ACA Healthcare Cost?

[treemoney]

I am thinking about retiring the end of next year. One of my biggest unknown costs is healthcare. I will be 61 then and my partner will be 59. We are both healthy, go to the Dr's 1 - 2 times a year and both take 2 maintenance drugs. My question is how much are those of you on ACA and being able to keep your MAGI below the $65,800 max paying a year including out of pocket?

We currently live in NJ, but are thinking of relocating to FL. I realize this will vary from state to state, but am trying to come up with some numbers.

 

[joeea]

It varies rather widely by state.

Go to https://www.healthcare.gov/ and play with it a bit to see what you might expect to pay.

Try it for NJ and FL.

 

[zinger1457]

The Kaiser Foundation has a good calculator to determine how much of a subsidy you might get and what you might pay for a Silver/Bronze plan. If your health is good it's probably worth looking at a lower cost Bronze plan that is HSA eligible. Suggest you do a search on the forum, many threads discussing ACA subsidies and MAGI.

https://www.kff.org/interactive/subsidy-calculator/

 

[OldConch]

The Kaiser Foundation has a good calculator to determine how much of a subsidy you might get and what you might pay for a Silver/Bronze plan. If your health is good it's probably worth looking at a lower cost Bronze plan that is HSA eligible. Suggest you do a search on the forum, many threads discussing ACA subsidies and MAGI.

https://www.kff.org/interactive/subsidy-calculator/

+1 on this calculator. You don't need to enter an email on this one.

 

[Senator]

If you are not married, and have never been, there are a lot more ways to make healthcare affordable.

 

[saydiver]

I am thinking about retiring the end of next year. One of my biggest unknown costs is healthcare. I will be 61 then and my partner will be 59. We are both healthy, go to the Dr's 1 - 2 times a year and both take 2 maintenance drugs. My question is how much are those of you on ACA and being able to keep your MAGI below the $65,800 max paying a year including out of pocket?

We currently live in NJ, but are thinking of relocating to FL. I realize this will vary from state to state, but am trying to come up with some numbers.

You can go to the FL Blue website and look at their 2020 plans and play what if.

In FL the rate varies by county and is more expensive the more south you are located with the greater Miami area being the most expensive. I can tell you if you don't keep your MAGI below the $65,800 max, you will pay dearly in FL for an ACA HSA plan.

DH is 61 and his rate for a non-subsidized FL Blue Bronze Blue Options HSA plan that has a $6000 deductible is over $1200 a month for 2020.

 

[Dtail]

In FLA in general, you will have great access to a wide doctor network, especially through Florida Blue.
As been mentioned, you will definitely need to stay below 65k to recive the tax subsidies.
The tax subsidies can be substantial by staying below 150% of FPL. At below 150% FPL, premiums in many counties can be in the range of 150 monthly with a max OOP of ~3k yearly.

 

[ShokWaveRider]

In FLA in general, you will have great access to a wide doctor network, especially through Florida Blue.
As been mentioned, you will definitely need to stay below 65k to recive the tax subsidies.
The tax subsidies can be substantial by staying below 150% of FPL. At below 150% FPL, premiums in many counties can be in the range of 150 monthly with a max OOP of ~3k yearly.

We second this, FLB has the best access to service providers we have experienced anywhere in the country we have lived, all/majority of providers take the plans, as do the hospitals.

Access to, and cost of ACA healthcare is one of the complaints we DO NOT have here in Florida. Now the humidity and sink holes are another story.

 

[candrew]

Access to, and cost of ACA healthcare is one of the complaints we DO NOT have here in Florida. Now the humidity and sink holes are another story.

.....along with named storm systems?

 

[Rianne]

My question is how much are those of you on ACA and being able to keep your MAGI below the $65,800 max paying a year including out of pocket?

It's easy for us to keep MAGI below the max.
1. Contribute to TIRA maximum amount
2. Contribute max to HSA - must have an HSA approved policy on ACA
3. We have cash (already taxed) set aside to make up any difference


You do have to guess regarding your taxable income from the portfolio. We've been on ACA since 2013, so we get how it works. I suggest finding an insurance broker, they are paid by the HI company. That way you'll understand the benefits to your liking. We signed on to the lowest Bronze plan HSA approved.

 

[GTFan]

It's easy for us to keep MAGI below the max.
1. Contribute to TIRA maximum amount
2. Contribute max to HSA - must have an HSA approved policy on ACA
3. We have cash (already taxed) set aside to make up any difference

Only drawback to this being that HSAs are usually not available for cost-shared Silver plans, which are the best deal going if you can keep income below 250% FPL.

If you don't think you'll need to use the policy then yeah Bronze w/HSA can often be free with subsidies.

 

[Z3Dreamer]

Only drawback to this being that HSAs are usually not available for cost-shared Silver plans, which are the best deal going if you can keep income below 250% FPL.

If you don't think you'll need to use the policy then yeah Bronze w/HSA can often be free with subsidies.

I second this. Bronze HSA here.

 

[treemoney]

Thank you everyone for your replies. One clarification about us, we are married. As for my question of what are you paying on an ACA plan keeping MAGI in check? What I am looking for, is what you are actually paying. I've looked at websites and gotten those numbers, but I am curious of how true they are. We currently have 15k - 24k per year budgeted. Hoping that we have over budgeted.

 

[ivinsfan]

Thank you everyone for your replies. One clarification about us, we are married. As for my question of what are you paying on an ACA plan keeping MAGI in check? What I am looking for, is what you are actually paying. I've looked at websites and gotten those numbers, but I am curious of how true they are. We currently have 15k - 24k per year budgeted. Hoping that we have over budgeted.

You need to research this yourself.. It's 2020 prices, state you live in,policy you select ,number in your family and your income. So many variables no else's numbers will help give you clarity.

 

[orchid55]

You should be fine with that amount for premiums if you stay below the cutoff. My husband and I (63 and 61) do not get subsidies up-front and we pay $17,000 per year for a Bronze HSA policy. Last year we paid $19,000 for a Bronze HSA policy.

 

[SecondCor521]

Thank you everyone for your replies. One clarification about us, we are married. As for my question of what are you paying on an ACA plan keeping MAGI in check? What I am looking for, is what you are actually paying. I've looked at websites and gotten those numbers, but I am curious of how true they are. We currently have 15k - 24k per year budgeted. Hoping that we have over budgeted.

I understand your question. You're asking for out of pocket costs after subsidies.

The problem trying to answer your question is that it varies a great deal. Your age, MAGI, tobacco use or not, and the county or zip code you live in all affects the premiums you will pay. And then the plan you choose and your health care utilization will affect any OOP costs (copays, deductibles, non-covered expenses).

I could tell you what I pay, but I would rather not, because I don't think it would help you. What you really want to know is if the numbers you are seeing are accurate.

I would say that if you are correctly filling out the information on your state's health insurance exchange website and you understand how MAGI is calculated, then the numbers they provide are probably very accurate. I should add that they are accurate in my case, but state exchanges can be either individually implemented or they can use the federal exchange at healthcare.gov, so the quality could vary. I don't have firsthand knowledge of either of the states' exchanges that have been mentioned.

For health utilization, the only thing I know is to look at your current health and recent health history and make guesses. Maybe do best case, worst case, and most likely case if you really want to analyze it.

Be sure you know about how HSAs and CSRs and APTCs work. If you have specific questions about those things, there are a lot of good websites out there - the Kaiser Family Foundation one is often recommended and I think they do a good job.

 

[joeea]

Thank you everyone for your replies. One clarification about us, we are married. As for my question of what are you paying on an ACA plan keeping MAGI in check? What I am looking for, is what you are actually paying. I've looked at websites and gotten those numbers, but I am curious of how true they are. We currently have 15k - 24k per year budgeted. Hoping that we have over budgeted.

I am currently paying $349/month for premiums. Virtually nothing out of pocket. That will change when I go on Medicare soon.

I used to pay $264/month last year before we moved to this state. Almost nothing out of pocket.

 

[golfnut]

It's easy for us to keep MAGI below the max.
1. Contribute to TIRA maximum amount
2. Contribute max to HSA - must have an HSA approved policy on ACA
3. We have cash (already taxed) set aside to make up any difference


You do have to guess regarding your taxable income from the portfolio. We've been on ACA since 2013, so we get how it works. I suggest finding an insurance broker, they are paid by the HI company. That way you'll understand the benefits to your liking. We signed on to the lowest Bronze plan HSA approved.

We are in Illinois as well. However, there was only one HSA bronze plan offered and it wasn't cheap premium wise. We ended up with w/ a BCBS hmo plan that wasn't hsa eligible. Wish there more hsa options.

 

[RunningBum]

Thank you everyone for your replies. One clarification about us, we are married. As for my question of what are you paying on an ACA plan keeping MAGI in check? What I am looking for, is what you are actually paying. I've looked at websites and gotten those numbers, but I am curious of how true they are. We currently have 15k - 24k per year budgeted. Hoping that we have over budgeted.

The sources cited here are totally accurate, including the premiums, subsidy amounts, deductibles, and out of pocket max. As everyone is saying, what others are paying has no bearing on what you pay. Do your own work instead of going for the lazy, inaccurate, way of asking others.

The unknown, that nobody can answer, is what costs will be next year, and the year after that, and so on. But it's still more accurate to base it off your current information and guess on a % increase.

 

[Conundrum]

I used healthsherpa.com as part of my initial research. In the end it was pretty darn close to the actual number when I purchased through healthcare.gov. I also used the search feature a bunch here and on bogleheads. I read ALOT of information.

Staying below $65,840 has been fine for us in our first year of ACA. We use quicken so I had a lot of data in place on how and what we spend money on. We definitely had a well researched budget on paper before we pulled the trigger.

We do have a good cushion in a taxable MM fund should something unexpected happen. This serves three purposes. Emergency fund, managing MAGI and also gives me some flexibility in not having to sell assets during a downturn or mitigate damage somewhat. Life isn’t perfect. As the saying goes, plan for the worst and hope for the best. Seems to me there is a good chance I will see a black swan event sometime in the next 30-40 years so I better have a darn good plan to hopefully survive it.

Also, having zero debt of any kind helps manage thresholds and tax liability. It has always been a dream and goal of ours to be completely debt free. Turns out it worked out well for ACA too.

In the end though please use input as information only. Due diligence is crucial to making a plan that can to some degree weather some storms. Everybody’s plan is totally unique.

 

[Rianne]

We are in Illinois as well. However, there was only one HSA bronze plan offered and it wasn't cheap premium wise. We ended up with w/ a BCBS hmo plan that wasn't hsa eligible. Wish there more hsa options.

You're in Chicago suburbs, very different options. We pay $8.68 in premiums every month. $12K deductible. The discount frim the HI co. cuts the cost in 1/2 or more. $12K max out of pocket for family, $6K for DH, $6K for me. So far, only saw Dr. for annual check up and blood work. I one visit for a rash from OxyClean.

 

[swakyaby]

My question is how much are those of you on ACA and being able to keep your MAGI below the $65,800 max paying a year including out of pocket?

I chose a bronze HDHP ppo plan with HSA for DH (62) and I (57). If I keep my MAGI below $65,400, my annual premium for the 2 of us is $6,548. Without the subsidy, it would have been $24,750. This is exactly what the ACA website quoted. So in this instance, if it sounds too good to be true, it actually is true! The additional out-of-pocket expenses for a 2nd doctor's visit, lab tests, and prescriptions have not exceeded $1,000.

Next year, Blue Shield of California states my unsubsidized annual premium for 2020 will be $27,107 for the 2 of us. Keeping my MAGI below 400% FPL will save me $20,343 in premiums next year.

 

[duckcalldan]

My wife and I just moved from VA to WA, and got sticker shock when changing plans. We’ve been on a Bronze+HSA plan for several years, basically free after subsidies. But here in WA an equivalent plan is nearly $500/mo after subsidies. Reason being is a very narrow spread between Silver and Bronze (second lowest Silver plan price determines your subsidy) and the Silver plans here are much more affordable than those equivalent plans in VA.

Don’t know what will be happening in 2020, but our county will be going from 4 to 6 providers so here’s hoping for a lower price for a Bronze plan next year.

Of course, with a smaller subsidy comes with the opportunity for a larger Roth conversion.

 

[Big_Hitter]

you need to estimate the premiums and your OP max - I'm budgeting $2K a month for healthcare

 

[teejayevans]

Florida plans differ based on what county you’re in. You can’t compare, too many variables.