Author Topic: Health Coverage Outside of ACA  (Read 1958 times)

Rollin

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Health Coverage Outside of ACA
« on: July 07, 2016, 06:21:12 AM »
Have any of you purchased coverage outside of the Affordable Care Act (i.e., not go through the exchange)? I am FIREing in 18 days and because I stayed so long this year I do not qualify for any subsidies. My quote using the ACA website was $918/month for my DW and me.

I just looked at ehealthinsurance.com and saw that I could get short-term coverage (up to 180 days) for about $300-500 for the both of us (depending on deductables, etc.). So that is a much better rate for the last 4 months of the year. Next year my Modified Adjusted Gross Income will qualify me for coverage with a subsidy.

rubybeth

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Re: Health Coverage Outside of ACA
« Reply #1 on: July 07, 2016, 06:37:04 AM »
Well, you're not really "outside of the ACA" since it's a law, not a type of insurance. ;)

If you're just looking at the federal website for plans, you may also want to check with an insurance broker in your state/region/county (if your state doesn't have an exchange--then look there, as well). I know some people have had better luck going directly to insurance providers and searching on their sites for coverage and applying directly (in my state, that would be Medica, HealthPartners, etc.) but that varies by state.

jim555

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Re: Health Coverage Outside of ACA
« Reply #2 on: July 07, 2016, 08:03:19 AM »
Did you factor in the penalty for no insurance since the short term coverage is not considered "credible"?  Maybe Medicaid is an option for you (if your monthly income is low enough and your state expanded)?  It is based on monthly income your previous income for the year is not considered.
« Last Edit: July 07, 2016, 08:08:12 AM by jim555 »

Rollin

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Re: Health Coverage Outside of ACA
« Reply #3 on: July 07, 2016, 08:57:53 AM »
jim555 I was wondering about that (if it was credible or not). I think I am going to try the broker route, as that is their business and not mine. I'm finding that in my preparation for FIRE I study and research for hours at a time and that gets me to a level of understanding way more than the average citizen, but still not far enough (or far enough to get me into trouble :)). Also, I've had pretty good experience going the broker route (mortgage and insurance to be specific).

Thanks.

Spork

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Re: Health Coverage Outside of ACA
« Reply #4 on: July 07, 2016, 09:05:06 AM »
following...  Mostly want to hear of "outside of the exchange" costs/experiences as compared to "inside the exchange."  I'm currently on a plan in the exchange, but I'm finding doctor selection is not great on my plan.  If there was a comparable plan outside the exchange ... I would be interested.

catccc

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Re: Health Coverage Outside of ACA
« Reply #5 on: July 07, 2016, 09:46:37 AM »
A few times in my adult life, I have purchased indemnity health insurance.  It was basically just in case something catastrophic happened, I wouldn't be on the hook for more than some high deductible.  I didn't plan on using it at all, really, which was an easy bet because I was young and healthy.  For me, the plan was a back up for a random accident or something similar.  (I am still relatively young and healthy and would do it again, actually.)

These purchases of health insurance were all pre-ACA, so IDK what similar plans, if any are available now.  I did find them on ehealthinsurance.com.

Good luck!

Choices

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Re: Health Coverage Outside of ACA
« Reply #6 on: July 07, 2016, 10:02:00 AM »
Well, you're not really "outside of the ACA" since it's a law, not a type of insurance. ;)

If you're just looking at the federal website for plans, you may also want to check with an insurance broker in your state/region/county (if your state doesn't have an exchange--then look there, as well). I know some people have had better luck going directly to insurance providers and searching on their sites for coverage and applying directly (in my state, that would be Medica, HealthPartners, etc.) but that varies by state.

We used ehealthinsurance once and it was just a giant hassle to have the middle man and have multiple sets of paperwork and multiple people calling and emailing us when they "lost" said electronic paperwork. When it was open enrollment time again, we used ehealthinsurance to compare the rates among various companies, but we purchased directly from one company's website and it was a huge improvement.

Cpa Cat

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Re: Health Coverage Outside of ACA
« Reply #7 on: July 07, 2016, 10:09:52 AM »
Yes. We don't qualify for subsidies.

The marketplace is convenient for shopping and enrolling, but it's not always the best cost. For example, in 2015, I enrolled in a bronze HSA-eligible plan on the exchange, but in 2016 it was delisted, and only more expensive bronze plans were available. I found the exact plan - $80/mo cheaper than anything on the exchange - through the provider's website.

If you know for sure that you don't qualify for subsidies, then it is absolutely worthwhile to shop around. There are major health insurance providers who do not participate in the ACA exchanges at all.

There's been a lot of talk from some insurers that the Marketplace has not been profitable, because they're finding that a higher-risk pool of people use the Marketplace. If that's the case, then the cost savings of non-exchange plans could expand in the future.

Rollin

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Re: Health Coverage Outside of ACA
« Reply #8 on: July 07, 2016, 10:38:59 AM »
Thank you for all the responses so far. I just got off the phone with a local person that assists in ACA information and she stated that the short-term stuff could end me up with a penalty if I utilize it for 3 months or more. So, I think the simplified route will be best and that is do what we all normally do - shop around and compare!

Sibley

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Re: Health Coverage Outside of ACA
« Reply #9 on: July 07, 2016, 10:50:58 AM »
You can still get individual health policies directly from insurers. They will probably comply with ACA's coverage rules. The subsides don't apply though, if you want a subsidy then you have to go through the Marketplace (most states use the Federal site, but some states have their own).

Rollin

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Re: Health Coverage Outside of ACA
« Reply #10 on: July 07, 2016, 11:46:25 AM »
Another update - my COBRA (for me and DW) is less than the open market! $870 vs. $920, and better coverage.

Axecleaver

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Re: Health Coverage Outside of ACA
« Reply #11 on: July 07, 2016, 03:03:24 PM »
Congrats on FIRE! It really depends on your state, each state determines the rules for what plans are allowed on the Exchange and which are permitted off the Exchange. In NY the plans are essentially the same, although you can get a lot more "options/riders" off-Exchange. Rates are the same on or off exchange here, but that's not always true in every state.

I also recommend you price two single adults, vs a married couple. Single policies are sometimes cheaper than married couples (because lots of childless married couples have kids). This is especially true for couples who have different coverage needs.

Also look at the annual deductible. You only have six months left to use it this year, so a high deductible plan may not make sense for you. Next year, it probably will.

If you like, you can use the short coverage gap exemption this year. This allows you to go without insurance for "no more than two months." healthcare.gov Source