The ACA Saga Continues

[Islandtraveler]

Well, I thought I had it figured out. I need to apply for Health Insurance through the exchange this year. I have been researching the benefits of a HSA which I also intend to start. Problem is, not one of the plans listed on the exchange is HSA compatible. None! Nada! Zippo! What gives? I need the HAS deduction to reduce MAGI. Anyone else run into this issue? I am from New York. I don’t know if that has any relevance. Thanks for your help.

[Texas Proud]

I am not trying to do HSA as I am already lower than I need to be....

But, there are no compatible plans here either...

[Sue J]

We are offered a few but even with the reduced income from the HSA deduction the cost would be more than double the bronze plan we are considering. The bronze plan (non HSA) deductible is HIGHER than the HSA limit of $6550 each. In what universe does that make any sense?

[MBSC]

Quote:

Originally Posted by Islandtraveler Well, I thought I had it figured out. I need to apply for Health Insurance through the exchange this year. I have been researching the benefits of a HSA which I also intend to start. Problem is, not one of the plans listed on the exchange is HSA compatible. None! Nada! Zippo! What gives? I need the HSA deduction to reduce MAGI. Anyone else run into this issue? I am from New York. I don’t know if that has any relevance. Thanks for your help.

I used zip code 11968. It returned 62 pages of plans. The first page contained no HSA plans but pages 2 and 3 contain plans with 'HSA' in the name and their "plan details" page also says they are HSA eligible.

[Mulligan]

Island, you may find an HSA plan off exchange through the direct websites of the health care insurers.

[gauss]

But the plan would need to be purchased on-exchange for access to any subsidies that may be available based on 2017 income (ie less than 400% of FPL).

-gauss

[Mulligan]

True, but I was thinking if anyone was wanting the tax deduction, you would be up a notch or two in the income brackets. I purchase the HSA, but in my area the non HSA plans are cheaper. If I was in 15% bracket I would not incur any savings using HSA.

[BarbWire]

Does anyone have handy the website that is a directory for off-exchange insurance (the off exchange version of healthcare.gov?)

Thanks

[frank]

what site are you guy using?

[MBSC]

Quote:

Originally Posted by BarbWire Does anyone have handy the website that is a directory for off-exchange insurance (the off exchange version of healthcare.gov?)Thanks

It has a lower priority than the exchange so it may not yet be fully updated for 2017 but here you go. https://finder.healthcare.gov/

[BarbWire]

Thank you!

Based on what I see for Texas thus far, it may be time to find a new state for domicile in 2017. It's not just that the available policies are expensive: they are horrible products, offering minimal "insurance" against a major or even ruinous financial hit in the case of a major medical event.

I could probably stomach an HMO since I use scant medical services, but to forgo any out-of-network deductible or max -- when networks are tiny -- terrifies me.

And it needn't be "major" -- reading the fine print, the major insurer uses one of the two big hospital chains here as "in network" but notes that they have no ER docs on contract (nor, it is likely, anesthesiologists, radiologists or pathologists). So a compound fracture could still be a sizeable financial event as it would require surgery to repair.

Arrrrgh!

[ivinsfan]

Quote:

Originally Posted by BarbWire Thank you! Based on what I see for Texas thus far, it may be time to find a new state for domicile in 2017. It's not just that the available policies are expensive: they are horrible products, offering minimal "insurance" against major or even ruinous in the case of a major medical event. I could probably stomach an HMO since I use scant medical services, but to forgo any out-of-network deductible or max -- when networks are tiny -- terrifies me. And it needn't be "major" -- reading the fine print, the major insurer uses one of the two big hospital chains here as "in network" but notes that they have no ER docs on contract (nor, it is likely, anesthesiologists, radiologists or pathologists). So a compound fracture could still be a sizeable financial event as it would require surgery to repair. Arrrrgh!

Right, so the bigger question here is some large hospital and clinics have lost a huge part of their patient base because of insurance changes. What will they do to stay in business? How will they fill the OR's and beds? It's as plain as the nose on your face, that people can't pay rack rate such as 140K for a heart valve repair out of their own pockets. It won't matter if they pay lifetime monthly payments if they don't have the money.

Will they gradually go to billing the insurance price for everyone, in my DH case the 140K got knocked down to about 35K still a lot of money but doable for some people. BCBS MN just dumped about 250K from the Mayo Clinic system in one fell swoop.

[MBAustin]

Quote:

Originally Posted by BarbWire Does anyone have handy the website that is a directory for off-exchange insurance (the off exchange version of healthcare.gov?) Thanks

https://www.ehealthinsurance.com is one.

[Freedom56]

My premium for Anthem Blue Cross Silver PPO is increasing by 34%. I'm going to a bronze plan since we only use our insurance for annual check-ups.

[MrPotatoChip]

at this point it feels like there's almost no reason to buy the insurance except out of habit or unless you're getting the taxpayer to buy it for you. If you would pay $7-8k/year to insure yourself, ask yourself what you would do with no insurance if something small or something big happened. If you have a small medical issue, maybe it costs you $5-10k which sucks but you're still ahead given the premium savings and that you'd have had to pay nearly all of that out of your deductible anyway. If something really big happens like you get cancer and need $100-200k worth of treatments, what are the odds you would trust the mediocre doctor in your network with your life instead of going to a top cancer hospital and specialist who definitively aren't in your network? If you had the money, you'd pay it but since it would have been out of network and uncovered, at least you're $20k ahead in that situation with your premium and deductible savings.

[JoeWras]

Quote:

Originally Posted by MrPotatoChip a If you had the money, you'd pay it but since it would have been out of network and uncovered, at least you're $20k ahead in that situation with your premium and deductible savings.

On these plans, is Out of Network truly "uncovered?" If so, wow.

On my w*rk plan and on my after-w*rk plan provided by Megacorp, Out of Network just has a higher deductible. The after-work (ain't retirement since they pay nothing into it) plan has an extra 3k you have to pay out of pocket for out of network, then you are done.

[HadEnuff]

Quote:

Originally Posted by Islandtraveler Well, I thought I had it figured out. I need to apply for Health Insurance through the exchange this year. I have been researching the benefits of a HSA which I also intend to start. Problem is, not one of the plans listed on the exchange is HSA compatible. None! Nada! Zippo! What gives? I need the HAS deduction to reduce MAGI. Anyone else run into this issue? I am from New York. I don’t know if that has any relevance. Thanks for your help.

Did you look at Exceluss Blue Cross/Blue Shield (if available where you are)?

I'm Upstate (Chemung County) and on the NY State of Health website it shows it being available here. They have some that are, and some that are not HSA compatible.
I have not been able to hook up with the people that broker the policies here, so I have not confirmed it, and wouldn't be shocked to death to find out the information on the website was not 100% accurate.

[GTFan]

Quote:

Originally Posted by JoeWras On these plans, is Out of Network truly "uncovered?" If so, wow. On my w*rk plan and on my after-w*rk plan provided by Megacorp, Out of Network just has a higher deductible. The after-work (ain't retirement since they pay nothing into it) plan has an extra 3k you have to pay out of pocket for out of network, then you are done.

Yep, the way things have gone for 2017 (HMO-only exchange plans in large parts of the country), there is no OON coverage. You're on the hook for everything except emergency care.

The PPO plan I had this year had a $25k OON deductible per person, the two options we have for 2017 are HMO and have no coverage. Fortunately one of them is BCBS which has a good network here in the ATL, but we'll have to watch stuff like a hawk if we need anything more than a doctor visit.

I have retiree medical as an option from Megacorp which has OON coverage, but the only choice is a Bronze plan at almost $1100 a month for two. No thanks. I figure if the ACA exchanges fall apart (think it's a 50/50 chance now) it's my fallback plan, but a big ouch vs. the way cheap subsidized ACA Silver plans I'm getting now.