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This Year Last Chance for Medically Underwritten HSA Plans?
Old 02-25-2013, 08:14 AM   #1
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This Year Last Chance for Medically Underwritten HSA Plans?

I am considering whether I would be be wise to pursue an individual HSA plan at some point this year, near the end if still employed, before the 2014 Patient Protection and Affordable Care Act (PPACA, Obamacare) changes take effect.

My situation:
  • I am currently covered by my employer's HSA plan; but, I expect that to end either this year or next.
    • I am actually hoping to join the class of 2013 or 2014 as ESR/consulting to ease myself into full time ER.
    • If cost savings are significant without fear of attrition (other companies doing the same thing), my employer (well less than 50 employees) end this benefit even if I stay.
  • Mid-40's with no known health issues living in a state with relatively low health insurance premiums for BC/BS HSA policies (which I just discovered last year thanks to others here).

My current thinking is that if a PPACA policy is a better deal for me down the road that I can always move that direction at a later date; but, this may be my last chance to obtain a really low cost HSA eligible grandfathered policy.

Am I missing something important with this plan? Does anyone else see landmines that I may be missing? I have seen a few other posts mentioning a similar approach, including the one clipped below, but no warnings/naysayers/etc. So, am I just being overly cautious/concerned?

Quote:
Originally Posted by GLM View Post
...
What we have picked was in the private market for $506/month - with the same company as we have had so we can keep our Doctors. We like them and they took a long time to find. This coverage is also HSA eligible has a $10,000 deductible and a 25% co-pay up to the $11,200 OOP max. we have never hit the $3000 deductible and obviously hope not to . Note to those who might wonder - I am being charged a 10% ($23/month ) "medical rate up " because of my medications - which total less than $100/ month - and I pay for as long as we do not hit the deductible.

The decision to forgo cobra coverage (besides not intending to hit the deductible) was the thought that we might be better off getting into a plan before the PPACA kicks in next year . I thought it just might give us more options this year and get us in a group that needed to under go underwriting- perhaps mitigating cost increases going forward to some degree. (hey I can hope ) If wrong we can change later.
.....
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Old 02-26-2013, 11:22 AM   #2
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Here's some links about grandfathered plans...

FAQ: Grandfathered Health Plans - Kaiser Health News

Should You Keep Your Grandfathered Health Insurance Plan?


In my situation, I have an HSA, started before 2010 so it is grandfathered. When the exchanges are up, I'll definitely see what it has to offer, but am leaning towards keeping my HSA in the immediate future.
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Old 02-26-2013, 12:37 PM   #3
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Cool, the more I read about this, the muddier it gets for your situation. Here is an interesting quote lifted from Easysurfers links.

If you have a grandfathered plan, then you can keep it even though it will not meet minimum coverage requirements in 2014. If your coverage started after March of 2010, then you will be forced to get a new plan.

Does this mean it's a moot point and you will be forced into the exchanges anyways? Now if you find out the plan you are applying for is truly a grandfathered plan, you can still join it even now, even though you personally have not joined it prior to that March 2010 deadline. All I can add is what I know compared to what I have, and it isn't even close; grandfathered plan wins hands down. My situation: Age 48, currently pay $76 a month for $5500 deductible. A Kaiser "guesstimate link" slotted me around $500 monthly for, I believe a 2k deductible.
Maximum out of pocket for grandfathered currently is under $6500. "New plan" would be $8000. Doesn't sound that different, but in reality it is. I have had no medical expenditures in the three years I have been on this plan. So currently, I would go from about $950 a year, to $6000. My math off the top of my head isn't great, but a 600% increase or so doesn't sound very appealing to me. So I think I will pass, and stick with my grandfathered plan. Other peoples situation may be different, however.
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Old 02-26-2013, 09:07 PM   #4
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Thank you both very much. If I am reading correctly, I have already waited too long in my situation since I would have to be covered by a grandfathered plan through an employer to avoid the coverage before March of 2010 gotcha. (That was the piece that I was missing; I was pretty sure I had to be missing something.)

The good news for me is that I should be able to manage my income enough after ER to qualify for subsidies bringing the cost of some PPACA policies down to a manageable level assuming no more major changes before actual implementation.

My fear, and the situation I was trying to avoid, is that I will be working to afford healthcare after PPACA in the same way that many are currently doing before PPACA. Now, I guess I just have to wait and see what actually rolls out.

Thank you again for providing this very useful information.
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Old 02-26-2013, 09:15 PM   #5
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If you are able to get subsidies, maybe it will be better for you. I didn't actually get my individual plan until summer of 2010. But the individual plan I got through ehealthinsurance was a grandfathered plan, so I am able to be grandfathered. It all can be very confusing.
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Old 02-27-2013, 08:39 AM   #6
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Quote:
Originally Posted by Mulligan View Post
If you are able to get subsidies, maybe it will be better for you.
I keep hearing this sort of thing about people getting subsidies. Even managing their income to make sure to maximize the subsidies.

If someone is truly in poverty, sure they should get help with their medical care. But for folks who aren't poor (and I doubt few here are truly poor) isn't it unethical to expect or take subsidies from your fellow citizens?
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Old 02-27-2013, 01:48 PM   #7
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Quote:
Originally Posted by mpeirce View Post
I keep hearing this sort of thing about people getting subsidies. Even managing their income to make sure to maximize the subsidies.

If someone is truly in poverty, sure they should get help with their medical care. But for folks who aren't poor (and I doubt few here are truly poor) isn't it unethical to expect or take subsidies from your fellow citizens?
Personally, I consider taking the subsidies in exactly the same light as tax planning which is generally seen as above board and has been repeatedly supported by the judiciary in the United States including a somewhat famous quote/opinion by federal judge Hand: Any one may so arrange his affairs that his taxes shall be as low as possible; he is not bound to choose that pattern which will best pay the Treasury; there is not even a patriotic duty to increase one's taxes.

I am not trying to change anyone's opinion on this topic; rather, I am only providing my point of view on the subject.
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Old 02-27-2013, 01:50 PM   #8
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Quote:
Originally Posted by CoolChange View Post

Personally, I consider taking the subsidies in exactly the same light as tax planning which is generally seen as above board and has been repeatedly supported by the judiciary in the United States including a somewhat famous quote/opinion by federal judge Hand: Any one may so arrange his affairs that his taxes shall be as low as possible; he is not bound to choose that pattern which will best pay the Treasury; there is not even a patriotic duty to increase one's taxes.

I am not trying to change anyone's opinion on this topic; rather, I am only providing my point of view on the subject.
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