2022 ACA Exchange Experiences

[PaunchyPirate]

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Originally Posted by Murf2 It went well for me. Easy sign up as I had no changes. I haven’t heard from BCBS yet & can’t remember what went on last year. I do have a question, though. The listed price on the exchange will all credit applied was more than 8.5% of MAGA. Does this get adjusted by the insurer or do I have an issue? Thanks Murf

What level of coverage did you sign up for? If you went with a higher priced Silver plan or a Gold plan, then your payments will be higher.

The 8.5% is your maximum you will pay for the second lowest cost Silver plan in your location. Your subsidy will be calculated to ensure that. If you then take that subsidy and use it on a Gold plan, you will have to pay more.

[Murf2]

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Originally Posted by PaunchyPirate What level of coverage did you sign up for? If you went with a higher priced Silver plan or a Gold plan, then your payments will be higher. The 8.5% is your maximum you will pay for the second lowest cost Silver plan in your location. Your subsidy will be calculated to ensure that. If you then take that subsidy and use it on a Gold plan, you will have to pay more.

Thanks for the reply! I think I knew that at one time.[emoji846]

Kinda a bad deal though. I had to go up several plans to find one that had my doctors covered.
Still it’s a good deal overall.

Thanks again
Murf

[RetiredAndLovingIt]

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Originally Posted by Murf2 Thanks for the reply! I think I knew that at one time.[emoji846] Kinda a bad deal though. I had to go up several plans to find one that had my doctors covered. Still it’s a good deal overall. Thanks again Murf

I ran into that as well. If I take the 2nd lowest cost silver plan ( Blue Shield California) I will pay less than $500 for the whole year. If I choose (which I probably will) my preferred insurance company Kaiser, it will cost me close to $2000.
The SLCSP is also percentage based on your income so it's 2% or so.

[FLSUnFIRE]

Kept the same Bronze Plan HSA and was pleased to see that my premiums went up only 5%. Since this is my first year not w*rking, I estimated my income as $35K so I'll be paying much less than the full price in 2022. I'll probably ensure my MAGA is lower to get the full subsidy but I decided to be a little conservative. It was pretty darn easy for my first renewal.

[connor77]

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Originally Posted by tominboise Us too. Never imagined insurance would be this affordable.

Isn't it so affordable because someone else is paying for your insurance? My wife and I are about to retire but are not feeling great about having others subsidize our health insurance.

Since it seems most people on this site have enough money to retire early it sure seems probable that they could also buy their own insurance without needing others to subsidize it for them.

What am I missing or is this just the way it is in order avoid paying $2,500 a month for an off the marketplace plan?

[qwerty3656]

In Michigan, even if I put my income right at 133% of poverty, I would still pay over $700 a month for insurance (for 3 people) for lowest silver plan - way more than 8.5%?

Edit: Assuming anything under $30k and you are forced onto medicare.

[USGrant1962]

My Maryland Bronze HSA HMO went up 11.75%, unsub.

[Choosehappy]

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Originally Posted by connor77 Isn't it so affordable because someone else is paying for your insurance? My wife and I are about to retire but are not feeling great about having others subsidize our health insurance. Since it seems most people on this site have enough money to retire early it sure seems probable that they could also buy their own insurance without needing others to subsidize it for them. What am I missing or is this just the way it is in order avoid paying $2,500 a month for an off the marketplace plan?

The price of healthcare on the ACA in Arizona is ridiculously expensive. We are going to have a Silver EPO plan that’s $1550/mo. before subsidies, $1045/mo. after. We’re purposefully keeping our expenses down to take advantage of the credit. It may seem reasonable, but the out of pocket for the year is $17000. That’s crazy. This year we’re on COBRA PPO paying $1275/mo with an out of pocket of $8000. Silver PPO ACA plans start at $2300/mo.

[PaunchyPirate]

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Originally Posted by qwerty3656 In Michigan, even if I put my income right at 133% of poverty, I would still pay over $700 a month for insurance (for 3 people) for lowest silver plan - way more than 8.5%? Edit: Assuming anything under $30k and you are forced onto medicare.

What income are you inputting? Poverty level is $21,960 for a family of three this year. I get $29,280 for 133% of that (although maybe I don’t know how to calculate that correctly). So, yes, that amount would be forced to Medicare.

Using $35,000 for a fictitious 3 person family in Wayne county, Michigan, I see Silver plans as low as $9.69 per month and they have Cost Sharing enhancements to lower deductibles and copays.

[BubbaChris]

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Originally Posted by connor77 Isn't it so affordable because someone else is paying for your insurance? My wife and I are about to retire but are not feeling great about having others subsidize our health insurance. Since it seems most people on this site have enough money to retire early it sure seems probable that they could also buy their own insurance without needing others to subsidize it for them. What am I missing or is this just the way it is in order avoid paying $2,500 a month for an off the marketplace plan?

I can understand how this can be interpreted as unfair at a micro level (ACA Premium Tax Credits). I could complain about my tax dollars going towards education when we never had children and it's been well over a decade since either of us were enrolled in college level courses.

Similar arguments can also be made about how the Social Security dollars that were being deducted from my paychecks were going into the pockets of then-current retirees. I'd much rather they had been going into the equivalent of a 401k account where my contributions were effectively being held in my name. Then I wouldn't have to worry about the trust fund going empty, creating the possibility my SS payments will be reduced.

If you were on an employer sponsored health insurance plan, the amount taken out of your paycheck for insurance was a very small portion of the actual cost. The people really paying for it were those behind how your employer funded operations (e.g. their customers if they were a manufacturer or service provider).

The program for ACA Premium Tax Credits is there to be used. And since we're playing by the rules, it has allowed us to retire before a few years before we become eligible for Medicare. Without that option we could not retire yet, so please don't make assumptions about what resources "most people on this site" have available to them.

Best regards,
Chris

[USGrant1962]

Quote:

Originally Posted by connor77 Isn't it so affordable because someone else is paying for your insurance? My wife and I are about to retire but are not feeling great about having others subsidize our health insurance. Since it seems most people on this site have enough money to retire early it sure seems probable that they could also buy their own insurance without needing others to subsidize it for them. What am I missing or is this just the way it is in order avoid paying $2,500 a month for an off the marketplace plan?

You really shouldn't worry about getting a health insurance subsidy. There is only a tiny segment of the population that is NOT subsidized and that is not based on income/wealth. Basically only those who are upper income and retired and under 65; and maybe those who stay on unsubsidized COBRA between jobs. I guesstimated one time it is maybe 1% of the population, though probably less now with the elimination of the subsidy cliff. About 11 million are on ACA plans, or 3% of the population, and I've seen somewhere that 85% of those are subsidized.

Everyone else is subsidized in one way or another. Examples:

• Warren Buffet, Charlie Munger, Bill Gates, Steve Ballmer, Michael Bloomberg and 61 million others - 65+ on Medicare, subsidized
• Elon Musk, Mark Zuckerberg, and 156 million others - employer provided, business expense deduction and not taxed on personal income taxes, subsidized
• Small business owners/self-employed - business expense deduction and not taxed on personal income taxes, subsidized
• The poor - Medicaid, subsidized
• Me - can deduct health insurance against my consulting income on Schedule C, subsidized

The whinging that people under 65, unemployed, and with assets should be the only ones to pay full freight is silly, especially because it is a rounding error in the nation's health insurance bill.

[connor77]

Thanks BubbaChris and USGrant for the different perspectives.

[RetiredAndLovingIt]

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Originally Posted by PaunchyPirate What income are you inputting? Poverty level is $21,960 for a family of three this year. I get $29,280 for 133% of that (although maybe I don’t know how to calculate that correctly). So, yes, that amount would be forced to Medicare. Using $35,000 for a fictitious 3 person family in Wayne county, Michigan, I see Silver plans as low as $9.69 per month and they have Cost Sharing enhancements to lower deductibles and copays.

I got similar when I checked. zip 48103, 33K 2 x 60 YO and 1 -18 YO
Kid would be put on Medicaid or CHIP and silver premiums starting at 0. Tax credit is $1356 and I sorted by lowest premium which was 0. and 33 plans available. Obviously we have no idea what doctors and hospitals that they would want which would change their choice but the point being that they can get plans at no or very low cost with 0 deductable

[scrabbler1]

Just to expand on one of USGrant's items in his fine list, an employee covered under his or her employer's group health plan pays for HI in 2 ways, the way I did when I was working. (1) employer subsidy, which is tax-free, and (2) pretax payroll deductions. In both instances, the tax benefit rises as income rises, exactly the opposite of the fairer ACA subsidies which decrease as income rises.

[Rainbowdash]

Disagree with most of USGrant list.
People on Medicare have spent their entire working life paying into the system, after 65 they still need to pay premium into it, not subsidized
People who are working where part of their HI is paid by their employer is because that’s part of their pay, not subsidized
People who can deduct their HI premium because they own a business, that’s the benefit of providing jobs to others, and improve our entire economy, not subsidized
People on Medicaid, I agree, subsidized

[qwerty3656]

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Originally Posted by PaunchyPirate What income are you inputting? Poverty level is $21,960 for a family of three this year. I get $29,280 for 133% of that (although maybe I don’t know how to calculate that correctly). So, yes, that amount would be forced to Medicare. Using $35,000 for a fictitious 3 person family in Wayne county, Michigan, I see Silver plans as low as $9.69 per month and they have Cost Sharing enhancements to lower deductibles and copays.

It looks like its PPO vs HMO. Plenty of cheap HMOs, but the cheapest PPO I could find was over $700 a month. We live right on the border of Ohio (basically a suburb of Toledo) and all our doctors/hospitals are in OHIO. I think I need a PPO if I want any hope of getting approved to use those doctors/hospitals.

[DayDreaming]

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Originally Posted by DayDreaming I applied for coverage on my state exchange - GetCovered.nj.gov - and it tells me that I am deceased. How sad, there were still things I wanted to do before I died! I wish I had blown some more dough! Their first suggestion was that I contact Social Security to correct the problem. I contacted SS and they said there is no record of me being deceased, so the problem is not there. I contacted getcovered.nj.gov and they said to just write a letter stating that I am alive, sign & date it, and upload an image of it to their website. I did that and got another notice saying that I need to provide proof, so I'm back to square one. Arrgh!

In case this helps anyone else: they did finally accept my signed and date letter stating that I am not deceased. I did not have to provide any other information.

[FLSUnFIRE]

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Originally Posted by DayDreaming I applied for coverage on my state exchange - GetCovered.nj.gov - and it tells me that I am deceased. How sad, there were still things I wanted to do before I died! I wish I had blown some more dough! Their first suggestion was that I contact Social Security to correct the problem. I contacted SS and they said there is no record of me being deceased, so the problem is not there. I contacted getcovered.nj.gov and they said to just write a letter stating that I am alive, sign & date it, and upload an image of it to their website. I did that and got another notice saying that I need to provide proof, so I'm back to square one. Arrgh!

I'd have been tempted to call back and threaten to haunt them until they revive you in their system!

[scrabbler1]

DayDreaming, you remind me of a 1973 "All in the Family" episode when Archie is mistakenly declared dead by the VA. He and Edith got the VA office to clear things up and the VA agent shows them a punch card (egads!) with one of its holes indicating that. Archie's quick response: "Fill that in!"

A different man, Archie Binker, was supposed to be declared dead, but at the end of the episode, Archie mentions that the other man (deceased) is waiting for the VA to declare him dead LOL!

https://www.imdb.com/title/tt0509805/?ref_=fn_al_tt_1

(note: the Storyline mistakenly refers to a different episode)

[PaunchyPirate]

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Originally Posted by qwerty3656 It looks like its PPO vs HMO. Plenty of cheap HMOs, but the cheapest PPO I could find was over $700 a month. We live right on the border of Ohio (basically a suburb of Toledo) and all our doctors/hospitals are in OHIO. I think I need a PPO if I want any hope of getting approved to use those doctors/hospitals.

So that's a different story than your original post on the topic. For what it's worth, the max 8.5% of your income is set up to set a baseline price for the Second Lowest Cost Silver Plan (SLCSP) in your location. Nothing more. For 2022, You will be given a subsidy to ensure you pay no more than 8.5% of your income to get the SLCSP. If you choose to use that subsidy on a different plan (better or worse), you are permitted to do that, but you will pay the difference in cost if it's higher.

By the way, at an income of $35,000, you won't even be paying 8.5% for that SLCSP. It's a graduated scale that maxes out at 8.5% in 2022. I don't know the percentage for $35,000, but I think it's in the 6% arena.