Author Topic: ACA Shopping  (Read 3439 times)

Tubby

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ACA Shopping
« on: October 03, 2016, 10:50:57 AM »
Getting my ducks in a row for retirement in 2017 at 56 years old.

I've been looking at the Obamacare plans and my first inclination is to get into a gold plan, but we are in good health and don't foresee any major issues in the next year or two (I know, "but who does?").

Given that, might it be a better idea to get into a cheaper silver (or bronze) plan and pay the out of pocket and higher co-pays if anything pops up? At the next renewal, I assume that I could upgrade to a more comprehensive plan if need be.

jim555

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Re: ACA Shopping
« Reply #1 on: October 03, 2016, 11:19:07 AM »
Silver plans with cost sharing reductions (CSR) would be something to look at.  FPL would need to be under 250% for the CSRs.

tipster350

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Re: ACA Shopping
« Reply #2 on: October 03, 2016, 12:38:25 PM »
Silver plans. As mentioned above this is what you want if you are possibly seeking CSR. In general the Silver offers the best balance of coverage and out of pocket costs. However, over the long term, for people paying the premium themselves, the average total paid out of pocket be roughly the same for all plan levels.

seattlecyclone

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Re: ACA Shopping
« Reply #3 on: October 03, 2016, 12:53:38 PM »
If you're in reasonably good health and paying the out-of-pocket max on a silver or bronze plan wouldn't be a severe financial hardship, one of those plans is likely to be a better buy. If you do acquire some chronic health issues that would cause a higher coverage level to be a better deal in your situation, you can always switch for the next plan year.

Exflyboy

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Re: ACA Shopping
« Reply #4 on: October 03, 2016, 09:34:09 PM »
Yeah I kinda see it as the lower the plan the more self insured you are.. But only for one year.

Now of course one has to be a bit cautious when it comes to looking at the max OOP cost, the reality is that max OOP might be quite a bit higher if you get cancer or have some accident when a non covered specialist is asked for their opinion when your laying unconscious .. "Oh an extra $3000 please" which the insurance company doesn't cover.

Having said that, if say $25k in a single year won't hurt too bad then yeah, go for the bronze..:)

Classical_Liberal

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Re: ACA Shopping
« Reply #5 on: October 07, 2016, 12:32:01 PM »
If you're in reasonably good health and paying the out-of-pocket max on a silver or bronze plan wouldn't be a severe financial hardship, one of those plans is likely to be a better buy. If you do acquire some chronic health issues that would cause a higher coverage level to be a better deal in your situation, you can always switch for the next plan year.

+1

This is the most important thing to remember about ACA, you can change plans.  There are two types of devastating medical costs.  This first is an accident or single incident of some kind that lands someone in the hospital for a period of time from which one recovers within a relatively short period of time. For a mustachian having to pay 10-20K from the stash sucks, but is easily doable and you move on with life.

The second is a chronic condition that requires regular medical care.  In the event of this, ACA provides significant relief.  This person was previously uninsurable if switching plans and could be bankrupt in a few short years of treatment, now he/she gets subsidies to make it "affordable".   IMO this is a huge safety net for the early retiree.

I supposed a third issue may be some type of expensive planned procedure (ie hip replacement from 10 years of rock climbing).  For this I would seriously consider medical tourism if I had a high deductible plan or again, switching plans the next year and waiting to have it done.

One last consideration.  It is possible to get plans that are not in the ACA marketplace. If you do not get subsidies and you are a healthy young person, it may behove you to get a high deductible plan that offers specific things you are looking for.  It still may be cheaper to pay the penalty and get the non marketplace plan for your specific needs.  Then, in the event of a chronic problem that would raise your rate, switch to a subsidized ACA plan as soon as possible.

Spork

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Re: ACA Shopping
« Reply #6 on: October 07, 2016, 12:59:54 PM »

One last consideration.  It is possible to get plans that are not in the ACA marketplace. If you do not get subsidies and you are a healthy young person, it may behove you to get a high deductible plan that offers specific things you are looking for. It still may be cheaper to pay the penalty and get the non marketplace plan for your specific needs.  Then, in the event of a chronic problem that would raise your rate, switch to a subsidized ACA plan as soon as possible.

Wait... is that true?  If you buy a non-marketplace plan, are you subject to the penalty?  I'm near the edge of subsidies and I was considering trying a year off the marketplace just to see if the options were better.

Classical_Liberal

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Re: ACA Shopping
« Reply #7 on: October 07, 2016, 01:03:36 PM »

One last consideration.  It is possible to get plans that are not in the ACA marketplace. If you do not get subsidies and you are a healthy young person, it may behove you to get a high deductible plan that offers specific things you are looking for. It still may be cheaper to pay the penalty and get the non marketplace plan for your specific needs.  Then, in the event of a chronic problem that would raise your rate, switch to a subsidized ACA plan as soon as possible.

Wait... is that true?  If you buy a non-marketplace plan, are you subject to the penalty?  I'm near the edge of subsidies and I was considering trying a year off the marketplace just to see if the options were better.

http://obamacarefacts.com/private-health-plans-outside-the-marketplace/

Yes, but you will likely have to pay the tax penalty, unless you are under 30 or can get a hardship exception.

Edit: At least that is my understanding.

Spork

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Re: ACA Shopping
« Reply #8 on: October 07, 2016, 01:15:15 PM »

One last consideration.  It is possible to get plans that are not in the ACA marketplace. If you do not get subsidies and you are a healthy young person, it may behove you to get a high deductible plan that offers specific things you are looking for. It still may be cheaper to pay the penalty and get the non marketplace plan for your specific needs.  Then, in the event of a chronic problem that would raise your rate, switch to a subsidized ACA plan as soon as possible.

Wait... is that true?  If you buy a non-marketplace plan, are you subject to the penalty?  I'm near the edge of subsidies and I was considering trying a year off the marketplace just to see if the options were better.

http://obamacarefacts.com/private-health-plans-outside-the-marketplace/

Yes, but you will likely have to pay the tax penalty, unless you are under 30 or can get a hardship exception.

Edit: At least that is my understanding.

So far, what I am seeing is that the penalty is for "not having insurance" -- not for "not having insurance via the marketplace".  The latter doesn't make sense to me.... but... it's government, so it may still be true.

Jammu

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Re: ACA Shopping
« Reply #9 on: October 07, 2016, 10:09:06 PM »
My understanding is that you can buy a plan off the exchange but subsidies are limited to exchange policies.


Frs1661

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Re: ACA Shopping
« Reply #10 on: October 08, 2016, 05:45:54 AM »
You can get off marketplace plans that are aca-compliant, and plans that are not.  If it meets the minimum coverage required by the aca you won't be required to pay the penalty. If it does not you will.

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