but it's on a BCBS HMO with no "out of network" options. There are several bronze options that are PPO with either a $5,000 or $6,000 deductible with that also being the max OOP. Monthly costs are close. I'm not sure what's different other than that.

There was a note that Aetna doesn't advertize policies that start more than 60 days in the future. I'm curious if they will have anything better. When I first checked ehealthinsurance.com there were only two providers. Now I think there are four. Unfortunately, none of the new ones look better than the original BCBS policies.

I can't imagine you getting a policy less than COBRA unless it has fewer benefits or you are well below 50 yo.
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Old 10-31-2013, 09:59 AM   #13
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I can't imagine you getting a policy less than COBRA unless it has fewer benefits or you are well below 50 yo.
For what it's worth, ex-Megacorp just sent me an annual COBRA open enrollment packet in case I wanted to sign up for anything in early November.

The HSA-eligible plan I used to have (roughly Silver level coverage) would be $387/mo for me only, and would be $1,046 for DW and me. (Why I cost $387 and it would cost $659 to add her is beyond me, since I'm no longer subsidized and she's three years younger.) A Gold-level PPO would cost $1,567 per month for both of us. Ouch! (Needless to say, I'm not doing any of this.)
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Old 10-31-2013, 10:02 AM   #14
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I just check out Blue Cross of Texas and they tell you that you do not get a credit if you do not do something up front...
It's pretty much that way all around.

(Caution: Legislative and regulatory sausage-making ahead) In one of the early rounds of dickering, there was a 'Proof of Insurance' certificate that would be sent out, similar to a 1098 or 1099 reporting form. You would file this form to get the tax credits or next years subsidy. It was pointed out however that this was PAPERWORK (O noes!) which there was already too much of. Never mind that under the 2013 and earlier system I have to keep a dozen cancelled checks and old policy paperwork for seven years if I deduct my medical insurance expense, which this one form would have replaced. A real problem was also pointed out, similar to one that exists in many states requiring auto insurance to register or renew a car, that someone might buy insurance, submit the proof to claim the subsidy, and drop the insurance. The online tracking through the exchange was proposed as a way to avoid this.

It ain't perfect by a long shot, but it's what we got. I don't expect to get the subsidy, but I'll jump through the hoop to qualify for the tax credit, just in case. Heck, look at all the other silly things I do like tax loss harvesting, or saving every home improvement receipt for the past 30 years, just in case...
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Old 10-31-2013, 01:34 PM   #15
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The HSA-eligible plan I used to have (roughly Silver level coverage) would be $387/mo for me only, and would be $1,046 for DW and me. (Why I cost $387 and it would cost $659 to add her is beyond me, since I'm no longer subsidized and she's three years younger.) A Gold-level PPO would cost $1,567 per month for both of us. Ouch! (Needless to say, I'm not doing any of this.)
We just got the premiums next year for DH's retiree coverage:

Unsubsidized:

Regular PPO - per month - $1852 for retiree and spouse; $5370 for retiree and family (this would be a retiree with spouse and children)

HDHP - per month - $1518 for retiree and spouse; $2001 for retiree and family

Thankfully, we get subsidized coverage:


Regular PPO - per month - $2780 for retiree and spouse; $3665 for retiree and family (this would be a retiree with spouse and children)

HDHP - per month - $954 for retiree and spouse; $1256 for retiree and family

I can't imagine anyone choosing to go for the regular PPO which has a $750 deductible versus the HDHP which was a $3000 deductible (these are family deductibles).

In our case, DH is on Medicare so we need coverage for me and kids and that is $780 a month on the subsidized plan. Not horrible - but an increase of $301 a month from this year!


Luckily
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Old 10-31-2013, 01:59 PM   #16
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I can't imagine anyone choosing to go for the regular PPO which has a $750 deductible versus the HDHP which was a $3000 deductible (these are family deductibles).
Some things don't make sense. For example, in my wife's plan for 2014 her church is sponsoring her for the Gold level plan. If we wanted to, we could "buy up" to the platinum plan for an extra $1450 a year. But on that plan, the deductible is only $500 less, the OOP max is only $600 less and the copays are the same in either case (20%). All coverages apart from the deductible and OOP max are identical.

So in reality you could *never* construct a scenario in which taking the Platinum plan is better.
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Old 10-31-2013, 02:01 PM   #17
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Some things don't make sense. For example, in my wife's plan for 2014 her church is sponsoring her for the Gold level plan. If we wanted to, we could "buy up" to the platinum plan for an extra $1450 a year. But on that plan, the deductible is only $500 less, the OOP max is only $600 less and the copays are the same in either case (20%). All coverages apart from the deductible and OOP max are identical.

So in reality you could *never* construct a scenario in which taking the Platinum plan is better.
You are forgetting the mathematical IQ of the general public. See my sig line.
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Old 10-31-2013, 02:20 PM   #18
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You are forgetting the mathematical IQ of the general public. See my sig line.
I just realized the $1450 a year difference was for "employee plus spouse" which wasn't offered (at our request to keep me eligible for the exchange). For employee only it was "only" $900 more. Not that changes the bad math....
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Old 10-31-2013, 02:42 PM   #19
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I can get a policy that's less than my COBRA but it's on a BCBS HMO with no "out of network" options. There are several bronze options that are PPO with either a $5,000 or $6,000 deductible with that also being the max OOP. Monthly costs are close. I'm not sure what's different other than that.

There was a note that Aetna doesn't advertize policies that start more than 60 days in the future. I'm curious if they will have anything better. When I first checked ehealthinsurance.com there were only two providers. Now I think there are four. Unfortunately, none of the new ones look better than the original BCBS policies.

I can't imagine you getting a policy less than COBRA unless it has fewer benefits or you are well below 50 yo.

Actually the plans listed on ehealthcare seem better than what I have with COBRA.... I am over 50 by a few years, but DW is a few under.... with 2 kids...

The BCBS plans are the HMOs, but do not have my docs.... the first Humana (what I have now) is over $200 per month more... that is a lot of cost to keep my docs...
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Old 10-31-2013, 03:25 PM   #20
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The more I think about this the more it appears as a real issue. I was under the (obviously mistaken) belief that tax credits would flow as long as the policy was offered on the exchange, even if it was not purchased there.
I think you can do this, with qualification. You can be be enrolled in exchange plans without going through the exchange. Your insurer may enroll you in exchange subsidized plans they offer as was mentioned about FL, online brokers like ehealth are supposed to be able to do it but they have same problem with the FED data hub not working so they can't until they get their system working.

Here's a couple of IRS links on the credit; it does have to be an exchanged purchased plan, it can be in the form of advanced credit or taken when taxes are filed.

Questions and Answers on the Premium Tax Credit
The Premium Tax Credit

ehealth CEO offers to run FED exchange

EHealth CEO offers to help run Obamacare website - NBC News.com
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