Obamacare renewal

[NorcalBlue]

...snip...

What a mess

Welcome to government run health care.  Isn't it wonderful?

I guess I just assumed there were some drawbacks going onto Medi-Cal?  Thought I read something about them being able to claw back the amount they covered once you die?  The other problem is, I'll be setting up a Roth Ladder next year and will be maxing out the amount I can transfer into my Roth while staying in the 15% tax bracket.  Therefore, my income is going to be much higher than the 15k level of Medical.  Just seems like a PIA going back and forth.  And yeah, I probably have some eithical hangups as well.

Any downsides in your guys opinion on using Medi-Cal?  Also, I didn't know it was monthly or I could have used it last year.  I made $90k or so, but that was the first 2 months of the year.  After that, I didn't make anything other than dividend income.

Yeah, better than no coverage for your pre-existing condition if your cancer came back!.. I.e bankruptcy or death!

[jim555]

My UI ran out mid year, I then reported the drop in income and it put me in Medicaid.  Estate recovery is for 55+.  I am under 55 so it is not an issue right now.

[Tyler]

We re-enrolled yesterday.  With new part-time work our income is highly unpredictable for next year, so we elected to bypass the pre-paid subsidies and pay the full rate each month.  It'll all be sorted out when we eventually file our 2016 taxes, and perhaps we'll get a large return. 

I did find one quirk in the healthcare.gov enrollment process.  Our application was mostly pre-filled using info from last time (we also used the ACA in 2015).  Knowing that we planned to pay the premium in full and receive our subsidies with our tax return, I first selected not to enter our income info.  But when I reviewed the info before submitting the application, I noted that it had my old employer still listed and said we are offered 2016 health insurance from them (with no way to change that setting).  That would disqualify us from subsidies we are legally entitled to!

The only way to fix it was to go back and enter income info, including roughly what we make in investments and our expected income for 2016.  That also brings up the option to verify whether employer health insurance is an option for you.  Once the application is submitted and you shop for plans, you can still choose whether to receive your subsidy each month or to pay it yourself and reconcile it with your taxes.  Problem solved.

While the process wasn't intuitive, it ultimately was pretty easy. 

[Financial.Velociraptor]

FV, was your Tourette's syndrome pre-existing or caused by the proces of trying to get a health plan?

Pre-existing.  Symptoms usually start in adolescence. 

[arebelspy]

FV, was your Tourette's syndrome pre-existing or caused by the proces of trying to get a health plan?

I laughed. :)

[Abe]

More ACA ridiculousness:
My wife recently got a new job and her health insurance is better than mine. I enrolled in her plan, and emailed my HR office to advise them that I wanted to cancel. They said ok, send proof of coverage. It took me a while to get it to them, and now they said I had to send within 30 days, but now I can't and have to keep paying for un-needed insurance until May, when we can adjust benefit options. Putting aside the inherent unfairness of this scam, my Question is: should I finally get that MRI I've been putting off to recoup my expenses for next several months?

[jim555]

More ACA ridiculousness:
My wife recently got a new job and her health insurance is better than mine. I enrolled in her plan, and emailed my HR office to advise them that I wanted to cancel. They said ok, send proof of coverage. It took me a while to get it to them, and now they said I had to send within 30 days, but now I can't and have to keep paying for un-needed insurance until May, when we can adjust benefit options. Putting aside the inherent unfairness of this scam, my Question is: should I finally get that MRI I've been putting off to recoup my expenses for next several months?

Both insurances are from private employers?  That is not an ACA related problem.

[Abe]

They claim it is due to the ACA. The HR person couldn't fully explain what part of the ACA allows them to do what they're doing, making me think you are right and they are just trying to scam me. I asked to talk to an HR managed to explain their actions.

[Gin1984]

They claim it is due to the ACA. The HR person couldn't fully explain what part of the ACA allows them to do what they're doing, making me think you are right and they are just trying to scam me. I asked to talk to an HR managed to explain their actions.

It is not from the ACA, the law that only allowes changes withing thirty days of a life event was in place way before the ACA.  They are not trying to screw you, it is the law, just not the law they are citing. 

[Pookie]

I left my job in July of this year to manage our properties full time! Yeah! This morning, I renewed our ACA insurance. We received subsidies in 2015 because of my "job" income. For 2016, if I list our MAGI, we don't qualify for anything and our children can get Medicaid. Our premium is over $1,000 for regular coverage. (vs $450 for covering all 4 of us) NC didn't expand Medicaid. Do I need to find something to increase our income to $25K in 2016? At this point with our income, we won't qualify to receive any subsidies - which would be nice to reconcile with at tax time IF for some reason our estimates are wrong.

If I can increase our (MAGI) income to $25k, our premium is @ $45/month! What do I do????? Since we own rentals, our income is under $10,000. Is this all just really a blessing in disguise? Am I missing the benefit here?

AND...I have spent so many HOURS trying to get everything sorted out, sending in documentation, not getting the correct coverage (lax communication btw healthcare.gov and United Healthcare), mixed up premiums......I have been in tears many times over the frustration of it all!!!

[jorjor]

They claim it is due to the ACA. The HR person couldn't fully explain what part of the ACA allows them to do what they're doing, making me think you are right and they are just trying to scam me. I asked to talk to an HR managed to explain their actions.

It is not from the ACA, the law that only allowes changes withing thirty days of a life event was in place way before the ACA.  They are not trying to screw you, it is the law, just not the law they are citing.

I'll revise this a bit to add detail. The ACA REQUIRES an insurer to allow changes within X days of a life event. The insurer may allow changes outside of that window, but is not required to do so. They usually don't, of course, because of antiselection issues.

It is called a special enrollment period, and is actually 60 days for non job-based plans and 30 days for job based plans. I am not sure of the exact restrictions before the ACA, but it likely would have varied by state.

[Mr. Green]

I left my job in July of this year to manage our properties full time! Yeah! This morning, I renewed our ACA insurance. We received subsidies in 2015 because of my "job" income. For 2016, if I list our MAGI, we don't qualify for anything and our children can get Medicaid. Our premium is over $1,000 for regular coverage. (vs $450 for covering all 4 of us) NC didn't expand Medicaid. Do I need to find something to increase our income to $25K in 2016? At this point with our income, we won't qualify to receive any subsidies - which would be nice to reconcile with at tax time IF for some reason our estimates are wrong.

If I can increase our (MAGI) income to $25k, our premium is @ $45/month! What do I do????? Since we own rentals, our income is under $10,000. Is this all just really a blessing in disguise? Am I missing the benefit here?

AND...I have spent so many HOURS trying to get everything sorted out, sending in documentation, not getting the correct coverage (lax communication btw healthcare.gov and United Healthcare), mixed up premiums......I have been in tears many times over the frustration of it all!!!

Unless your income is so low that you (the adults) qualify for Medicaid as caretakers/parents of children, you may need to get your income above ~25k if you want affordable healthcare options. I deal with Medicaid in NC for my father and the info presented on the State's website can be confusing. If ACA is saying you're below the income level to qualify for subsidies I would recommend you go to your county Department of Social Services office and either inquire about or apply for Medicaid to be sure there isn't a provision that extends coverage to you as parents earning less than 100% of the Federal Poverty Line.

https://dma.ncdhhs.gov/medicaid/get-started/eligibility-for-medicaid-or-health-choice/medicaid-income-and-resources-requirements

[jim555]

I left my job in July of this year to manage our properties full time! Yeah! This morning, I renewed our ACA insurance. We received subsidies in 2015 because of my "job" income. For 2016, if I list our MAGI, we don't qualify for anything and our children can get Medicaid. Our premium is over $1,000 for regular coverage. (vs $450 for covering all 4 of us) NC didn't expand Medicaid. Do I need to find something to increase our income to $25K in 2016? At this point with our income, we won't qualify to receive any subsidies - which would be nice to reconcile with at tax time IF for some reason our estimates are wrong.

If I can increase our (MAGI) income to $25k, our premium is @ $45/month! What do I do????? Since we own rentals, our income is under $10,000. Is this all just really a blessing in disguise? Am I missing the benefit here?

AND...I have spent so many HOURS trying to get everything sorted out, sending in documentation, not getting the correct coverage (lax communication btw healthcare.gov and United Healthcare), mixed up premiums......I have been in tears many times over the frustration of it all!!!

You should aim for a income of 101% FPL.  This will get you the max subsidy and children will get CHIP.

[Mr. Green]

You should aim for a income of 101% FPL.  This will get you the max subsidy and children will get CHIP.

I was doing some projecting with ACA earlier this year so I'd have some idea as to cost when we FIRE and I was amazed how high our income had to be for our (future) children to not use CHIP. For a family of 4 the threshold was ~50k!

[Frugal_NYC]

Is anyone (early retiree perspective) worried about insurance continuing to massively outpace the rate of inflation?  Or is the view if you keep you income super low you will be OK?

[jim555]

Is anyone (early retiree perspective) worried about insurance continuing to massively outpace the rate of inflation?  Or is the view if you keep you income super low you will be OK?

I keep my income below 138% FPL so it is not an issue.  I worry they will repeal the ACA, then I will be hurt.

[Mr. Green]

Is anyone (early retiree perspective) worried about insurance continuing to massively outpace the rate of inflation?  Or is the view if you keep you income super low you will be OK?

It's simply not possible. The same way the rise in college costs isn't sustainable. Eventually the system will break. In the case of college, people will just stop going. But having half the country choose not to have healthcare isn't going to work.

[jorjor]

Is anyone (early retiree perspective) worried about insurance continuing to massively outpace the rate of inflation?  Or is the view if you keep you income super low you will be OK?

It's simply not possible. The same way the rise in college costs isn't sustainable. Eventually the system will break. In the case of college, people will just stop going. But having half the country choose not to have healthcare isn't going to work.

What's the breaking point though? If you said this in the 90s when trends were much higher than today, would you have thought it would have been allowed to get to this point?

[seattlecyclone]

You should aim for a income of 101% FPL.  This will get you the max subsidy and children will get CHIP.

I was doing some projecting with ACA earlier this year so I'd have some idea as to cost when we FIRE and I was amazed how high our income had to be for our (future) children to not use CHIP. For a family of 4 the threshold was ~50k!

Yeah, I was surprised by this as well. In Washington the threshold is $75k for a family of four, with $30/month premiums per kid.

[Pookie]

Since NC didn't extend or expand (?) Medicaid, we make too much to qualify but there's a gap between 100% of the PL and Medicaid. How do they think people are supposed to pay for insurance if they fall in this gray area. I don't want to go back to work but at this point we'll be paying over $12k year!
Yuck!

[jim555]

Since NC didn't extend or expand (?) Medicaid, we make too much to qualify but there's a gap between 100% of the PL and Medicaid. How do they think people are supposed to pay for insurance if they fall in this gray area. I don't want to go back to work but at this point we'll be paying over $12k year!
Yuck!

They screwed some folks.  Thank your local politicians for it.

[Mr. Green]

Is anyone (early retiree perspective) worried about insurance continuing to massively outpace the rate of inflation?  Or is the view if you keep you income super low you will be OK?

It's simply not possible. The same way the rise in college costs isn't sustainable. Eventually the system will break. In the case of college, people will just stop going. But having half the country choose not to have healthcare isn't going to work.

What's the breaking point though? If you said this in the 90s when trends were much higher than today, would you have thought it would have been allowed to get to this point?

That I can't say. Not considering the problem of high health care costs, the introduction of the ACA would, in theory cause a non linear jump in insurance costs because it made insurance available to all the sick people who were previously denied access.

Personally, I don't think health insurance is the root of the problem. I think the actual cost of care is. Have you seen some of the insane prices people get charged on hospital bills? No amount of "overhead" can account for why a ten cent alcohol wipe costs $5. There are hospital administrators running around making multi-million dollar salaries and specialized "wings" like cancer centers are popping up everywhere because they're making so much money they have to invest in capital improvements to lower the margin so they resemble some kind of non-profit. Again, very similar to what's happening at colleges. I was hoping when the Feds forced hospitals to open their books on why things cost what they do some things would start to change but that data has been slow in making its way to the consumer.

[jorjor]

Is anyone (early retiree perspective) worried about insurance continuing to massively outpace the rate of inflation?  Or is the view if you keep you income super low you will be OK?

It's simply not possible. The same way the rise in college costs isn't sustainable. Eventually the system will break. In the case of college, people will just stop going. But having half the country choose not to have healthcare isn't going to work.

What's the breaking point though? If you said this in the 90s when trends were much higher than today, would you have thought it would have been allowed to get to this point?

That I can't say. Not considering the problem of high health care costs, the introduction of the ACA would, in theory cause a non linear jump in insurance costs because it made insurance available to all the sick people who were previously denied access.

Personally, I don't think health insurance is the root of the problem. I think the actual cost of care is. Have you seen some of the insane prices people get charged on hospital bills? No amount of "overhead" can account for why a ten cent alcohol wipe costs $5. There are hospital administrators running around making multi-million dollar salaries and specialized "wings" like cancer centers are popping up everywhere because they're making so much money they have to invest in capital improvements to lower the margin so they resemble some kind of non-profit. Again, very similar to what's happening at colleges. I was hoping when the Feds forced hospitals to open their books on why things cost what they do some things would start to change but that data has been slow in making its way to the consumer.

I partially agree.  I have posts in some other thread suggesting as much. The ACA left that aspect almost completely untouched. Though, one can argue that the current system which is dominated by employer-subsidized health insurance, which largely masks the true costs from those who seek care, has allowed cost of care to skyrocket.

I'm a health actuary, btw, so I get to see this stuff a lot.

[Mr. Green]

I partially agree.  I have posts in some other thread suggesting as much. The ACA left that aspect almost completely untouched. Though, one can argue that the current system which is dominated by employer-subsidized health insurance, which largely masks the true costs from those who seek care, has allowed cost of care to skyrocket.

I'm a health actuary, btw, so I get to see this stuff a lot.

I read this article in Time two years ago that absolutely blew my mind. For one, the depth of the analysis in the article, not to mention how long it was. 42 pages! Makes me hope I live a life of good health and die in my sleep without ever stepping foot in a hospital. Time has since locked down the article to subscribers only but I found a copy of it through a university. Truly amazing stuff.

http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf

[Pookie]

If we didn't have a birth mother/egg donor (I am being nice) who won't allow her (my step dtrs) to get passports, we'd move overseas! I have had amazing dental work in Guatemala for pennies on the dollar and in Taiwan. Our system is so over priced...like one said - alcohol wipes for $5. One aspirin for $3. Reusable drill bit for $1100! Hello????

Still trying to figure out  how to get our income up. Even if we add three more properties, we still won't get to $25k because of the awesomeness of passive income and tax deductions....crazy!

[Mr. Green]

If we didn't have a birth mother/egg donor (I am being nice) who won't allow her (my step dtrs) to get passports, we'd move overseas! I have had amazing dental work in Guatemala for pennies on the dollar and in Taiwan. Our system is so over priced...like one said - alcohol wipes for $5. One aspirin for $3. Reusable drill bit for $1100! Hello????

Still trying to figure out  how to get our income up. Even if we add three more properties, we still won't get to $25k because of the awesomeness of passive income and tax deductions....crazy!

Perhaps simply not taking some of the deductions you can will end up being less expensive than than trying to find more income. If you were at 20k, removing 5k in tax deductions would get you to 25k and only cost you about $1,000 in taxes. I'm sure the savings you would reap through subsidies would far outweigh that, and would at least bring the cost of care down to something reasonable. For instance, you don't have to depreciate a rental that year. Take your property tax deductions because you can't make those up, but just don't take the depreciation deduction.

[Exflyboy]

I partially agree.  I have posts in some other thread suggesting as much. The ACA left that aspect almost completely untouched. Though, one can argue that the current system which is dominated by employer-subsidized health insurance, which largely masks the true costs from those who seek care, has allowed cost of care to skyrocket.

I'm a health actuary, btw, so I get to see this stuff a lot.

I read this article in Time two years ago that absolutely blew my mind. For one, the depth of the analysis in the article, not to mention how long it was. 42 pages! Makes me hope I live a life of good health and die in my sleep without ever stepping foot in a hospital. Time has since locked down the article to subscribers only but I found a copy of it through a university. Truly amazing stuff.

http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf

Dear God that article made me ill reading it!

[Vee2001]

Perhaps simply not taking some of the deductions you can will end up being less expensive than than trying to find more income. If you were at 20k, removing 5k in tax deductions would get you to 25k and only cost you about $1,000 in taxes. I'm sure the savings you would reap through subsidies would far outweigh that, and would at least bring the cost of care down to something reasonable. For instance, you don't have to depreciate a rental that year. Take your property tax deductions because you can't make those up, but just don't take the depreciation deduction.

Is this possible?  Where can I find more information?  I have about $37.5k in depreciation per year and $80k in "losses" that will be carried over to the 2015 tax year.  Do I have to burn through my carry over losses first?

It's not a big deal to me right now because I want that $25k/year loss to go on my 1040 and lower my AGI (due to earned income).  However, I could see going ER in the next year or two and the ability to fine tune my AGI / MAGI (I still don't fully understand what goes into MAGI) seems very useful.

[rtrnow]

Perhaps simply not taking some of the deductions you can will end up being less expensive than than trying to find more income. If you were at 20k, removing 5k in tax deductions would get you to 25k and only cost you about $1,000 in taxes. I'm sure the savings you would reap through subsidies would far outweigh that, and would at least bring the cost of care down to something reasonable. For instance, you don't have to depreciate a rental that year. Take your property tax deductions because you can't make those up, but just don't take the depreciation deduction.

Is this possible?  Where can I find more information?  I have about $37.5k in depreciation per year and $80k in "losses" that will be carried over to the 2015 tax year.  Do I have to burn through my carry over losses first?

It's not a big deal to me right now because I want that $25k/year loss to go on my 1040 and lower my AGI (due to earned income).  However, I could see going ER in the next year or two and the ability to fine tune my AGI / MAGI (I still don't fully understand what goes into MAGI) seems very useful.

I'm certainly not an expert, but my understanding is that you must pay taxes on the depreciation that you could have taken when you sell. That's regardless of whether you actually took the depreciation write off. That said, you still may come out ahead not taking it and paying more capital gains later.

[jorjor]

I partially agree.  I have posts in some other thread suggesting as much. The ACA left that aspect almost completely untouched. Though, one can argue that the current system which is dominated by employer-subsidized health insurance, which largely masks the true costs from those who seek care, has allowed cost of care to skyrocket.

I'm a health actuary, btw, so I get to see this stuff a lot.

I read this article in Time two years ago that absolutely blew my mind. For one, the depth of the analysis in the article, not to mention how long it was. 42 pages! Makes me hope I live a life of good health and die in my sleep without ever stepping foot in a hospital. Time has since locked down the article to subscribers only but I found a copy of it through a university. Truly amazing stuff.

http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf

Dear God that article made me ill reading it!

It was made into a book too, if you want to read that.

[Mr. Green]

I partially agree.  I have posts in some other thread suggesting as much. The ACA left that aspect almost completely untouched. Though, one can argue that the current system which is dominated by employer-subsidized health insurance, which largely masks the true costs from those who seek care, has allowed cost of care to skyrocket.

I'm a health actuary, btw, so I get to see this stuff a lot.

I read this article in Time two years ago that absolutely blew my mind. For one, the depth of the analysis in the article, not to mention how long it was. 42 pages! Makes me hope I live a life of good health and die in my sleep without ever stepping foot in a hospital. Time has since locked down the article to subscribers only but I found a copy of it through a university. Truly amazing stuff.

http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf

Dear God that article made me ill reading it!

It was made into a book too, if you want to read that.

Really? I didn't know that!

[Pookie]

Figured out for now......let's see what happens on our 2016 taxes. We can not take some of our mileage deductions and a few other expense and get our income up to $25k. We got a decent subsidy.....thank goodness! Let's hope it all comes out in the wash come December 2016. I don't see how accountants and the gov't. can keep up with all of this!
On a side note, our income is so low that our girls qualified for Medicaid. Now I have a DSS worker looking over my taxes to see if we qualify for Medicaid. Don't mean to sound rude but they don't understand tax returns or AGI or expenses. We already had one DSS worker tell us earlier this year that we don't qualify because of our gross income - which isn't even used to qualify. After the way we were treated yesterday (like idiots) by one worker, I'd rather just PAY for insurance for our girls and not step foot in DSS. Can't imagine how people who really need help are treated when they walk into DSS.
I am thankful for AMA but it has been a headache and taken MANY hours so far to apply, etc.

Thanks for everyone's input!

[Spork]

And right after I asked that question, I got another letter from the marketplace asking again for the same thing.  I'm not sure if that is a rejection of my submitted docs or just them being redundant.  When I login to healthcare.gov, it isn't any more clear there either.  Damn it, I guess I have to call them.

That happened to me last year.  Calling wasn't much help.

My original document submission was as a single merged PDF submitted in the "other" category when you upload the files.  After I got that "need more info" message, I resubmitted the info as separate files categorized appropriately.  I also noticed that my first "proof of income" submission was a screenshot of my brokerage statement that didn't have my name and address visible, which I later read was a requirement for any submitted document.  The second time I submitted the full statement with the pertinent info highlighted.  Those two changes did the trick for me.

Mine was uploaded as a single PDF categorized as "other" as well.  Following your lead, I busted it into chunks I could correctly categorize and uploaded it again.

oh bloody hell....

I am still getting the "need more information" from them.  (I'm a couple hours from home, living out of a ratty hotel room, dealing with a very sick relative and have been for the last month.)  They've given me a list of probable documents they would want -- none of which I will have.  Any further idea what these jackasses want? 

What I've supplied:
* brokerage account balance screenshot
* Trad IRA account balance screenshot (since I will be doing roth conversions as income)
* letter from employer saying my last day was X

[Tyler]

What I've supplied:
* brokerage account balance screenshot
* Trad IRA account balance screenshot (since I will be doing roth conversions as income)
* letter from employer saying my last day was X

Based on their completely non-transparent system with no real feedback, it's anybody's guess. 

But here's mine: 

1) I don't think they like screenshots.  Try submitting a full PDF statement from your brokerage and make sure it includes your name and address.

2) They generally don't care about account balances because the benefits are not means tested.  The only thing that really matters is income (for investments -- dividends, interest, and capital gains).  If you're trying to make the argument that you will use your account balances to generate income in the future in ways that you have not in the past, you may need to be more specific. 

Beyond that, I'm not sure what to tell you.  :/  Sorry you're dealing with that.

[Spork]

What I've supplied:
* brokerage account balance screenshot
* Trad IRA account balance screenshot (since I will be doing roth conversions as income)
* letter from employer saying my last day was X

Based on their completely non-transparent system with no real feedback, it's anybody's guess. 

But here's mine: 

1) I don't think they like screenshots.  Try submitting a full PDF statement from your brokerage and make sure it includes your name and address.

2) They generally don't care about account balances because the benefits are not means tested.  The only thing that really matters is income (for investments -- dividends, interest, and capital gains).  If you're trying to make the argument that you will use your account balances to generate income in the future in ways that you have not in the past, you may need to be more specific. 

Beyond that, I'm not sure what to tell you.  :/  Sorry you're dealing with that.

I guess I included traditional IRA balance because it will be a reportable event-- I'll be starting a Roth conversion leader.

[Spork]

What I've supplied:
* brokerage account balance screenshot
* Trad IRA account balance screenshot (since I will be doing roth conversions as income)
* letter from employer saying my last day was X

Based on their completely non-transparent system with no real feedback, it's anybody's guess. 

But here's mine: 

1) I don't think they like screenshots.  Try submitting a full PDF statement from your brokerage and make sure it includes your name and address.

2) They generally don't care about account balances because the benefits are not means tested.  The only thing that really matters is income (for investments -- dividends, interest, and capital gains).  If you're trying to make the argument that you will use your account balances to generate income in the future in ways that you have not in the past, you may need to be more specific. 

Beyond that, I'm not sure what to tell you.  :/  Sorry you're dealing with that.

20 minutes on the phone with them.  All they can do is read me the Eligibility notice they mailed me verbatim.  At one point they told me I should send my 2015 1040 (which doesn't exist yet).  It took me several minutes to explain to them why I haven't done my 2015 taxes.  They finally said 2014 would be enough -- EVEN THOUGH MY 2014 INCOME IS TOO HIGH TO QUALIFY. 

I was getting the impression she just wanted me off the phone so she could be done with me. 

[thriftyc]

All else fails - you could immigrate to Canada!  The high US$ verses the CND$ right now is an ideal time to come to the great North and FIRE!  - Healthcare coverage included too. ;)

[arebelspy]

What I've supplied:
* brokerage account balance screenshot
* Trad IRA account balance screenshot (since I will be doing roth conversions as income)
* letter from employer saying my last day was X

Based on their completely non-transparent system with no real feedback, it's anybody's guess. 

But here's mine: 

1) I don't think they like screenshots.  Try submitting a full PDF statement from your brokerage and make sure it includes your name and address.

2) They generally don't care about account balances because the benefits are not means tested.  The only thing that really matters is income (for investments -- dividends, interest, and capital gains).  If you're trying to make the argument that you will use your account balances to generate income in the future in ways that you have not in the past, you may need to be more specific. 

Beyond that, I'm not sure what to tell you.  :/  Sorry you're dealing with that.

20 minutes on the phone with them.  All they can do is read me the Eligibility notice they mailed me verbatim.  At one point they told me I should send my 2015 1040 (which doesn't exist yet).  It took me several minutes to explain to them why I haven't done my 2015 taxes.  They finally said 2014 would be enough -- EVEN THOUGH MY 2014 INCOME IS TOO HIGH TO QUALIFY. 

I was getting the impression she just wanted me off the phone so she could be done with me.

Can't you just pay the whole thing, with no subsidies, for a month or two until you get your 2015 taxes done, then resubmit, get subsidies, and get a credit for all the rest of the subsidies straightened out when you do your taxes next?  It'll cost you an extra few hundred bucks, temporarily, right?

An interest free loan to them, but the opportunity cost seems way higher than the time value of the effort put into fixing it now instead of later.

[jim555]

What I've supplied:
* brokerage account balance screenshot
* Trad IRA account balance screenshot (since I will be doing roth conversions as income)
* letter from employer saying my last day was X

If you are reporting Roth conversions be sure to divide it by 12 and give a monthly amount.  This is because of the way they calculate income.  Legally Medicaid is monthly based while APTC is yearly based.  So they care about how the income comes in.  This is assuming you want to stay out of Medicaid. 

[electriceagle]

Figured out for now......let's see what happens on our 2016 taxes. We can not take some of our mileage deductions and a few other expense and get our income up to $25k. We got a decent subsidy.....thank goodness! Let's hope it all comes out in the wash come December 2016. I don't see how accountants and the gov't. can keep up with all of this!
On a side note, our income is so low that our girls qualified for Medicaid. Now I have a DSS worker looking over my taxes to see if we qualify for Medicaid. Don't mean to sound rude but they don't understand tax returns or AGI or expenses. We already had one DSS worker tell us earlier this year that we don't qualify because of our gross income - which isn't even used to qualify. After the way we were treated yesterday (like idiots) by one worker, I'd rather just PAY for insurance for our girls and not step foot in DSS. Can't imagine how people who really need help are treated when they walk into DSS.
I am thankful for AMA but it has been a headache and taken MANY hours so far to apply, etc.

Thanks for everyone's input!

Surely theres a traditional IRA somewhere that can be converted to roth?

[Spork]

What I've supplied:
* brokerage account balance screenshot
* Trad IRA account balance screenshot (since I will be doing roth conversions as income)
* letter from employer saying my last day was X

Based on their completely non-transparent system with no real feedback, it's anybody's guess. 

But here's mine: 

1) I don't think they like screenshots.  Try submitting a full PDF statement from your brokerage and make sure it includes your name and address.

2) They generally don't care about account balances because the benefits are not means tested.  The only thing that really matters is income (for investments -- dividends, interest, and capital gains).  If you're trying to make the argument that you will use your account balances to generate income in the future in ways that you have not in the past, you may need to be more specific. 

Beyond that, I'm not sure what to tell you.  :/  Sorry you're dealing with that.

20 minutes on the phone with them.  All they can do is read me the Eligibility notice they mailed me verbatim.  At one point they told me I should send my 2015 1040 (which doesn't exist yet).  It took me several minutes to explain to them why I haven't done my 2015 taxes.  They finally said 2014 would be enough -- EVEN THOUGH MY 2014 INCOME IS TOO HIGH TO QUALIFY. 

I was getting the impression she just wanted me off the phone so she could be done with me.

Can't you just pay the whole thing, with no subsidies, for a month or two until you get your 2015 taxes done, then resubmit, get subsidies, and get a credit for all the rest of the subsidies straightened out when you do your taxes next?  It'll cost you an extra few hundred bucks, temporarily, right?

An interest free loan to them, but the opportunity cost seems way higher than the time value of the effort put into fixing it now instead of later.

I can't say I know for sure, but my temporary eligibility for subsidy ends February 1. I suspect not. And my 2015 income is too high to qualify anyway.

The first 1040 with eligible income will be 2016 taxes... And it will be 2017 ACA sign up before that will be usable.

[ender]

In England you also have private Doctors and insurance.

The doctors commit a certain amount of days to the nhs and the rest private. So you can go private or have insurance to go private as well as the basic underlying health service.

Years ago I screwed my knee up playing rugby. I had private insurance.
I went to my nhs doctor who referred me to a specialist. The specialist examined the knee and told me what needed (kneeded?) doing to resolve the issues.
At that point i could wait on the NHS waiting list and get the operation (18 month waiting list but no cost) or go private.

Private was covered by my private insurance. Took 2 weeks to the operation, done in a private hospital and by the same specialist who would have done it at the NHS hospital 2 miles away.


If you can afford the private coverage then things can be done quicker but it costs more. Otherwise I'd have got the same treatment but it would have take longer but covered under the NHS.


I see no reason why a similar system could work in the states. No system is perfect but this one here now is an expensive shambles.

I think it's inevitable that we will end up with a system like this.

A two tier system, with universal healthcare available for everyone, and then a secondary market which is basically "luxury" health insurance market.

Of course, the NHS isn't perfect by any stretch of the imagination either..

[brooklynguy]

Can't you just pay the whole thing, with no subsidies, for a month or two until you get your 2015 taxes done, then resubmit, get subsidies, and get a credit for all the rest of the subsidies straightened out when you do your taxes next?  It'll cost you an extra few hundred bucks, temporarily, right?

An interest free loan to them, but the opportunity cost seems way higher than the time value of the effort put into fixing it now instead of later.

This is true for any premium tax credits (which take the form of refundable tax credits), but not for any cost-sharing subsidies (which are paid by the government directly to the insurer, and not to the taxpayer).

[arebelspy]

Can't you just pay the whole thing, with no subsidies, for a month or two until you get your 2015 taxes done, then resubmit, get subsidies, and get a credit for all the rest of the subsidies straightened out when you do your taxes next?  It'll cost you an extra few hundred bucks, temporarily, right?

An interest free loan to them, but the opportunity cost seems way higher than the time value of the effort put into fixing it now instead of later.

This is true for any premium tax credits (which take the form of refundable tax credits), but not for any cost-sharing subsidies (which are paid by the government directly to the insurer, and not to the taxpayer).

Ah.  To be honest, I haven't fully wrapped my head around the cost sharing subsidies yet.  I suppose if I settle in the US for a bit and become subject to the ACA, I'll have to.  Thanks for the correction/clarification.

[Exflyboy]

Judging by the fact the GOP sent another half assed bill to the President to be vetoed.. I think its fair to say that if a Republican Government is elected next time the ACA is probably done for.

So a few RE plans may be on hold for a while sadly.

[Spork]

Judging by the fact the GOP sent another half assed bill to the President to be vetoed.. I think its fair to say that if a Republican Government is elected next time the ACA is probably done for.

So a few RE plans may be on hold for a while sadly.

Yes and no.  I think over time it will change*.  The worst thing that could happen (and it will) is to change it.  Let people/business adapt and make a change. 


*by change I mean: any planning you or any business involved have done, toss it out and start over.

[seattlecyclone]

Can't you just pay the whole thing, with no subsidies, for a month or two until you get your 2015 taxes done, then resubmit, get subsidies, and get a credit for all the rest of the subsidies straightened out when you do your taxes next?  It'll cost you an extra few hundred bucks, temporarily, right?

An interest free loan to them, but the opportunity cost seems way higher than the time value of the effort put into fixing it now instead of later.

This is true for any premium tax credits (which take the form of refundable tax credits), but not for any cost-sharing subsidies (which are paid by the government directly to the insurer, and not to the taxpayer).

Ah.  To be honest, I haven't fully wrapped my head around the cost sharing subsidies yet.  I suppose if I settle in the US for a bit and become subject to the ACA, I'll have to.  Thanks for the correction/clarification.

Cost sharing subsidies in a nutshell: get your AGI below 200% of the poverty level (but high enough not to qualify for Medicaid in your state), and you get a platinum plan for the price of a silver plan.

Of course it's not quite that simple, but this is a good approximation. In reality platinum plans pay for 90% of average customer medical bills, while the cost sharing silver plans pay for 94% if you're under 150% of the poverty line, 87% if you're between 150-200%, and 73% if you're between 200-250%. Regular silver plans pay 70%.

The annoying part is that you have to convince the exchange your income will actually be that low before they'll sell you the plan. I haven't FIREd yet, but I fully expect to be unable to buy one of these plans until I've filed at least one tax return with low enough income. We'll see if the bureaucrats running the exchange pleasantly surprise me.

[arebelspy]

Can't you just pay the whole thing, with no subsidies, for a month or two until you get your 2015 taxes done, then resubmit, get subsidies, and get a credit for all the rest of the subsidies straightened out when you do your taxes next?  It'll cost you an extra few hundred bucks, temporarily, right?

An interest free loan to them, but the opportunity cost seems way higher than the time value of the effort put into fixing it now instead of later.

This is true for any premium tax credits (which take the form of refundable tax credits), but not for any cost-sharing subsidies (which are paid by the government directly to the insurer, and not to the taxpayer).

Ah.  To be honest, I haven't fully wrapped my head around the cost sharing subsidies yet.  I suppose if I settle in the US for a bit and become subject to the ACA, I'll have to.  Thanks for the correction/clarification.

Cost sharing subsidies in a nutshell: get your AGI below 200% of the poverty level (but high enough not to qualify for Medicaid in your state), and you get a platinum plan for the price of a silver plan.

Of course it's not quite that simple, but this is a good approximation. In reality platinum plans pay for 90% of average customer medical bills, while the cost sharing silver plans pay for 94% if you're under 150% of the poverty line, 87% if you're between 150-200%, and 73% if you're between 200-250%. Regular silver plans pay 70%.

The annoying part is that you have to convince the exchange your income will actually be that low before they'll sell you the plan. I haven't FIREd yet, but I fully expect to be unable to buy one of these plans until I've filed at least one tax return with low enough income. We'll see if the bureaucrats running the exchange pleasantly surprise me.

Gotcha. Thanks for the quick and dirty!  Believe it or not, I've ready your whole exhaustive primer on the thing (and GCCs), but then I quickly forget what I've read.  :)

[jim555]

The annoying part is that you have to convince the exchange your income will actually be that low before they'll sell you the plan. I haven't FIREd yet, but I fully expect to be unable to buy one of these plans until I've filed at least one tax return with low enough income. We'll see if the bureaucrats running the exchange pleasantly surprise me.

I had no problem, went from year of salary and year of severance together in 2014 to UI and interest in 2015.  They didn't even ask for documents.  Then again I am in NY which has its own exchange.

[NorcalBlue]

I got dumped into the Medical approval process because I couldn't prove that I'd be making enough to qualify for ACA credits.  I won't go into the details, but the process has been the biggest mess ever.  What a joke.

Anyway, I'm currently getting insurance outside of the ACA (because I didn't qualify for the ACA and Medical still hasn't approved me).  Here's my question:  If I just continue to carry my independent insurance, will I get my premiums reimbursed when I do my taxes next year (assuming my income stays low)?  Or, do I have to be under the ACA to get reimbursed (in which case I'm screwed, since I didn't qualify because California said my income is to low.....yet they still haven't approved me for Medical).