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Honored Advisor

Obamacare impact?

Have you been receiving mailings from your health insurance company about your options? Ours has been sending things for a few months, but how helpful they have been is debatable.

First, there was the one about a website that was " coming soon",with a map to follow in making choices. Who keeps up with website addresses that don't exist yet.

Then, we got a colorful flyer from BCBS of NC, telling us to contact our agent right away for guidance. When I reached ours, she explained that the company hadn't even started their training for the transition yet. She advised me call back in about six weeks...which at that point was October 1st. I marked it on the calendar.

Funny, but I thought I had read somewhere that September 14 was the deadline for making coverage decisions. When your agent's not even sure she will be trained by then, it sort of leaves me scratching my head. Not really a worry, but one of those random " When will we have to make a move?" random thoughts every so often.

Honestly, I hadn't been too worked up over the whole thing, because I knew we had our coverage in place for 2013, and figured it was the insurer's responsibility to let us know when things had to change. I have sort of pondered what effect the ACA would have on our premiums.

we have controlled ours well with a HSA -linked plan for a decade or so now. There have actually been years when we had no premium increase over the previous year. I think we pay $404 a month now, for the two of us. I expect a bit of a jump for next year, since we will be turning sixty. Beyond that, I was worried about hikes to help pay for other peoples' insurance.

Finally, yesterday, we got a mailing that made some sense. Since our plan was already in place on March 23,2010 - the date the ACA passed - we are grandfathered. Unless we elect to change our coverage, we are largely " protected from the significant rate increases that others may face due to health care reform".

In other words, if we stick with what we've got, which we had hoped to do anyway, we shouldn't have huge rate increases. I ought not to have a big learning curve to climb, and no big decision to make.

My question is this: Why not tell the Grandfathered Plan people this good news a long time ago?

Are any of you facing a big change, or like us, are you grandfathered, with fewer concerns? What is your health insurer telling you about the impact of Obamacare?
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8 Replies
Senior Contributor

Re: Obamacare impact?

Been through the whole website for Obamacare, one day when the kids were out, trying to make heads or tails of it.

What confuses me, is that under Obamacare, we could have an out of pocket cost of over $12K for a major health issue, with the co-pay.  I guess, it is because we have assets, and supposedly can afford a high co-pay.

Conversely, we don't have a high income, so our premiums would qualify for a substantial subsidy (actually, a little over half).

The more I looked into it, the more it seemed like something that was spawned in a government committee.   Subsidize us, because we don't make much money, but penalize us, because we live a thrifty life, and manage to build up a little equity.  If we were at the same income level, but wasted enough money in Vegas or whatever, to get our net worth down below a certain level, we might have a maximum co-pay of $2500 or so, depending on how poor we could make ourselves.

 

To go on, our 'cost of insurance' would go up by over 75%, but after Uncle Sam throws in some of your money, it is cheaper out of pocket, than what we have  (but remember we get a subsidy of a little over 50%, do the math and 50% of 175%, and it comes out to about 85% of our current premium).

Now, the tough decision.   Do we save several hundred dollars a year, but expose ourselves to several thousand dollars more co-pay, if we have a big medical bill?  Right now, if one of the kids were to have something horrible happen to them, our max out of pocket would be $4K, and if something happened to all of us at once, the max our of pocket would be $5k, for the whole family, in any one year, no matter how many different issues we had.  Compare that, to the maximum co-pay of $12K, and even after reading it through several times, I am still not sure if that is $12K per person, for each of the 4 of us (max $48K), or the max for the family, or even if it is a max per year, or per health issue.

Of course, under Obamacare, we could go up to the better plan, and get the max co-pay down to about what we have now, give or take a couple hundred $$$ (but still not sure if that is per person, or the whole family, per year, or per occurance, etc), but that would make it slightly more expensive than the plan we have now out of pocket, and WAY pricier, once you add in what the taxpayer kicks in.

Now that prices are lower, and our income likely to drop some, we likely would qualify for a greater subsidy.   However, we are paid up until July of next year, and I intend to wait and see what happens, before I jump ship.

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Honored Advisor

Re: Obamacare impact?

Did you havevyour currentbplan before March 23, 2010? If do, you may be grandfathered, too, and could potentially keep what you have now. My thinking is that it is at least the devil that we know....
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Senior Contributor

Re: Obamacare impact?

Your confusing information does not surprised me in the least. What a mess this is going to be for honest people. Of course there will some who spend down and probably at Vegas.

 

I have a friend who has had a on going illness for over ten years. They saved and saved and did without. She has now gone into a nursing home. He is spending down by replacing everything in the house and remodeling.  The poor woman did not get to enjoy any of this and now must know he is fixing it up for the next wife. She is a college grad but did not get to work  and use her degree instead she stayed home and cared for the animals.

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Senior Contributor

Re: Obamacare impact?

Yes, we are grandfathered in, which is why I plan to keep what we have, until the mess gets sorted out.

 

The law specifically states you can keep your old plan, as long as you want, but the fine print says that any change, no matter how small, can cause your plan to not qualify.

So, young people, who have another child, get kicked out, because addind a child changes the plan.

As do people who may have a little money saved up, and want to raise the deductable a bit, and save on premiums.

Or getting married.

Or deciding you need a lower deductable, or wish to add or change prescription benefits, etc.


I compare it to a car lease that says your lease is violated if you put on seat covers, or different hubcaps.

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Contributor

Re: Obamacare impact?

Our dreaded packet from BC/BS came yesterday. We are not grandfathered, as we joined a newer group last year to lower our premiums. With no materniy, we couldn't stay in the old policy anyway. They want to dump us into the new Bronze individual policy, which means a 60% increase in monthly premium and the 12,700 out of pocket limit and 50% coinsurance up from 15%. This is good?? Luckily, we have an HSA we have been paying into for a number of years without having to withdraw anything. We can swing a few years of the $12,000 if need be. Why do middle aged people have to pay for maternity coverage?

 

I am concerned about our son, newly married three weeks ago. The BC/BS insurance they bought had a $3000 out of pocket limit. They figured they could piece that amount together in case they needed to. Now, they are to go into the same Bronze plan. There is not way on God's green earth these precious newlyweds could ever pay $12,000. I repeat, this is good??

 

I understand about the subsidies, but isn't it just a help with the monthly premium? No way does that help with the astronomical out of pocket.

 

Would we be better off paying a bit more for a higher plan with a lower out of pocket?

 

Also, if a farmer is to be eligible for the subsidy, how will they figure our income?  Some years good, some bad. Cash poor, asset rich.

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Honored Advisor

Re: Obamacare impact?

I figure this thread will be more pertinent, as more families receive the letter. Ours came, saying we are grandfathered, and shoukd see " minimal" imoact on our rates. Friends from our high school days are posting stories simlar to yiurs, or are being told their $1 million limits are too low, so their existing insurance ceases to exist on January first.

Now, Congress is digging its herls over Obamacare again. It is going to be an interesting battle over the debt deiling, and maybe delaying implementation.
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Senior Contributor

Re: Obamacare impact?

I went through that on the website, run the numbers through on the silver plan, at least for your son.   If they aren't making much money, chances are the subsidy on the monthly premiums will make it close to the same out of pocket price for them (after the subsidy).   I think I said it before, I can't see anything that 'saves' us money in Obamacare, just bureaucrats shuffling around who pays for what, and imposing on us the insurance they think we should have, rather than what we want.

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Honored Advisor

Re: Obamacare impact?

With the budget ceiling showdown now involving Obamacare, one has to wonder what families are doing in terms of decision making. I have seen a lot of traffic from some FB friends, who were just unprepared for the letters they got this week.

Get ready for another shootout over this one in the next couple of weeks....
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