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

[DektolMan]

In CT last year Bronze plan foe me now 64 and DW 63 was $15.18.


JUst renewed, same plan this year $14.16 but if my income is a dollar over the threshold the premium is $1895 per month. Crazy the way the law was written. This is why we are delaying taking SS till 66.

 

[teejayevans]

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?

HSA plans are different in that most preventive care is paid for, flu shots, shingles vaccine, colonoscopy etc.Of course if you don’t need these services...

 

[zinger1457]

HSA plans are different in that most preventive care is paid for, flu shots, shingles vaccine, colonoscopy etc.Of course if you don’t need these services...

Preventive care is suppose to be covered under all ACA plans.

 

[Smitty700]

JUst renewed, same plan this year $14.16 but if my income is a dollar over the threshold the premium is $1895 per month. Crazy the way the law was written. This is why we are delaying taking SS till 66.

$1 of income, an extra $22,572 in tax. How's that for a marginal tax rate?

Stupid. But that's one of those common sense fixes that everyone knows is needed but the gridlock in Washington prevents.

 

[pb4uski]

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

I think it has become a bit distorted over time, but the original design of subsidies was to provide the excess of silver level premiums over a sliding scale percentage of income based on your overall income in relation to the federal poverty level (aka FPL).

So for example... let's say that 400% FPL for a married couple was $64,000... they would be expected to pay $6,310 (9.86% of $64k) a year for their health insurance... so if silver level premiums were $12,000 a year their subsidy would be $5,690... ... IOW subsidies would pay any excess of the cost of insurance over 9.86% of their $64k of income.

However, if they chose a bronze plan that cost $8,000 a year then their subsidy would be the same since subsidies are based on a silver plan and their cost would only be $2,310 a year ($8k - the same $5,690 subsidy)... this gave healthy low and middle income people an opportunity to reduce their health insurance costs even more while at the same time taking a chance on deductbles and co-pays.

Then later, when the Trump administration refused to pay insurers for deductibles and copays for silver plans the cost of silver premiums went up and as a result subsidies went up... so for example, if that $12k silver plan then increased to $15k because the government was not covering deductible and copays.... the subsidy increased to $8,690 ($15k - 9.86% of $64k income)... so that $8k bronze plan now is fully subsidized and the family contribution is $0.

 

[LiveBelowMeans]

I’m one of the saps paying full price. Florida Blue blue options bronze hsa: $1917.98 per month with a $6000 deductible each for wife and I. 58 and 57 years old. It’s crazy....

 

[pb4uski]

Yup... that is why we are waiting until when we are on Medicare in 2020 before redomesticating to Florida... if we did it now it would cost us $1,400/month more than what we pay now for a bronze plan.

 

[ripper1]

Preventive care is suppose to be covered under all ACA plans.

Thanks Zinger

 

[Willers]

In our state the unsubsidized costs went down significantly, but because of how subsidies are calculated, the subsidies went down even more so the premium of our bronze HSA plan increased $180/month.



Not great news except that we may get a large deferred comp payout in 2020. If we do we'll well over the cliff and the reduced cost will be a benefit.

 

[ShokWaveRider]

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.

Here is an example that would apply to us if we HAD to draw say $100k from IRAs or other qualified accounts.

1) Take an interest only loan out for however many years of expenses needed till Medicare, Home LOC, or whatever that can be tapped as needed. Interest will be way less than those HI premiums.

2) Do not take SS till Medicare kicks in.

3) Only take enough from IRAs so one just clears the Medicaid threshold.

Seems like a no brainer to me. What am I missing?

 

[jimbee]

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.

Here is an example that would apply to us if we HAD to draw say $100k from IRAs or other qualified accounts.

1) Take an interest only loan out for however many years of expenses needed till Medicare, Home LOC, or whatever that can be tapped as needed. Interest will be way less than those HI premiums.

2) Do not take SS till Medicare kicks in.

3) Only rate enough from IRAs so one just clears the Medicaid threshold.

Seems like a no brainer to me. What am I missing?

Your numbers 1 and 2 are exactly what a friend of mine did. He remortgaged his house for additional spending money to better control withdrawing from tax deferred accounts, staying within the 400% FPL threshold.

 

[ShokWaveRider]

Your numbers 1 and 2 are exactly what a friend of mine did. He remortgaged his house for additional spending money to better control withdrawing from tax deferred accounts, staying within the 400% FPL threshold.

Other than a potential Tax torpedo when Medicare time is reached, it seems like common sense. Even with the tax it would most likely be cheaper than ~$25k pa HC costs + Deductible + Max OOP.

 

[MRG]

My subsidy went down as did the cost of all plans. Another insurer joined our market but I stayed with BCBS.

The plan I did have in 19 is no more, it's closest equilivent was $500 a month cheaper! I choose something with a lower max OOP and its cheaper still. My cost went from $350 monthly to $165 and an 800/1600 deductible/max OOP.

 

[bushpilot]

$2.09 / month for a bronze plan.

 

[davebarnes]

$811/mo -> $732 for Kaiser bronze HDHP HSA for 62 female.
Thank you Jared Polis and a very complicated re-insurance plan here in Colorado.

 

[BeachOrCity]

Yup... that is why we are waiting until when we are on Medicare in 2020 before redomesticating to Florida... if we did it now it would cost us $1,400/month more than what we pay now for a bronze plan.

Why would you not just get a catastrophic plan in Florida?

 

[ncbill]

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.

Here is an example that would apply to us if we HAD to draw say $100k from IRAs or other qualified accounts.

1) Take an interest only loan out for however many years of expenses needed till Medicare, Home LOC, or whatever that can be tapped as needed. Interest will be way less than those HI premiums.

2) Do not take SS till Medicare kicks in.

3) Only take enough from IRAs so one just clears the Medicaid threshold.

Seems like a no brainer to me. What am I missing?

Doesn't seem outrageous for those in their late 50s/early 60s...within the last few years I read of one RE couple on another forum facing unsubsidized premiums of around $30k for the upcoming year.

Since they were both about to turn 64 & already located in a border state I recommended they take an extended trip south of the border & put the $30k towards that instead.

 

[pb4uski]

Why would you not just get a catastrophic plan in Florida?

Because the last time that I checked a catastrophic plan in Florida for a 64 yo is about the same as a bronze plan... for 2020 the cheapest bronze plan is $2,074/month for a couple. My recollection is that the catastrophic premium is similar to the bronze premium because Florida allows age rating (Vermont does not).

Meanwhile, our Vermont cat plan for 2020 is $535/month vs $1,091/month for a bronze plan.... a large part of that difference is that Vermont does not allow age rating and the cat plan is designed for people under 30.

So if we moved to Florida before Medicare our health insurance would be $1,539/month more.... more than wiping out the state income tax savings in a couple months.

OTOH, Medigap premiums are about the same so once we are on Medicare in 2020 the health insurance difference is not an issue. I feel fortunate to have benefitted from this quirk in Obamacare combined with a quirk in health insurance pricing where we live... managing income to allow us to buy a cat plan and living in a state that prohibits age rating so the cat plan is substantially lower than a bronze plan... for 7 years from when Obamacare began until when we are eligible for Medicare.

 

[BeachOrCity]

Wow! DC is age rated and Catastrophic plans are 1/2 bronze plans. Basically because aca does not allow risk pooling and transfers from catastrophic and metal levels. But does allow transfers and harmonizing between metal levels. This combined with
— predominance is young healthy types
— lack of knowledge of catastrophic plan savings.
— huge paper work required and lack of enrollment assistance to do it

Make the catastrophic a winner in DC. last year we did not get our exemption cert until later in December. We were certificates number 1 and 2. This year we did it right on nov 1st. Still certificates 1,2.

While spreading with word could make premiums rise if all my fat middle aged friends sign up, I do it anyway.

I guess all this means is if people want to lower their premiums they have to become experts in what works where for their situation !

Because the last time that I checked a catastrophic plan in Florida for a 64 yo is about the same as a bronze plan... for 2020 the cheapest bronze plan is $2,074/month for a couple. My recollection is that the catastrophic premium is similar to the bronze premium because Florida allows age rating (Vermont does not).

Meanwhile, our Vermont cat plan for 2020 is $535/month vs $1,091/month for a bronze plan.... a large part of that difference is that Vermont does not allow age rating and the cat plan is designed for people under 30.

So if we moved to Florida before Medicare our health insurance would be $1,539/month more.... more than wiping out the state income tax savings in a couple months.

OTOH, Medigap premiums are about the same so once we are on Medicare in 2020 the health insurance difference is not an issue. I feel fortunate to have benefitted from this quirk in Obamacare combined with a quirk in health insurance pricing where we live... managing income to allow us to buy a cat plan and living in a state that prohibits age rating so the cat plan is substantially lower than a bronze plan... for 7 years from when Obamacare began until when we are eligible for Medicare.

 

[pb4uski]

Yes, looking at BCBS's recent rate filing, there are about 70k subscribers to ACA plans.... given income in our area I suspect many get subsidies and almost all would qualify to buy a cat plan even though they are over 30 based on unaffordability... but only 7 subscribers to the cat plan are over 30.... and DW and I are 2 of the 7.

Knowledge is power, I guess.

 

[Willers]

$811/mo -> $732 for Kaiser bronze HDHP HSA for 62 female.
Thank you Jared Polis and a very complicated re-insurance plan here in Colorado.

As with any change in policy there are winners and losers. You are a winner on this one. We’re losers. So it goes on politics...

 

[Eucerin]

Question about MAGI for ACA purpose.
2019 est MAGI was 36k, but worked a part time at income 4k. Can I buy IRA at 4k so to keep the MAGI at 36k?
Is IRA gets 100% deduction as long as within the limit 6k?

 

[ShokWaveRider]

Question about MAGI for ACA purpose.
2019 est MAGI was 36k, but worked a part time at income 4k. Can I buy IRA at 4k so to keep the MAGI at 36k?
Is IRA gets 100% deduction as long as within the limit 6k?

Yes, it was "Earned Income"

 

[Eucerin]

Yes, it was "Earned Income"

Great!!!
Thanks.

 

[GTFan]

I'm not an expert on ACA in every state, but where I live, if your MAGI is under approximately 27K, a silver plan for a married couple filing jointly is fully subsidized, resulting in $0 cost for the policy. I guess the real question would be, how the hell do two people live off $27K per year? Haha. The answer is...we live off savings, depending on the source of the savings may or may not affect MAGI, and 401k and IRA (non ROTH) withdrawals which do affect MAGI. We haven't started collecting SS (not old enough yet, woohoo!) nor have we started receiving pension payments so we aren't burdened with high levels of income.

Exactly. Folks that don't understand how people live on low income for ACA forget that savings are mostly tax-free. Or that in low COL states if you don't have debt you don't have a lot of expenses outside of travel. We can easily live on $1-2k/mo. here with all taxes and maint. included.

Our exact same Silver CSR Ambetter plan actually went down from $68 to $60/mo. for 2020, with slightly higher max OOP of $1050 pp. No deductible, zero copay, free generics etc. And the Medical Loss Rebate they gave last month paid for the entire year's premiums.

Of course that's with keeping income between 150-200% FPL which is easy to do in this relatively low COL state when everything's paid for.