Author Topic: Healthcare in FIRE  (Read 6582 times)

Monkey Uncle

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Re: Healthcare in FIRE
« Reply #50 on: April 03, 2018, 04:56:46 AM »
Oh be wary of your ACA plan "covering" you for out of network emergencies.. Basically its bullshit and you are wide open to very large balance bills!

All OON coverage means is your insurance company will pay your OON hospital what they would normally pay their in network hospital.

As this sum will be way less than than OON hospital will charge.. guess who gets the bill for the remainder?... YOU DO!

Basically if we travel more than about 50 miles we are out of network!

Another option is healthshare ministries which can provide travelling insurance. If we ever buy the van and tour the US we would probably go that route

This is true of all insurance plans in the U.S., not just ACA plans.  Well, possibly excepting Medicaid.  I haven't looked into that.

The BCBS extended network that was mentioned earlier is probably the best way to handle this issue.  Although you are open to being balance-billed, the BCBS affiliate that covers the area where you get sick is likely to have negotiated a rate that is closer to your in-network rate than if you were just paying the hospital's ridiculously inflated sticker price.
Took that job and shoved it - January 6, 2018

LAGuy

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Re: Healthcare in FIRE
« Reply #51 on: April 03, 2018, 07:14:32 AM »
@LAGuy , The only hesitation I'd have with your plan would be emergencies. Things could get really complicated if you got hit by a bus while crossing the street and woke up in the ICU at your local hospital a week later. You could very easily find yourself in a position where you were physically and/or mentally incapable of making the phone calls and filing the proper paperwork necessary to get yourself signed up for Medicaid. By the time you got well enough to get yourself covered by health insurance, you could easily already have racked up hundreds of thousands of dollars in medical bills. If I were you, I'd have some sort of insurance in place to cover me in the event of a catastrophic accident or sudden debilitating illness. Just in case.

Yeah, you'd need to have somebody who is instructed and authorized to handle your affairs. But you should really have that regardless of your insurance situation.

Medicaid can be retroactive up to 90 days.  However you must have been eligible in that retroactive period.  So in December when he is realizing the income he would not be eligible and better hope nothing happens.  Even 30 days can add up to a huge sum.

Well, you could realize the last trading day of the year. Yeah, you'd have no insurance for a day or 2 or 3. Better stay safe, haha! The bigger problem is the presumption that if you had a big medial problem you'll be needing insurance in the following year. And ACA open enrollment ends in mid December in most states. So, you'd need enough cash on hand to cover 2 years of living expenses on the off chance that your medical emergency comes at the end of the year and you can't realize any income the following year either in order to stay on Medicaid. Depending on your spend and investment plans, it might be better off to just invest that cash as it probably would throw off enough money to just pay ACA premiums anyways. Although! (lol this stuff is confusing), losing Medicaid eligibility due to an increase in income is a qualifying event to buy ACA insurance!! Haha!

The main reason I bring this up is I know some healthy folks are considering self insurance in FIRE. This route would give you a backdoor back into the insurance market if that was your plan.

jim555

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Re: Healthcare in FIRE
« Reply #52 on: April 03, 2018, 07:29:59 AM »
Well, you could realize the last trading day of the year. Yeah, you'd have no insurance for a day or 2 or 3.
Coverage is for whole months at a time, not fractions of a month.

LAGuy

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Re: Healthcare in FIRE
« Reply #53 on: April 03, 2018, 10:08:15 AM »
Well, you could realize the last trading day of the year. Yeah, you'd have no insurance for a day or 2 or 3.
Coverage is for whole months at a time, not fractions of a month.

I worded it poorly. I should have said, "You'd have no access to insurance for a day or two or 3." Medicare coverage is immediate...there's a "presumption of enrollment" if you're "poor" - with "poor" being defined by income, but not assets. So, if you got sick on December 20th and you didn't have insurance (because you didn't buy any all year) you would be covered under Medicaid because your income was still under the threshold. The idea isn't to be covered for the month of December. The idea is to be NOT covered and still showing a low enough income to be Medicaid eligible for as long as possible.

jim555

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Re: Healthcare in FIRE
« Reply #54 on: April 03, 2018, 11:08:00 AM »
Well, you could realize the last trading day of the year. Yeah, you'd have no insurance for a day or 2 or 3.
Coverage is for whole months at a time, not fractions of a month.

I worded it poorly. I should have said, "You'd have no access to insurance for a day or two or 3." Medicare coverage is immediate...there's a "presumption of enrollment" if you're "poor" - with "poor" being defined by income, but not assets. So, if you got sick on December 20th and you didn't have insurance (because you didn't buy any all year) you would be covered under Medicaid because your income was still under the threshold. The idea isn't to be covered for the month of December. The idea is to be NOT covered and still showing a low enough income to be Medicaid eligible for as long as possible.
Medicaid coverage begins no more than 45 days from application.  Today is 4/3/18, apply today and it starts for 5/1/18.  Apply on 4/16/18 and it starts on 6/1/18.  However it can be retroactive up to 90 days, provided you are eligible in the retroactive period.  So have no coverage all year, harvest your income in month X.  But be aware that for that harvest month you are not eligible, so do the harvest on the last day of the month.  Hopefully you never get sick and never have to invoke the application.  If you do get sick go to the ER, explain the situation, they will have you apply with a retroactive request.

How this would work in the real world is to be seen.
« Last Edit: April 03, 2018, 11:34:54 AM by jim555 »

heybro

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Re: Healthcare in FIRE
« Reply #55 on: April 17, 2018, 04:22:53 PM »
Hey Bro! That’s a fun username.

You're the first one to notice.  :)  Thanks dude!