2020 ACA Costs, What did you Actually Spend for Coverage?

[Murph]

To ACA from COBRA

To keep our Ohio doctors, we opted for a silver plan that will cost 1400/mo after the 680 subsidy. HSA eligible with 30% copay, 4K deductible and 13,800 max oop. Sucks.

 

[maestro]

WOW....those subsidies actually put some people at 8 dollars or 0 per month. How is this possible?

In Texas, I am going from $15/mo. in 2019 to ZERO in 2020. [emoji4] Bronze plan with 6500 deductible, just for me. Living off my mega-corp pension and cash to keep MAGI low until I go on Medicare in 2 years at 65. I am blessed.

 

[Ablatus]

Hsa

I was in an HSA healthplan the last 3 years but now I have a found a very similiar plan that is going to save me 2000 a year in premiums. I only go to the Dr. once a year so the higher ded. and out of pocket shouldn't be a problem. Only difference is this is not HSA qualified. The 4550 hsa deduction will only save me 1000 dollars in taxes. So am I missing something here?

I am 60 and switching down to a Bronze so I can contribute max to it and deduct it from my 40k disability teacher retirement income, which is taxable. It grows tax free, like an IRA, but if I use interest/growth funds for medical down the road, I will not have to pay taxes on it, like I would using IRA withdraw funds. Am I thinking this through correctly? Fyi My portion next year, per month in California Both PPO 2020 Silver $540, Bronze $301 (my silver 2019 was $448)

 

[meridiver]

I guess I must be missing something. Why are those premiums shown above so expensive? The folks must have very high income or MAGI. Forking out ~$24k a year PLUS Deductibles seems ludicrous. Unless one's income is so much, then HI Insurance Premium costs become moot.

Perhaps we are simply not as wealthy as some, but if I had to withdraw money from NON qualified accounts to live, I would develop a different strategy to keep healthcare costs low as long as I could before Medicare kicks in.

One possible scenario missing in your analysis is the blessing/curse of passive rental income. DH and I retired a year ago in our mid-50’s. We earn passive net rental income above the subsidy cutoff limit. Since it is monthly rental income, there is no way that I know of to shift the income, take two years at once, or any other timing strategy. (There’s no way to bunch enough of our rental expenses in any given year either). If anyone has any suggestions, I’d love to hear them.

It’s amazing to get that income every month, but on the flip side, we are stuck with about $20k/yr in Health Ins costs until we either sell the property (and take a huge cap gains tax hit), or reach Medicare age. As I said, I’m not complaining, I’m just pointing out an ER scenario where there is no way to qualify for the subsidy.

 

[Canoeboy]

We are new to ACA in 2020. Monthly premium is $714 (with $1499 subsidy) for gold plan in or area of Virginia for a family of 3 with planned MAGI just under the cliff. Saving about 10k/year vs. COBRA for 2019. Gold plans were cheaper than silver.

 

[meleana]

I don't know how you guys have such cheap ACA plans. I went on the NY site- put in $35,000 per yr. income (living off cash first year) (anything under $35,000 for an individual would throw me into Medicaid) and the silver plans still came up around the $300+ per month mark for a silver plan.


In NH- where we will be moving soon- they are less- the threshold is $25,000 (or you go into Medicaid)- but the silver plans (all EPOs' or HMO's) vary between $87 per month and $207. Gold's at $345.


Both of these include an approx. $800 per month subsidy and an cost reduction for out of pocket expenses.


BUT- you cannot go out of network HMO's require referrals.And since I will be new to the state I don't know who my doctors will be.



My other option is $545 or so for retiree medical or Cobra (through my husband's employer since he is retiring)- a PPO plan through Aetna- good in both states and can go out of network. But high deductible plan.



But this would allow me to move without worrying about anything for a while until we get settled, since it is nationwide.



In 18 months I would be eligible for Medicare.


So not sure what to do. Moving the beginning of the year and will be in a flux.

 

[Dtail]

Very large differences between states and sometimes counties in the same state.
We have been blessed in that Florida appears to be one of the best choices for ACA premiums if one manages down their MAGI.

 

[ShokWaveRider]

Very large differences between states and sometimes counties in the same state.
We have been blessed in that Florida appears to be one of the best choices for ACA premiums if one manages down their MAGI.

Very true. What we are coming up against now is, if we took SS and the other Countries we have lived and worked in SS equivalents, along with a modest withdrawal from our IRAs, we would be well over the ACA Cliff. We do not have any heirs and want to manage our stash till we Kark it, hopefully leaving a little for our charities, but not a fortune. The result would be very HI Costs basically equivalent to our US SS payments. Seems like money down the crapper to me. So we delay our SS, and live on cash and cash dividends in order to save that money.

We do have an option of moving to Canada till DW is Medicare age, and then snow birding. We could do the same with the UK too. Then re-evaluating when she hits 65. The Problem there is I will be 70 then and who knows what can happen in between.

I do not know whether the powers that be realize what a worry Healthcare is for the majority of the population, whether Employee or otherwise. Not sure they care either, as all their healthcare costs are pretty much taken care of.

The Saga continues.

 

[steveark]

This year we paid $16k for my wife and myself, or $1309 per month. We actually meet with the insurance people today to figure out 2020. My wife goes on Medicare so it should go down some. My one day a week consulting gig makes six figures so I'm not eligible for any subsidies. I'll go on Medicare in 2021.

 

[Dtail]

Very true. What we are coming up against now is, if we took SS and the other Countries we have lived and worked in SS equivalents, along with a modest withdrawal from our IRAs, we would be well over the ACA Cliff. We do not have any heirs and want to manage our stash till we Kark it, hopefully leaving a little for our charities, but not a fortune. The result would be very HI Costs basically equivalent to our US SS payments. Seems like money down the crapper to me. So we delay our SS, and live on cash and cash dividends in order to save that money.

We do have an option of moving to Canada till DW is Medicare age, and then snow birding. We could do the same with the UK too. Then re-evaluating when she hits 65. The Problem there is I will be 70 then and who knows what can happen in between.

I do not know whether the powers that be realize what a worry Healthcare is for the majority of the population, whether Employee or otherwise. Not sure they care either, as all their healthcare costs are pretty much taken care of.

The Saga continues.

I guess the bright side to some extent of your equation is that it would be much worse if you and the DW had a larger age difference and thus you would be forced to take RMD's while still trying to manage your MAGI for her.

 

[BeanCounter62]

I also pay full rate for ACA (with 8 years to go before Medicare).

Oregon rates increase by age, 2019 was $1,011/mo (gold plan) and 2020 will be $1,086. Extremely limited options in Southern Oregon.

I painfully fell off the ACA cliff twice (due to higher than expected gains in my VG taxable investments). (Cash flow from dividends & gains from investments and rental income used to seem like a *good* thing to have. Improving my tax situation is an issue for another post. I also have income from Rental properties and a Charitable Remainder Trust).

My pacemaker replacement this year maxed out my $6,500 OOP payments. The "list price" of the surgery was $105,000. Insurance paid over $90,000. Debating a silver plan this year - no major surgery expected - still working on my spreadsheet to compare WhatIfs for 2020. Even paying over $12k/year in premiums, it's good for me to be covered.

 

[Cayman]

Another sap paying an absurdly overinflated premium of just over $24,000/year. That's for 2 of us in our early 50's - just the premium, actual healthcare costs will be much more.
Sad to see the state of U.S. healthcare today.