ACA, Subsidies and Better off Americans (which means many FIRE)

[Walt34]

My Doc pushes a brand name drug every time a new one comes out and I have to push her back to generic covered by my plan.

I've never had that happen and if it did I think I'd find a new doc pretty quick. Here in WV state law requires the pharmacy to fill a prescription with a generic unless the physician specifically states the brand name is needed.

 

[Teacher Terry]

There are also little quirks to the ACA that people don't know about if it does not affect them. When I retired our pensions totaled 40k yet our health insurance through the state I retired from were 10k/year. It wasn't considered un-affordable because it was supplied by an employer and my insurance was only 350.00/month. The rest was for my DH. They did not consider what his cost was when figuring this. Later I learned it was an oops they had not thought about. We were fine because we had savings but some people do not.

 

[youbet]

We cannot afford that at $57 & 63. I would have to put all our assets in a trust and use the emergency room. If that was the norm.

Is it that easy? Can you really put all your assets into a trust and qualify for public welfare? I thought the gov't was cracking down on that type of behavior.

 

[GTFan]

None of the sites I have looked at have ever shown a catastrophic plan, so I have no idea what they cover or what they cost....

I looked into it last year for my son and the cost was not much less than the cheapest Bronze plan. No more than 5-10% less IIRC. So YMMV although it is a viable option for some to save money.

 

[daylatedollarshort]

We cannot afford that at $57 & 63. I would have to put all our assets in a trust and use the emergency room. If that was the norm.

Just curious what you expect to spend for health care at Medicare age. We have $10K a year in the budget for health care with Medicare for a couple, based on what I've researched and have read about others paying on this forum.

 

[Teacher Terry]

My friends are paying much less for Medicare supplements, etc with the same coverage that I have and same health network. They are paying about a fourth of what we do.

 

[youbet]

Just curious what you expect to spend for health care at Medicare age. We have $10K a year in the budget for health care with Medicare for a couple, based on what I've researched and have read about others paying on this forum.

Medicare Parts A, B and D plus type F supplements plus Irmaa plus a few incidentals soak up every bit of $10k from our budget. We're 69 yo. We're glad to have the coverage and are able to pay for it, but it is a major line item in our budget that needs to be accounted for!

 

[REWahoo]

Medicare Parts A, B and D plus type F supplements plus Irmaa plus a few incidentals soak up every bit of $10k from our budget. We're 69 yo.

Interesting. Similar age and our total is under $5k, likely due to having no Irmaa costs and opting for the HD version of Plan F.

 

[youbet]

Interesting. Similar age and our total is under $5k, likely due to having no Irmaa costs and opting for the HD version of Plan F.

And I believe you've mentioned you're able to get by with low premium Part D policy since you've managed to be maintenance drug free. And you might be avoiding the Part D deductible altogether. Higher premium X 2 policies + 2 deductibles would be close to a kilobuck alone.

Our Irmaa situation isn't permanent. We had a blip in income for a couple years. But right now, ouch!

Not complaining. Glad to have the coverage. But we definitely have to plan paying for it.......

 

[Texas Proud]

I looked into it last year for my son and the cost was not much less than the cheapest Bronze plan. No more than 5-10% less IIRC. So YMMV although it is a viable option for some to save money.

Thanks for the info...

Some of the bronze plans have such high deductible I considered them catastrophic anyhow...

 

[youbet]

My friends are paying much less for Medicare supplements, etc with the same coverage that I have and same health network. They are paying about a fourth of what we do.

A couple on Medicare typically pays between $5k and $10k / yr depending on specific plans/supplements and with or without Irmaa. (See my and REWahoo's earlier posts.) Are you saying you're paying between $20k and $40k? If so, wow!

 

[daylatedollarshort]

A couple on Medicare typically pays between $5k and $10k / yr depending on specific plans/supplements and with or without Irmaa. (See my and REWahoo's earlier posts.)

Thanks for the info, youbet. That is in line with the Consumer Expenditure Survey which on a per person basis for households 65+ would be a mean of $6,771 per year per couple ($5,756 for 1.7 person household). I'm in a high cost of living area so $10K plus a bit of a buffer seemed a reasonable amount to use for our household.

 

[daylatedollarshort]

Thanks for the info...

Some of the bronze plans have such high deductible I considered them catastrophic anyhow...

Catastrophic plans were shown on our ACA enrollment screen for our area this year but the premium for our zip code was not much different than the Bronze plan and the Bronze plans had better coverage.

 

[nun]

Here is the most popular Medicare program for MA state retirees (the CIC version). It costs $84/month and is very comprehensive. So add that to part B and the total annual premiums are around $2.5k or an individual with very low out of pocket costs.

https://www.unicarestateplan.com/pdf/OMEBrochFY2017.pdf

 

[Corporateburnout]

Here is the most popular Medicare program for MA state retirees (the CIC version). It costs $84/month and is very comprehensive. So add that to part B and the total annual premiums are around $2.5k or an individual with very low out of pocket costs.

https://www.unicarestateplan.com/pdf/OMEBrochFY2017.pdf

To get a similar plan for a non state employee in MA a BC/BS supplement plan monthly premium is $180, part B for new members in 2017 is $134 and a drug plan is an additional $40 for an annual cost of 4.5K with some out of pocket cost. That's why we budgeted 12K/year for health care which include dental expenses for the two of us.

I think it's prudent to budget 10K to 12K for Medicare and dental expenses per year for a couple.

 

[nun]

To get a similar plan for a non state employee in MA a BC/BS supplement plan monthly premium is $180, part B for new members in 2017 is $134 and a drug plan is an additional $40 for an annual cost of 4.5K with some out of pocket cost. That's why we budgeted 12K/year for health care which include dental expenses for the two of us.

I think it's prudent to budget 10K to 12K for Medicare and dental expenses per year for a couple.

Yes $2.5k for the state equivalent is a great deal. Probably a combination of a state subsidy, negotiating power and having a big customer pool.