Affordable Care Act - catastrophic plans cancelled

[SV THIRD DAY]

I have to agree....
Most cruisers I have met have Health Insurance AND Boat Insurance.
Of course my experience is limited to 4yrs in Mexico...so I could be a bit biases staying so close to the USA for those yrs.

[CatInHand]

You will be treated for emergency care, but long term issues such as cancer treatments require upfront pay.

Again, consider where you will be, and if US insurance is really better than local care.

[sailorboy1]

Originally Posted by SV THIRD DAY

BINGO....the exact decision all those "fine payers" are making.

I don't know what you mean by BINGO. The "fine payers" are making to the decision to not be insured, period! Not to wait till after they get sick, which is too late and I don't think possible to get coverage for their illness.

The ACA is what it is and a Law, lets give up on the rants and talk about how it will work and how to use it. If you don't like it take it up with the people you elected.

BTW - my wife is an HR manager and has had a lot of training on the ACA. But all the training is targeted to how it impacts businesses and she knows nothing about how it effects cruisers etc.

[colemj]

Originally Posted by CatInHand

Especially since WHO ranks Canadian healthcare above the US.

World Health Organization ranking of health systems - Wikipedia, the free encyclopedia

In fact, many countries rank above the US which suggests that you should consider your destination and the quality of the available care before considering the need for catastrophic, US based insurance.

This is interesting, but needs to be understood a bit more than simple "ranking".

A good part of the metrics involved in the ranking deal with distribution and availability of health care in a country.

So countries like Panama and Guatemala with geographically isolated and poor populations, along with limited road penetration and transportation, rank lower than I think they would in pure "quality of care and facilities".

This probably makes the US's 38th ranking higher than it would be otherwise, given the extensive road and transportation systems and little geographically isolated populations there.

Mark

[Boatguy30]

I would think most full time cruisers will be "making" far less than the cap on the subsidies. In my case, I may actually have to over report a bit of income to be eligible for the exchange.

I figure if you're pulling 50K++ on investment income alone I have to think you have the money to pay for better insurance. I know you were maybe hoping to stick that new hip on Medicare in a few years, but tough luck.

At the moment, FL is not doing the Medicaid expansion. Actually the Medicaid thing is one of the things I least like about the ACA. I really would prefer to pay and I think everyone should have to pay something except the totally destitute I suppose.

Not sure about these overseas blokes "never paid a cent" types.

When I lived in New Zealand, I paid about $50 to see my GP. Seems a good system as if it were "free" you'd have folks turning up every thine they get a sore neck.

[CatInHand]

Originally Posted by colemj

This is interesting, but needs to be understood a bit more than simple "ranking".

A good part of the metrics involved in the ranking deal with distribution and availability of health care in a country.

So countries like Panama and Guatemala with geographically isolated and poor populations, along with limited road penetration and transportation, rank lower than I think they would in pure "quality of care and facilities".

This probably makes the US's 38th ranking higher than it would be otherwise, given the extensive road and transportation systems and little geographically isolated populations there.

Mark

And as a first-world traveler with money you would have access to the best care making US insurance even less useful.

I think many people get locked into the idea that they can't get good care anywhere but their home country, and that's just not the case.

[svmariane]

I'm still investigating all this, and hit a few stumble blocks. I've registered with Washington state and have access to their website. Cannot - as of yet - get through/into the Federal website.

My wife is a non-USA citizen and has no SSN but DOES have an USA TIN (Taxpayer Identification Number) we use with the IRS (married filing jointly). As my spouse, the IRS claims that HER income from non-US sources be counted in our yearly filing. So she is a US tax payer. Hold that thought.

The stumbles:

1) Without an actual SSN she can't / won't be enrolled under ACA should I myself actually enroll. At least the Washington state website refuses to recognize her TIN.

One the one hand its strange, because I'm buying INSURANCE, so I should be able to include my family. But on the other hand, it's US tax-subsidized so I can see where non-US citizens / non-SSN registered folk should be told to bug off.

Then again - even retired we still pay Federal income tax on my income AND what she "earns" from non-US sources, using her US TIN to identify her on form 1040.

2) Apparently, even though the system ignores my non-SSN wife re: enrollment, she still counts as a dependent in calculating family size. Strange.

Is anyone else in a similar situation vis-à-vis the TIN? If so, have you tried the ACA website(s) State or Federal and what did you encounter?

[Mambo]

Originally Posted by colemj

We have a catastrophic plan through Blue Cross. There are no benefits and we are on the hook for the first $10,000, after which they pay. If we have a catastrophic illness on Dec. 31, we pay $10,000 and on Jan 1, we pay another $10,000 - after which they graciously pay until Dec 31 until hitting us up again.

This so-called "health plan" costs us $4,000/yr (more than our boat insurance in hurricane zones and a 3X higher deductible) for two healthy people ages 45 and 50 with no prior health problems or conditions. The price of this tremendous service has increased 20% each year for the past 5 years.

While Blue Cross and the rest of the US calls it "health insurance", we have never seen it in this light. To us it is "investment and asset insurance" - the entire purpose of which is to protect everything we own from being taken away from us in one fell swoop by a catastrophic illness. We don't view it in any way as purchasing access to affordable health care.

So I guess the answer to your question is No, we do not have medical insurance. Our assets are insured to a moderate level of care, however.

Your acquaintance is correct. We have yet to go anywhere that did not have as good, or better, health care than the US. And that includes all of what the US considers third world nations. When we do need healthcare, we simply go get it immediately and pay for it with the money we have in our pockets.

Literally. For $100, you can get an eye exam and treatment for a scratched cornea, a diagnosis and antibiotics for an ear infection, and get your teeth cleaned. And I don't mean $100 for each of those, although a filling will cost another $25 if you have hit the sugar too hard. Throw in another $50 and a dermatologist will remove that funny looking skin patch. All in modern, clean facilities with excellent physicians and dentists. And access is immediate or almost immediate - we get treatment upon walk-in or within a day or two for things like dental appointments. In the US, we usually can't get routine medical treatment at all because we aren't an "existing patient" or cannot wait two months for the next opening.

It is so ridiculously good and inexpensive outside the US, that we cannot understand why people in the US do not just fly to Guatemala or Panama or Mexico or Colombia or anywhere else for non-emergency medical care. You could fly to Panama (the major hospital is owned and operated by Johns Hopkins) or Guatemala, stay in a nice hotel, go to a state-of-the-art hospital or clinical facility and get cataract surgery with new state-of-the-art lens implants, then get a root canal and go home all total for less than 50% of the cost of doing it in the US (I pulled up these two medical examples because we have friends who have recently done just these and know the cost difference). Plus you get to lay on a beach under a palm tree or go visit some Mayan ruins.

Mark

Mark -
Go to ehealthinsurance.com and get another quote. I just picked up a PPO policy with a 3K deductable (3K additional 20% co-insurance), preventative care and 6 visits a year ($20 copay) and generic drug coverage. Total hit was $150/mo. That was in place of my $420/mo primo HMO coverage which had gotten too expensive. I have some pre-existing condition issues as well. Upshot - maybe you need to shop around more. I saw 10K deductable policies on ehealthinsurance for under $100/mo. I am in the same age bracket as you two.

[goboatingnow]

Somewhere after the signing of the magma carta, we went wrong and the bureaucracy went mad.


Dave

[Stugots]

Originally Posted by SV THIRD DAY

BINGO....the exact decision all those "fine payers" are making.

This has been discussed a few times already. You won't have the option of signing up after you get sick because you will be limited to enrolling during open enrollment periods.

[svmariane]

Currently Active Users Viewing This Thread: 29 (16 members and 13 guests)

Wow. Hot topic indeed.

Edit: Now 32 (18 members and 14 guests).

Hey you guests!! Consider joining up!

[goboatingnow]

Originally Posted by svmariane

Currently Active Users Viewing This Thread: 29 (16 members and 13 guests)

Wow. Hot topic indeed.

Edit: Now 32 (18 members and 14 guests).

Hey you guests!! Consider joining up!

We have guests , someone make tea.

Dave

[SV THIRD DAY]

Originally Posted by Stugots

This has been discussed a few times already. You won't have the option of signing up after you get sick because you will be limited to enrolling during open enrollment periods.

Oh it was discussed all right...and glossed over.

But all you have to do it use emergency care until the open enrollment and BINGO...you are in Baby. If you don't think people will do that...ha ha ha ..then you also could believe the Government cost estimates...ha ha ha . Just drive the damaged car and buy your new car insurance policy at open enrollment and Bingo then get your car fixed. There are cottage industies out there exploiting every loop pole under the tax code and anyone that doesn't think this will be the same is dreaming.

[Eumelia]

It's very hard to get definitive information. I have been hearing that many doctors and hospitals will be dropping out of B. O. Care or that some policies will be very restrictive of which doctors or hospitals they will cover. If I am cruising, how do I decide if the policy I'm looking at will provide care where I am or where I can get to? If I sign up now and make a mistake, how long do I have to wait before I can make a change? It seems that "coverage" does not equate to "care".

[CatInHand]

Originally Posted by SV THIRD DAY

Oh it was discussed all right...and glossed over.

But all you have to do it use emergency care until the open enrollment and BINGO...you are in Baby. If you don't think people will do that...ha ha ha ..then you also could believe the Government cost estimates...ha ha ha . Just drive the damaged car and buy your new car insurance policy at open enrollment and Bingo then get your car fixed. There are cottage industies out there exploiting every loop pole under the tax code and anyone that doesn't think this will be the same is dreaming.

.....so you rack up many thousands of dollars in bills that you are responsible for, and THEN sign up for insurance? How does that make sense?

New car insurance won't pay to fix an old dent. I don't get your analogy, either.