Obamacare and early retirement

[rbmrtn]

Quote:

Originally Posted by FIREd Am I reading this incorrectly? In my former place of residence, the $12,700 limit does indeed apply to the combination of medical and drugs (maximum out of pocket cost is the premium + $12,700 for the 2 of us).

Try going directly to Anthems site and get a quote, or the coveredCA site. I did a quick look with some random numbers and zip code and they show the deductible is for medical+drugs.

[FIREd]

Quote:

Originally Posted by rbmrtn Try going directly to Anthems site and get a quote, or the coveredCA site. I did a quick look with some random numbers and zip code and they show the deductible is for medical+drugs.

Thanks, I checked CoveredCA. I should have gone straight to the source.

[joe8012]

I'm in the same boat as you ripper1. I need to draw about 65-70K from IRA's to live on. I am paying $500/mo for a non-aca 10K ded plan for my wife and I. We moved to Fl and will loose our policy the end of this year. The ACA comparable plan will cost $1474/mo(Florida Blue Options 1419) with a $12500 ded. That is nearly triple my current cost for less coverage and the ACA plan is up 22.1% from last year.

[Mr._Graybeard]

I foundered when I tried to navigate the marketplace website last year, so I called a private insurance broker who was happy to help me fulfill my health insurance needs at the most economical cost. We're paying $149 per month after tax credits (two adults, 60 and 61) on an anticipated modified adjusted gross income of $40,000 (I may have to return some of that tax credit when I file my income tax in April).

The broker got a commission from Anthem Blue Cross and regularly reminds me that he's ready to help again when open enrollment begins in November. His services cost me zero.

NPR recently had an article on how private-sector insurance brokers were fitting into the state marketplace in Kentucky. I'd recommend that anybody who is uncertain how to get the most out of the ACA marketplace contact a broker to work as their advocate.

[ERhoosier]

Quote:

Originally Posted by Katiek I looked at some plans on health sherpa and they all seemed to be HMO or EPO. I didn't see any PPO plans although this was just a summary page, so I'm sure there were more offerings. I've had a PPO plan for years that I like and I'm hesitant to switch to an EPO. I need to look at the plans on the private exchange my company uses for retirees to see if they offer PPO plans there. If so, that would be one incentive for me to keep working until I can officially "retire" despite some of the benefits of ACA.

Also functionally true in my region. Relevant OON coverage is a fantasy. The ONLY non-HMO/EPO Exchange Plan here is a Bronze Plan with a family OOP max for OON care of $60,000!!! No wonder they label it a POS Plan
Basically, you are right that in many (not all) regions to get 'real' PPO HI you must keep a j#b with decent employer-sponsored HI benefits. In many regions (inc mine), Exchange Plan insurance means 2nd class status for HC

[Major Tom]

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Originally Posted by leyland It strikes me as a bit odd that you can actually have a substantial amount of money and still get hefty Obamacare subsides. Anyone using Healthcare.gov for health insurance and getting a hefty subsidy?

I'm on Medi-Cal (the California version of Medicaid). About half of my assets are in taxable accounts, and the dividends and interest from those put me under the required 133% of the FPL for Medi-Cal eligilibility.

My experience with the low income healthcare system in my county has been that it depends very much on which clinic you are signed up with. The first one I went to was in a poorer part of the area, and was not an enjoyable experience at all. Every time I wanted to visit the doctor, I ended up having to wait several hours (this particular clinic did not give appointments - everything was on a first-come first-served basis). To make things worse, the place was very crowded and let's just say that I wasn't exactly sharing the waiting room with a particularly choice segment of society (nice way to put it).

Then I decided to sign up with a clinic a few miles away in Berkeley, and the difference was like night and day. The premises are large, bright, and airy. The clientele represent a much wider cross-section of the community and things are done on an appointment basis, so the wait times are much better. On top of that, after trying a few different doctors, all of whom were pleasant, I have finally found one who welcomes questions, and responds to them in an intelligent, helpful, and unhurried fashion. He's an absolute gem.

While I have found that I do have to wait longer to see a doctor now that I am on Medi-Cal (Medicaid) than I did when signed up with an HMO through AETNA and my former employer, my clinic operates a system of prioritization that is very tolerable. For regular appointments, I typically have to wait a month but if I have a pressing issue, they will make time and see me the same day. About 6 months ago, I had a dull pain in my abdomen which concerned me. While there are a number of possible explanations, at least some of them can be serious. I explained this, and got to see a doctor the same day. I was scheduled for an ultrasound, which I had the next day. The technician gave me a guided tour of my insides as she was performing the ultrasound. She put my mind at rest so that by the time I saw the doctor again, I had already figured there was no cause for worry. My problem was gas, possibly due to my heavy regular intake of Brussels sprouts

It was good to be able to see a doctor swiftly.

So, to make a long story short, yes - the PPACA has indeed helped with my ER a great deal. Many here would not want to go on Medicaid but I think I got lucky and found a good clinic/hospital system.

[Jaded salami]

Quote:

Originally Posted by ripper1 Yeah, as long as you can keep your income under 62,000 you can get subsidies. Unfortunately for me and my wife our pension is over that somewhat and we will be stuck with sky high premiums and deductibles. It is funny how someone with 6 and 7 figure incomes will only have to pay as much as someone who barely makes 62,000.

Yes, I'm keeping our investment income under 50k, so my subsidy (Washington state) is around $4k a year. It was a factor in convincing my wife we were ok to retire, she was very surprised at the amount of the subsidy.

We don't feel guilty at all about it. We are in this financial position because of LBYM, sound investing and making smart money decisions. The ACA afforded us an opportunity to do more of the same.

[pb4uski]

Quote:

Originally Posted by ripper1 ...It is funny how someone with 6 and 7 figure incomes will only have to pay as much as someone who barely makes 62,000.

Yeah, because it is well known that it costs twice as much to provide health care to someone who makes $124,000 as it does to someone who makes $62,000. And 4 times as much for someone who makes $248,000.

[Snidely Whiplash]

Quote:

Originally Posted by pb4uski Have you looked into catastrophic plans? We have them and have been quite happy but we are healthy and really haven't had any claims.

I have looked into the catastrophic plans. Very few practitioners (none I would use) in my area participate with those plans. I hope your experience remains as good if you need to use your insurance.

Given the responses to the original poster, clearly the majority here are winners under the ACA. My opinion of the legislation is significantly lower since I'm one of the losers.

[Zathras]

I would have retired with or without the ACA.
I do sleep a lot better knowing it isn't as easy for the insurance company to drop me at any moment and the lifetime limit is gone.
My rates have also gone down a bit which I won't complain about.
No subsidies here, but that is just fine with me.

[Looking4Ward]

Quote:

Originally Posted by pb4uski Yeah, because it is well known that it costs twice as much to provide health care to someone who makes $124,000 as it does to someone who makes $62,000. And 4 times as much for someone who makes $248,000.

+1

[FUEGO]

To the OP, yes the ACA makes early retirement a lot easier for us.

Our kids would have been covered under the children's health insurance program (aka medicaid) regardless of the ACA. Now, the adults in the household will be able to get guaranteed issue coverage at a low price (with heavy subsidies).

Without ACA, we would probably have to work a couple extra years to cover the cost (in pure dollar terms and unpredictability) of private market insurance. And if we were denied coverage at some point, one of us would have to go back to work for HI.

[Snidely Whiplash]

Quote:

Originally Posted by ripper1 Yeah, as long as you can keep your income under 62,000 you can get subsidies. Unfortunately for me and my wife our pension is over that somewhat and we will be stuck with sky high premiums and deductibles.

Quote:

Originally Posted by joe8012 I'm in the same boat as you ripper1. I need to draw about 65-70K from IRA's to live on. I am paying $500/mo for a non-aca 10K ded plan for my wife and I. We moved to Fl and will loose our policy the end of this year. The ACA comparable plan will cost $1474/mo(Florida Blue Options 1419) with a $12500 ded. That is nearly triple my current cost for less coverage and the ACA plan is up 22.1% from last year.

Well, in a misery loves company kinda way, at least I'm not feeling like the only loser in this whole deal.

And I'm not impressed with those who argue that my increased premiums would have happened with or without Obamacare. What happened to the savings we were all told would accompany the passage of Obamacare?

Quote:

Originally Posted by Jaded salami We don't feel guilty at all about it. We are in this financial position because of LBYM, sound investing and making smart money decisions. The ACA afforded us an opportunity to do more of the same.

Im not following your thinking here. Are you equating the lack of guilt ref: the subsidy with your lifestyle and smart money decisions? How's that work?

For those who support the subsidy, I'm curious where you think that money comes from? I mean, philosophically you must view it as your right to get your healthcare subsidized, so the subsidy coming from the US "general fund" is OK?

[Chuckanut]

Quote:

Originally Posted by Zathras I do sleep a lot better knowing it isn't as easy for the insurance company to drop me at any moment and the lifetime limit is gone.

+1

The fear of losing health insurance or not being able to get it, or get it with to many exclusions is gone. The medical establishment could have done themselves a huge favor if they had changed this before the ACA.

IMHO, will help open some jobs for younger people as we older people retire. It would open more and better jobs is they get rid of the stupid 30 hour rule. Or better yet find a way to divorce health insurance from employment.

[rodi]

Quote:

Originally Posted by Major Tom So, to make a long story short, yes - the PPACA has indeed helped with my ER a great deal. Many here would not want to go on Medicaid but I think I got lucky and found a good clinic/hospital system.

Friends of ours were on "healthy families" here in CA which was an insurance program for folks higher then the federal medicaid income - but still low income... that got rolled into Medi-Cal with ACA and coveredCA. They didn't like the new label (stigma) -but their son just spent 2 weeks in/out of Childrens hospital with a really nasty case of lyme disease. He got excellent care and specialists tripping over themselves to look at his case. I was impressed with the coverage and care (not to mention the private room.) I think their concerns about being moved to Medi-Cal were alleviated by this incident.

[FUEGO]

Quote:

Originally Posted by rodi Friends of ours were on "healthy families" here in CA which was an insurance program for folks higher then the federal medicaid income - but still low income... that got rolled into Medi-Cal with ACA and coveredCA. They didn't like the new label (stigma) -but their son just spent 2 weeks in/out of Childrens hospital with a really nasty case of lyme disease. He got excellent care and specialists tripping over themselves to look at his case. I was impressed with the coverage and care (not to mention the private room.) I think their concerns about being moved to Medi-Cal were alleviated by this incident.

+1 on medicaid (or whatever nice name they use for it) for kids. Never heard anyone I know complain*, and many I know have kids on it.

It's looking like my kids will end up on the medicaid for kids plan since I think that's how low to moderate AGI households get Exchange insurance when you have kids. I'm not sure if paying extra to have them on our silver plated silver plan (at AGI of 133% of FPL) is an option or what the cost increment would be, or whether there would be any real benefit/detriment for our perfectly healthy children. The OOP costs will be way lower than our current HDHP, not that we'll overconsume medical services just for fun.

* Well, there was one mom who complained that her three kids couldn't get free braces for cosmetic reasons. Then after some wrangling she got 2 of them braces for free after some dentist somewhere found some medical reason to recommend braces. And one mom complained about having to attend a 1 hr prenatal class in exchange for getting five figures of free medical care.

[pb4uski]

Quote:

Originally Posted by Snidely Whiplash I have looked into the catastrophic plans. Very few practitioners (none I would use) in my area participate with those plans. I hope your experience remains as good if you need to use your insurance....

We were fortunate that our cat plan has the exact same network as our bronze plan (same carrier and according to them, same network for any skeptics).

[Major Tom]

Quote:

Originally Posted by pb4uski We were fortunate that our cat plan has the exact same network as our bronze plan

My brain wasn't in full gear when reading this and for a couple of seconds, I was wondering what possible connection a pet insurance plan could have to the PPACA

[pb4uski]

Quote:

Originally Posted by Major Tom My brain wasn't in full gear when reading this and for a couple of seconds, I was wondering what possible connection a pet insurance plan could have to the PPACA

OK, I'm too lazy to type out catastrophic... I'm retired!!!

[Fermion]

Quote:

Originally Posted by Snidely Whiplash For those who support the subsidy, I'm curious where you think that money comes from? I mean, philosophically you must view it as your right to get your healthcare subsidized, so the subsidy coming from the US "general fund" is OK?

The money comes from that vast pile that bails out banks, underwater homeowners, and underfunded public pensions.