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ACA premium anomaly.....thanks
01-06-2015, 02:42 PM
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#1
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Thinks s/he gets paid by the post
Join Date: Feb 2006
Posts: 4,872
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ACA premium anomaly.....thanks
This will be my first full year of ER, so no earned income, SS or pension yet. Thus my income will be very low...,.. Below the Federal poverty level in fact. I just applied to my state health exchange and was told I qualify for Medicaid program and can get health insurance and pay no premium, the value of my savings and investments doesn't matter. I support the ACA, but this is an anomoly as I can afford to pay something and there are people out there that really need this benefit
__________________
“So we beat on, boats against the current, borne back ceaselessly into the past.”
Current AA: 75% Equity Funds / 15% Bonds / 5% Stable Value /2% Cash / 3% TIAA Traditional
Retired Mar 2014 at age 52, target WR: 0.0%,
Income from pension and rent
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01-06-2015, 02:44 PM
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#2
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Administrator
Join Date: Jan 2008
Location: Chicagoland
Posts: 40,726
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Any tax deferred IRA accounts you can convert to generate taxable income to get you over the minimum?
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01-06-2015, 03:08 PM
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#3
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Sep 2012
Location: Seattle
Posts: 6,023
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Quote:
Originally Posted by MichaelB
Any tax deferred IRA accounts you can convert to generate taxable income to get you over the minimum?
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+1
IRA to Roth conversions count toward your MAGI and thus your ACA qualifying income. You don't need earned income.
If you are ok with the level of medical services on Medicaid though, I don't know why you should feel guilty. You paid for it while you were working.
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01-06-2015, 03:10 PM
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#4
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Thinks s/he gets paid by the post
Join Date: Feb 2006
Posts: 4,872
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Quote:
Originally Posted by MichaelB
Any tax deferred IRA accounts you can convert to generate taxable income to get you over the minimum?
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Yes, I could do that to soothe my guilt or just continue with the plan I currently have. The decision space is complex from a purely mathematical perspective.......and guilt and it becomes almost impossible :
__________________
“So we beat on, boats against the current, borne back ceaselessly into the past.”
Current AA: 75% Equity Funds / 15% Bonds / 5% Stable Value /2% Cash / 3% TIAA Traditional
Retired Mar 2014 at age 52, target WR: 0.0%,
Income from pension and rent
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01-06-2015, 03:14 PM
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#5
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Thinks s/he gets paid by the post
Join Date: Feb 2006
Posts: 4,872
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Yes I agree, but I'm a pinko bleeding heart liberal and prone to guilt. I will probably end up using the 15% tax bracket to do IRA to ROTH conversions.
__________________
“So we beat on, boats against the current, borne back ceaselessly into the past.”
Current AA: 75% Equity Funds / 15% Bonds / 5% Stable Value /2% Cash / 3% TIAA Traditional
Retired Mar 2014 at age 52, target WR: 0.0%,
Income from pension and rent
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01-06-2015, 03:18 PM
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#6
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Sep 2012
Location: Seattle
Posts: 6,023
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I used to feel guilty about things like that before I got spanked on the bottom while held upside down. Now I just go with the flow.
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01-06-2015, 03:45 PM
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#7
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Dec 2007
Location: Denver, Colorado
Posts: 6,258
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Quote:
Originally Posted by nun
and there are people out there that really need this benefit
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And why aren't we attacking whatever it is preventing them from participating? (Assuming, of course, these folks really "need this benefit.")
__________________
"It's tough to make predictions, especially when it involves the future." ~Attributed to many
"In theory, there is no difference between theory and practice. But, in practice, there is." ~(perhaps by) Yogi Berra
"Those who have knowledge, don't predict. Those who predict, don't have knowledge."~ Lau tzu
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01-06-2015, 04:50 PM
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#8
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Mar 2007
Posts: 14,328
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Quote:
Originally Posted by nun
.........I will probably end up using the 15% tax bracket to do IRA to ROTH conversions.
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I think I'd rather have subsidized regular health insurance than Medicaid, just for the quality of care.
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01-06-2015, 05:22 PM
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#9
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Thinks s/he gets paid by the post
Join Date: Jul 2009
Location: North Scottsdale
Posts: 1,545
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my gf who retired last year and had no health insurance after her cobra ran out was freaked about going on the Medicaid rolls. She's a former nurse. We converted roth ira to get her income up to $16500 more or less so that she could go into the exchange. Happy GF means happy BF.
__________________
FIRE'D in July 2009 at 51...Never look back!
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01-06-2015, 06:22 PM
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#10
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Thinks s/he gets paid by the post
Join Date: Feb 2006
Posts: 4,872
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Quote:
Originally Posted by travelover
I think I'd rather have subsidized regular health insurance than Medicaid, just for the quality of care.
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Well it insurance through a commercial insurer on the exchange, I just don't pay any premiums. I have the same PCP as I have now
__________________
“So we beat on, boats against the current, borne back ceaselessly into the past.”
Current AA: 75% Equity Funds / 15% Bonds / 5% Stable Value /2% Cash / 3% TIAA Traditional
Retired Mar 2014 at age 52, target WR: 0.0%,
Income from pension and rent
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01-06-2015, 06:55 PM
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#11
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Mar 2007
Posts: 14,328
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Quote:
Originally Posted by nun
Well it insurance through a commercial insurer on the exchange, I just don't pay any premiums. I have the same PCP as I have now
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Cool. I don't think that would be the case in all states.
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01-06-2015, 07:01 PM
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#12
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Nov 2010
Location: Sarasota, FL & Vermont
Posts: 36,376
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Quote:
Originally Posted by travelover
I think I'd rather have subsidized regular health insurance than Medicaid, just for the quality of care.
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+1 also, won't many providers not take Medicaid patients?
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
Retired Jan 2012 at age 56
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01-06-2015, 07:39 PM
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#13
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Thinks s/he gets paid by the post
Join Date: Oct 2008
Posts: 2,796
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I had to bump up my 2015 income, by doing a Roth conversion, to get to the $16,xxx minimum to avoid Medicaid. The ACA website was was acting like it felt sorry for me to have "not qualified" for Medicaid, and told me how to appeal. My PCP does take Medicaid, but very few specialists around here take Medicaid. I tried to find some concrete examples of how Medicaid coverage is inferior to "regular" insurance, but all I ever got was the basic answer "everyone knows Medicaid is no good". The only definite shortcoming I have found so far is the dearth of specialists who accept it.
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01-06-2015, 07:57 PM
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#14
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Thinks s/he gets paid by the post
Join Date: Oct 2008
Posts: 2,796
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Quote:
Originally Posted by Fermion
..............................
If you are ok with the level of medical services on Medicaid though, I don't know why you should feel guilty. You paid for it while you were working.
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How exactly is the "level of service" different on Medicaid? This question has intrigued me. I do believe it is substandard, but some insurance brokers have assured me it is just as good as regular insurance, except for finding a doctor who accepts it. Oh well, I suppose a lack of doctors who accept it could be reason enough to avoid it.
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01-06-2015, 08:14 PM
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#15
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jul 2008
Posts: 35,712
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I have read that Medicare payments to doctors are lower than from private insurers. It sounds like Medicaid payment is even lower. However, I have not seen some numerical examples.
Maybe it's just another case of getting what one pays for. Doctors want to be better paid for their service, not any differently than any of us.
__________________
"Old age is the most unexpected of all things that happen to a man" -- Leon Trotsky (1879-1940)
"Those Who Can Make You Believe Absurdities Can Make You Commit Atrocities" - Voltaire (1694-1778)
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01-06-2015, 08:28 PM
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#16
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Recycles dryer sheets
Join Date: Mar 2014
Posts: 257
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Medicaid pays poorly but with the ACA there was a significant increase in Medicaid to doctors. However that increase ends this year. Here's one article:
http://www.latimes.com/local/califor...101-story.html
I think it will hard to find a good doctor once these cuts are felt by the MD's practices.
When I was in private practice in Manhattan in NYC pre-ACA the Medicaid fee for an office visit with me as a psychiatrist was $17. No way to pay my office rent at those fees. I couldn't take Medicaid patients into my practice. Some of the Medicaid managed care plans paid better.
Sent from my iPhone using Early Retirement Forum
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01-06-2015, 10:01 PM
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#17
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Jul 2008
Posts: 35,712
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Thanks for the link.
California has one of the lowest Medicaid payment rates in the country. According to data compiled by the California Medical Assn., in April 2014 Medicare paid $45.69 for a basic office visit for a returning patient — more than twice the standard Medi-Cal rate at the time of $18.10. $18.10! Whoa!
Many people do not know what their health care service costs. But as we have had a $10K deductible policy, we have to pay every penny until we exceed that, so we know what everything costs. Per negotiated rate with our insurer, we pay something like $90 per regular visit with our family physician. Recently, I had a fungal+bacterial ear infection, and an otolaryngologist charged me $120 for the exam. Earlier, I went to a Walgreen Walk-in Clinic, and the nurse there charged $80 (her antibiotic cured the bacterial infection, but not the fungal one). The ear specialist gave me the right thing, and the infection cleared up in a few days.
If I were a doctor, I'd love to have patients with private insurance like myself.
__________________
"Old age is the most unexpected of all things that happen to a man" -- Leon Trotsky (1879-1940)
"Those Who Can Make You Believe Absurdities Can Make You Commit Atrocities" - Voltaire (1694-1778)
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01-06-2015, 10:08 PM
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#18
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Thinks s/he gets paid by the post
Join Date: Feb 2006
Posts: 4,872
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On the Medicaid program I get the same PCP as I have now. A state Medicaid person checked in the provider network and I double checked with the Doctor that he takes the state's Medicaid patients. My closest hospital is in network as well as some other great hospitals. I only get emergency coverage out of state and no coverage out of the US. So if I stay in state I don't see how my standard of care will be any less than anyone with regular insurance.
__________________
“So we beat on, boats against the current, borne back ceaselessly into the past.”
Current AA: 75% Equity Funds / 15% Bonds / 5% Stable Value /2% Cash / 3% TIAA Traditional
Retired Mar 2014 at age 52, target WR: 0.0%,
Income from pension and rent
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01-06-2015, 10:42 PM
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#19
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Nov 2010
Location: Sarasota, FL & Vermont
Posts: 36,376
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Sounds like your situation is the exception.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
Retired Jan 2012 at age 56
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01-07-2015, 05:46 AM
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#20
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Full time employment: Posting here.
Join Date: Feb 2008
Posts: 920
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Maybe you paid a larger share of the tax burden than most Americans during your earning years? Then can rationalize a lifetime aggregate producer/parasite ratio that comes out more in your favor.
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