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Old 03-11-2013, 02:58   #1
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Affordable Care Act - catastrophic plans cancelled

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.
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Old 03-11-2013, 04:35   #2
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Re: Affordable Care Act - catastrophic plans cancelled

This is indeed an extremely important issue for cruisers.

Please limit the discussion to practical solutions of this question and leave your politics at the door. Political ranting will be immediately deleted and sanctions will be issued without warning.
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Old 03-11-2013, 04:54   #3
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Re: Affordable Care Act - catastrophic plans cancelled

Quote:
Originally Posted by PamlicoTraveler View Post
THIS IS THE MOST IMPORTANT ISSUE AFFECTING CRUISERS LIVING ABOARD IN OTHER COUNTRIES.
No, this only affects US citizens living abroad, the rest of the worlds citizens aren't affected. My taxes help pay for a national health service which is free to use and has reciprocal arrangements across Europe for emergency treatment. Quite a good deal all round for those eligible.

You might want to have a look at the Divers "DAN" cover, it's been a while since I looked at it but it did provide some interesting cover in an emergency.

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Old 03-11-2013, 05:06   #4
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Since the preexisting condition limitation is gone can you go "naked" and if something happens sign up then?
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Old 03-11-2013, 05:14   #5
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Re: Affordable Care Act - catastrophic plans cancelled

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Since the preexisting condition limitation is gone can you go "naked" and if something happens sign up then?
A very interesting question.

I have been going "naked" for the 22 years I have been an expat (this time), and haven't needed a doctor in all that time, but how long can my luck hold out?

Granted, I have been in Europe all this time, where paid health care, even for catastrophic situations, is generally reasonable in price, so that I could probably pay for most eventualities myself (I guess that's called "self-insuring").

I realize that I'm now going to have to take some time and study the new system. I'll be interested to see what advice people come up with on here.

And with apologies to all non-US citizens, who don't face this issue. Move along now, nothing to see here
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Old 03-11-2013, 05:18   #6
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One company to contact would be Aflac. I'm not sure how the new system affects them but they offered insurance that wasn't considered "medical". All of the payouts would be to the policy holder or designated second beneficiary.
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Old 03-11-2013, 05:25   #7
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Re: Affordable Care Act - catastrophic plans cancelled

Pamlico Traveler, this sure is an important topic for cruisers and I wish I could offer some advice. I am just happy that my BCBS plan appears to be one of the "grandfathered" ones and only went up 75.00 a month!

It's not every day I see someone from Creedmoor, so I HAD to just reply and say that I live right down the road in the Enon Community. Small world!
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Old 03-11-2013, 05:32   #8
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Re: Affordable Care Act - catastrophic plans cancelled

as an australian citizen i have never spent a cent on health insurance. But over the years ive had to seek medical treatment and its always been first class and free when ive needed it. There has been a fair amount of politicking in the last few years to put a stop to this uncivilized state of affairs but so far they havent had much impact. I dont understand the system over there but i cant see it having any affect on non US citizens.
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Old 03-11-2013, 05:40   #9
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Re: Affordable Care Act - catastrophic plans cancelled

Traveler;
It's not clear from your post but I'll assume that you are buying coverage from BCBS of NC. I was a former resident of NC and was shocked to find out that health care coverage was not nearly as expensive in other states. I'm on my way down the east coast now and was discussing this issue with another cruiser here in NC and was told that BCBS is the only provider in NC so there is no competition. Two years ago we "moved" to Florida and are now residents of that state. Our address is at the SBI Mail Service in Green Cove Springs. As such we can buy insurance in Florida and the rates are dramatically lower. You don't say how many people you are covering, but I can buy a very good plan for about $450 per person per month and catastrophic plans ($6500 deductable) for less than $200 per month. Perhaps you should consider "moving" to another state while you are out of the country.
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Old 03-11-2013, 05:43   #10
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by charliehows View Post
I dont understand the system over there but i cant see it having any affect on non US citizens.
Exactly, it has no effect on non-US cruisers.

My policy has remained in force, my wife's was cancelled..... We are waiting on the other shoe to drop to find out what it will cost.

Quote:
Originally Posted by Transmitterdan
One company to contact would be Aflac. I'm not sure how the new system affects them but they offered insurance that wasn't considered "medical". All of the payouts would be to the policy holder or designated second beneficiary.
I see no such offering on Afflac's web site, do you have more info?
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Old 03-11-2013, 06:24   #11
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Re: Affordable Care Act - catastrophic plans cancelled

So have you tried to apply for the ACA subsidized policies? Of course it depends on your family income. For a family of 2 making up to about 55 or $60k, you get a decent discount on the policy. For us, the policy monthly cost (Washington state) will be much lower than the $10k deductible BC policy we have been been carrying. That's assuming I can actually finish the application process.
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Old 03-11-2013, 06:27   #12
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Re: Affordable Care Act - catastrophic plans cancelled

My wife and I are covered by a employer plan, but there has been so much info flying about I looked into the options. It looks like the bronze plan which is a 60/40 split with a max out of pocket of about 6300 a year isn't very different than a catastrophic plan like you had actually it is better coverage. Unless you have a six figure taxable income then the tax subsidies seem to bring it back down in line with what you are already paying.

For that plan two adults aged 55 non smokers the premium is $13,254. The tax credit with a $50,000 income would be $8504 bringing the annual cost to $4750. Or $395 dollars a month.

Subsidy Calculator | The Henry J. Kaiser Family Foundation

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Old 03-11-2013, 06:46   #13
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Re: Affordable Care Act - catastrophic plans cancelled

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.... Unless you have a six figure taxable income then the tax subsidies seem to bring it back down in line with what you are already paying.

For that plan two adults aged 55 non smokers the premium is $13,254. The tax credit with a $50,000 income would be $8504 bringing the annual cost to $4750. Or $395 dollars a month.

...
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Which would be about 40% less than what the current high deduct policy costs us.
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Old 03-11-2013, 07:02   #14
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Re: Affordable Care Act - catastrophic plans cancelled

You can buy an expat policy for this year, and probably for many subsequent that will satisfy the individual mandate. Bupa is a good example and common in Europe.

The sky is not falling.

Rebel Heart - Eric's Blog - the affordable care act (obamacare) and cruising*sailors
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Old 03-11-2013, 07:12   #15
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by rebel heart View Post
You can buy an expat policy for this year, and probably for many subsequent that will satisfy the individual mandate. Bupa is a good example and common in Europe.

The sky is not falling.

Rebel Heart - Eric's Blog - the affordable care act (obamacare) and cruising*sailors
Hi Eric:

That's a very nice and useful blog post about this issue.

One small quibble: you talk a lot about the "Physical Presence Test" for purposes of qualifying for the Foreign Earned Income Exclusion. Keep in mind that that is not the only way to qualify as a resident abroad -- there is also the Bona Fide Residence Test, which is an alternative to the Physical Presence Test. See: Foreign Earned Income Exclusion - Bona Fide Residence Test.

That's the one I have used for the last 22 years, although I probably always also meet the Physical Presence Test.
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