Affordable Care Act - catastrophic plans cancelled

[SV THIRD DAY]

Originally Posted by goboatingnow

France and Canada come close in my experience. Some countries make a reasonable stab at it. Some countries get all confused, mix up political ideology with healthcare , others just let you die in a free market

Dave

Sorry Dave, but I know WAY to many Canadians and have family in France to buy that one. The people with money come to the USA for their Heart surgery, just ask the former Canadian prime minister...ha ha ha. Again, people with money operate outside the rules set up for the masses...always have...always will.

[goboatingnow]

Originally Posted by SV THIRD DAY

Sorry Dave, but I know WAY to many Canadians and have family in France to buy that one. The people with money come to the USA for their Heart surgery, just ask the former Canadian prime minister...ha ha ha. Again, people with money operate outside the rules set up for the masses...always have...always will.

Oh I'm not arguing that the uber rich get what they want ( even if they don't need it) what the uber rich do is of no concern to most people or general healthcare policy. I mean I know people that pick hospitals based on the food menu and the decor on the walls.

Dave

[Stumble]

For those people that legitimately are overseas most of the year (more than six months a year), there is an exception to the insurance requirement IF you have a health insurance plan in a foreign country. So if you are cruising Europe and buy a policy in say France, you can use that policy to meet the ACA insurance carriage requirement.

See http://www.dol.gov/ebsa/faqs/faq-aca13.html for more information. It is thru the Department of Labor since most people who deal with this are employed overseas.

[Richard5]

Cash is king. Last year I had a respiratory infection and required steroidal inhalant therapy. The ER bill was over $2,000 but by paying cash the hospital settled for less than $800.

This yr I cut my hand open but good which required an ER visit for stitches. The ER bill was $2,600 but they settled for the cash price of $555.

An OV with my Dr is billed at $135 but the cash price is usually $65 and as low as $35. No difference in service.

The problem isn't health CARE as much as health INSURANCE. The advent of HMOs and PPOs ruined what we had. There again, blame Congress, et al.

The ideal would be for us to go back to the system we once had. Few but the providers think of going back to what once worked.

[HBWT]

Judging by some of the recent comments, I'm sure this is going to get shut down rather quickly but I will try and see if I can help with some of these questions. Like Rebel I work in the insurance market and I will try to shed a little light on this.

Open enrollment is October 1st - March 31st. ( this is debatable as it may be extending to May according to recent releases from IRS and HHS)
Every year following, open enrollment will be October 1st - December 31st. You can only sign up for health insurance at those dates unless you have a qualifying event. Loss of Job or significant loss of income are some of the qualifying "events."
This is nothing new as Medicare follows the exact same model. If you plan on going Naked and make less than 30,000 per year, you might want to look at the exchange plans a little closer.

Tax Credits are available for; ( Varies somewhat by state P.I. )
Single : $42,000
Family of 2 : $58,900
Family of 3 : $76,000
Family of 4 : $93,000

The fine is 1% of income or $95 per year per person (whichever is greater). This fine grows to 2.5% or $395 per year per person by 2016 and will increase with the CPI every year after. A quick side note ; you must have insurance for 275 consecutive calendar days per year. The fine will be assessed monthly after your 90 day exemption.

Most Catastrophic plans are being cancelled dependent by your state. In general, most individual plans are being canceled to comply with essential benefit rules. Some younger individuals may still have catastrophic plans with a possible HSA benefit.

Group plans at renewal period in 2014 will also be canceled to comply with minimum essential benefits. The employer mandate is extended to 2015 but the plans must meet QHP Guidelines in 2014. So if your group or probably better described "Association" plan is not protected by ERRISA trust or self funding rules, your plan will be canceled and replaced by another plan. Some Association plan companies are closing doors entirely because they cannot meet ACA guidelines.

At this time, I do not know of any foreign eligible health ( pay and claim ) policies active in the state or federal exchange eligible for tax credits. Tax credits and cost sharing are the two parts of the ACA that will reduce your total cost.

A medical indemnity plan like a critical illness plan will not qualify as a qualified health plan (QHP) and you will be subject to penalty.

If your spouse is eligible for a group plan, you are ineligible for tax credits in the exchange.

As Rebel said, the law is still out on the foreign exemption testing. As soon as I see a definitive ruling, I will post ASAP. I would not hold your breath as we are still waiting on a July Ruling for Risk Corridors.

Hope I could help.

[goboatingnow]

Now that is a helpful post

[Doodles]

Originally Posted by PamlicoTraveler

There was a thread dealing with ACA and "Obamacare" that was closed down by the moderators because of sniping and politics in the thread. THIS IS THE MOST IMPORTANT ISSUE AFFECTING CRUISERS LIVING ABOARD IN OTHER COUNTRIES.

We had a "catastrophic" care plan by Blue Cross Blue Shield that had a $10,000 deductible. We have never reached the deductible, so essentially this is just money we spent to insure against a catastrophic illness. We paid about $650 per month. That plan is not considered ACA compliant, so it has been cancelled, and the "mapped plan" with its "added benefits" (that we will never use) is $1,200 per month. This borders on making cruising impractical.

I understand that if you live out of the country for 330 days a year, you can get an exemption from buying a policy, but we spend 60-90 days in the US, depending on circumstances. We are considering going "naked," with NO insurance at all, for the first time in our lives. It seems like the opposite effect of what is intended. It's a not a good choice, but it may be what allows us to stay out here. We will pay a penalty, initially of 1% of income from what I understand. And that penalty is, of course, for nothing. If we get cancer or seriously sick in some way we will not have coverage.

For routine care I find the European system to be fine. We are now in Turkey and health care is affordable and available. Still, like many others, if I get seriously sick I want to go "home" for treatment.

I am interested in what others see as the best options. Stay away from opinions and politics so we can discuss this important issue.

I have a foreign plan that covers me globally but will in all likelihood not be ACA compliant, so I will just pay the fine. It is really not too much for the next several years after which I will quality for Medicare and no longer have the problem.

[Stugots]

Originally Posted by SV THIRD DAY

My insurance will double (thank you Obama)...so I'm paying the fine and taking a vacation to Mexico for our yearly health tests and procedures.

How much were you paying before and which level plan are you going with for the new one?

[SURV69]

The United States is the LAST of the "greater" nations to tackle this red herring ... it doesn't look pretty.

It wouldn't have looked "pretty", in 1950's either ... long before the cost of medical care skyrocketed to what it is now.

Like or hate O'Bama, some form of ACA will be here. It will be tweaked, twisted and adapted to the favor of the real money men in Washington ... through their lobbyists, but ... in one form or another it's FINALLY here after almost 50 years of talk.

The years of my paying almost $600 per month for high-deductible near-catastrophic for each of my employees(the ONLY insurance they had, which, by the way was obscene for what it covered), might now be over.

In times of an economy that appears will never recover in my lifetime ... and probably beyond ... in a time when most wages for anyone above the working poor are actually falling ... in a time when the real movers of the economy(the middle class), are disappearing ... this ACA is a big bone to chew for the segments of society who live below the more comfortable range of wages.

For the full-time boaters, most of whom, it appears, live in a near hand-to-mouth, day-to-day living this should be a big plus to allowing your lifestyle to continue.

Sometimes one really has to accept what's been handed to him/her ... especially when it really benefits one and one's loved ones.

I'm a veteran and use V.A. medical. I had to retire in 2012(age 62), because I couldn't work(heart, broken bones in foot, diabetes, two fractures to my back), for two years after my foot finally just "gave out".

Without V.A. medical, I'd be here, sitting with no reasonable way to earn a living, getting minimal SS(I've worked since my first back fracture in 1963 and another in 1971 ... earning low wages ... now getting low SS) ...
anyway ... I'd be sitting here "praying" for 2014 for ACA to kick in to finally see a doctor.

I'm sure the ACA system is going to be overwelmed by a throng of citizens who have not seen doctors long after they needed to ... full-time boaters included.

[Paul L]

Originally Posted by Richard5

Cash is king. Last year I had a respiratory infection and required steroidal inhalant therapy. The ER bill was over $2,000 but by paying cash the hospital settled for less than $800.

This yr I cut my hand open but good which required an ER visit for stitches. The ER bill was $2,600 but they settled for the cash price of $555.

An OV with my Dr is billed at $135 but the cash price is usually $65 and as low as $35. No difference in service.

The problem isn't health CARE as much as health INSURANCE. The advent of HMOs and PPOs ruined what we had. There again, blame Congress, et al.

The ideal would be for us to go back to the system we once had. Few but the providers think of going back to what once worked.

You may think you got a deal with cash, but in reality if you were insured the insurance company would have paid even less, and medicare even less than that. So the cash payer pays the most in the US system. The 'list' price of hospital fees is typically astronomically high, just to be bargained down. Lots of documented examples here in this Time article
TIME: Why Medical Bills Are Killing Us

[Stugots]

Originally Posted by Paul L

You may think you got a deal with cash, but in reality if you were insured the insurance company would have paid even less, and medicare even less than that. So the cash payer pays the most in the US system. The 'list' price of hospital fees is typically astronomically high, just to be bargained down. Lots of documented examples here in this Time article
TIME: Why Medical Bills Are Killing Us

I highly recommend everyone read that article. I read it when it was first published and it is the most in-depth look at the state of health care in the US I've ever come across. It dispells many myths and also provides concrete examples of waste and abuse in the US health care system.

[colemj]

Originally Posted by SV THIRD DAY

I'm pissed off that some Government idiot decided for me, a guy with a Vasectomy and Wife with no Ovaries, needs to pay for maternity insurance.

But Rich, you were also paying for that under your old plan. I don't know of any insurance of any type that doesn't pool risk. Even if you get a discount for not smoking, you are still paying for smoker risk.

You had a plan that only covered those things you personally or statistically were at risk for?

Mark

[goboatingnow]

Originally Posted by SV THIRD DAY View Post
I'm pissed off that some Government idiot decided for me, a guy with a Vasectomy and Wife with no Ovaries, needs to pay for maternity insurance.

I hear you friend, Im pissed off that I'm paying for schools i no longer need, traffic lights I don't go near, and to cap it all , finance for Greece. grrrr.

Dave

PS oh yeah , what about closing down that stupid public library, everyone has Kindles anyway!

[letsgetsailing3]

Originally Posted by rebel heart

Exact same case with my parents. Railing against social services as they withdraw social security cash from the ATM and use VA/Medicaire funding.

How is that irony, when they paid into social security, served in the military for VA benefits, paid taxes for medicare, and the ATM they're withdrawing from is connected to their own bank account? I'd say they have at least the same right to an opinion as anyone else.

That said, there are many helpful comments in this thread, so let's stay on the topic of U.S. cruisers and health care provisioning.

[Paul L]

Originally Posted by letsgetsailing3

How is that irony, when they paid into social security, served in the military for VA benefits, paid taxes for medicare, and the ATM they're withdrawing from is connected to their own bank account? I'd say they have at least the same right to an opinion as anyone else.

That said, there are many helpful comments in this thread, so let's stay on the topic of U.S. cruisers and health care provisioning.

Its still a social service supplied by the government, whether you pay into it over lifetime via fees, taxes or work. VA health care is government supplied health care.