Author Topic: 2018 ACA plans - are there viable alternatives?  (Read 1559 times)

Frugal-Investor

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2018 ACA plans - are there viable alternatives?
« on: November 02, 2017, 09:06:55 AM »
I retired early in 2014 at 54, emboldened by how ACA would address my biggest post-employment risk as a US resident/ citizen -- access to affordable and good quality health insurance.  After my COBRA coverage period ended, I used ACA health insurance for coverage, starting in 2015 and through to this year. A quick visit to healthcare.gov yesterday showed me that my monthly cost for a Bronze level plan in Virginia will go up from $495 to $1,525 ($6000 deductible, roughly comparable plans) for 2018 coverage. Gold coverage is $2880 (!%?&$! unbelievable). I receive no subsidy.

My goal is to identify and compare alternatives so that I can understand the risk exposure, coverage and cost of the options, lining up a chosen approach by 12/15/17. All options are on the table, including any combination of Medical Cost Sharing, temp health insurance policies, critical illness coverage, hospitalization plan coverage. Please weigh in with thoughts and ideas. I'll also share what I learn.

JRA64

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #1 on: November 02, 2017, 09:54:10 AM »
P2F. I was upset by the 30% increase last year and 40% increase this year. A 300% increase? Unbelievable!

Is there any way you can get your income below 400% of the Federal Poverty Level? That is just over $48,000 for a single person. That number includes investment dividends; if you are working part-time I think you can contribute to a non-dedcutible IRA / HSA and lower your income by that much. As I don't have healthcare coverage through an employer, I'm going to pay close attention to understanding the calculations for 2017 taxes. I'm running numbers for my situation to decide if I want to limit my income next year, push for employer health care coverage, etc.

Would your situation allow you to move? Someone told me yesterday that prices are affected by zip code. He said people living 30 - 60 minutes from where I am will pay several hundred more per month.  I haven't verified it. The lowest cost bronze plan (53 next year, non-smoker, female) I saw was $540 per month for me.

jim555

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #2 on: November 02, 2017, 11:53:49 AM »
Move to another state with cheaper rates.

Candace

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #3 on: November 02, 2017, 12:02:23 PM »
Have you consulted an insurance broker about non-Marketplace plans? That's what I did for 2017, which of course is different, but the broker found me cheaper plans than those available on the Marketplace. If you aren't eligible for a subsidy, you could at least check out the non-Marketplace plans. A broker doesn't charge you anything, and they have a good handle on what's available.

Good luck. I also live in Virginia, in Hampton Roads, and the plans in my universe went up from the $500's per month into the $700's per month for the cheapest plans. However, since I FIRE'd this year and plan to withdraw all money for 2018 expenses this year (2017), I'm stomping out most of my 2018 income and will get a subsidy.

About the premium amounts, I thought there was a limit to how much the insurance companies could make on these plans? I find it incredible that premiums that high could be lawful.

As a final thought, you could try using a Navigator or other service intended to help people with Obamacare signups. They may just come up with the same results, but you never know. The online system is FAR from perfect (duh).

Daisy

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #4 on: November 02, 2017, 12:45:57 PM »
I just FIREd in September and am going on Liberty's health sharing program when my employer insurance coverage ends. It seems like a good program for my needs. No network of doctors. Covers international (if bill is in English and USD), and covers some naturopathic stuff. I hope it works out!

If you go this route, can I shamelessly plug that you put my name in as a referral? Gives me $100. PM me if interested.

protostache

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #5 on: November 04, 2017, 12:50:56 PM »
About the premium amounts, I thought there was a limit to how much the insurance companies could make on these plans? I find it incredible that premiums that high could be lawful.

ACA mandates that insurance plans pay out a minimum of 80% to providers (called the Medical Loss Ratio). If an specific plan pays out less than that, people on that plan get a refund check eventually.

Frugal-Investor would you mind sharing what county you live in and how old you are? I'd like to try to dig into reasons why your premium went up by so much.

Monkey Uncle

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #6 on: November 05, 2017, 04:17:55 AM »
I'm sure the increase is quite shocking, but you do realize that 1,525/yr for someone your age is still cheap, right?  If you had employer-provided insurance, you would probably be paying that much or more just for your share of the premium (I'm paying considerably more than that for my employer-provided insurance).  It's wise to have enough padding in your FIRE budget to be able to handle not-completely-unexpected surprises like this.
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BTDretire

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #7 on: November 05, 2017, 05:45:31 AM »


Would your situation allow you to move? Someone told me yesterday that prices are affected by zip code. He said people living 30 - 60 minutes from where I am will pay several hundred more per month.  I haven't verified it. The lowest cost bronze plan (53 next year, non-smoker, female) I saw was $540 per month for me.

 I started or posted to a thread info about how one area had ACA premiums 2X what I would pay in my area. Made no sense to me. Also showed that a family of 4 in that area making $100k could also get a subsidy of $30,000 to pay their premium!
So yes, moving could make a difference.

JRA64

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #8 on: November 05, 2017, 06:33:22 AM »
I'm sure the increase is quite shocking, but you do realize that 1,525/yr for someone your age is still cheap, right?  If you had employer-provided insurance, you would probably be paying that much or more just for your share of the premium (I'm paying considerably more than that for my employer-provided insurance).  It's wise to have enough padding in your FIRE budget to be able to handle not-completely-unexpected surprises like this.

These are MONTHLY prices. The $1525/mo. premium listed by yhe OP is $18,300 per year. The gold plan OP referenced is almost $36,000 per year. And sure to go up a lot again next year.

maizeman

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #9 on: November 05, 2017, 06:49:12 AM »
A quick visit to healthcare.gov yesterday showed me that my monthly cost for a Bronze level plan in Virginia will go up from $495 to $1,525 ($6000 deductible, roughly comparable plans) for 2018 coverage. Gold coverage is $2880 (!%?&$! unbelievable). I receive no subsidy.

It might be worth re-checking this. I don't know your age, but assuming you are 60, I looked at zip codes in a couple of major virginia cities, and found prices starting at $600-700/month without a subsidy and gold-level plans at ~$1,500/month.

Given the sums of money involved, it might be worth rechecking the website to make sure they correctly stored all the info you entered and they weren't showing you the cost of family plans instead of individual plans (the price difference is about right for that), or checking the price of plans in nearby zip codes here (https://www.healthcare.gov/see-plans/) to see if there is something going really wrong with your own city's individual pricing.
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Metta

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #10 on: November 05, 2017, 07:03:00 AM »
My employer's plan for retirees aged 55-65 has also changed. They will be giving everyone a lump sum in a HSA-like account to pay for the coverage or coverage elsewhere if you want. But the prices for health insurance through the company are now fairly high. For me and my husband the lowest monthly amount would be $1810. Choosing the more expensive option would be $2424 a month. So somewhere between $21,720 and $29,088 per year which is more than some budgets on this board. This represents quite a hike in rates from what the other retirees are telling me.

The cost of my employer's plan pretty much matches what I am quoted by Healthcare.gov. There it would be $1525/month for Bronze and $2482/month for Silver without a subsidy.

We will take advantage of my husband's employer insurance since he doesn't want to stop professoring anyway. So we are in good shape and I am very glad we do not have to deal with this right now. I wonder whether the sharp increase in rates is due to the current uncertainty in the political environment.

Monkey Uncle

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #11 on: November 05, 2017, 02:41:25 PM »
I'm sure the increase is quite shocking, but you do realize that 1,525/yr for someone your age is still cheap, right?  If you had employer-provided insurance, you would probably be paying that much or more just for your share of the premium (I'm paying considerably more than that for my employer-provided insurance).  It's wise to have enough padding in your FIRE budget to be able to handle not-completely-unexpected surprises like this.

These are MONTHLY prices. The $1525/mo. premium listed by yhe OP is $18,300 per year. The gold plan OP referenced is almost $36,000 per year. And sure to go up a lot again next year.

Oops, my bad.  Need to read more carefully next time.
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Frugal-Investor

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Re: 2018 ACA plans - are there viable alternatives?
« Reply #12 on: November 21, 2017, 12:52:27 PM »
Here are additional details and an update:
(1) I live in Albemarle County (outside of Charlottesville) in Virginia. A recent Washington Post article summarizes how a combination of factors has driven up ACA policies in Virginia but especially in Albemarle County.

https://www.washingtonpost.com/local/where-are-the-most-expensive-aca-plans-in-america-charlottesville/2017/11/16/e1b352d8-ca27-11e7-aa96-54417592cf72_story.html?utm_term=.d4a93604954b

(2) There are many other wonderful places to live in the US and Canada, but my current plans are to stay where I currently live. Our community, the nearby national Park, view of mountains and general quality of life are all reasons that I love it here.

(3) The data that I entered in healthcare.gov for last year was incomplete. The consequence was that I didn't see that I was eligible for a bit of subsidy for my coverage for 2017. When I discovered this omission and made an update, the implication for 2018 coverage is that I will get a subsidy. Because of how my cost of coverage went from around $500 to around $1500/ month, this is significant.

(4) I make investment decisions that have the effect of changing my income, e.g. asset allocation decisions that limit or generate income and buy/ sell decisions that impact capital gains. I will end up bringing forward capital gains into 2017 and delaying recognition of some losses this year to downshift my 2018 income. I'll also factor into future investment decisions the potential impact of subsidy amounts the way I do more readily or naturally today with income tax implications.