Cruising and the Affordable Care Act.

[sailorboy1]

Originally Posted by Boatguy30

If you live in a state that is not expanding Medicaid like FL and you have any dependents you might have a problem with not making enough money. For example if you are a budget cruiser couple with 2 dependents, you can cruise on less than $23,500 a year. However that is not enough to qualify for the subsidy.

That looks to be the truth!

I just played on my State's site and if I put in an income of $30,000/yr the cost was $33/mo after the subsidy. But if I put in $10,000 the cost became $1,200/mo because I wouldn't be making enough to get a subsidy.

Not sure how that meets the "affordable" part, but sure seems important for a cruiser.

[Canibul]

Originally Posted by Paul L

I went to their web site and put in the info for a Quick Quote. Since they don't offer on their quote a selection for general out of country on their form (like a full time cruiser would need), I selected the next country we will spend the most time in. That is French Polynesia. The quote was approx. 5x what I am spending now. Not political at all.
I could not find anywhere on their site the actual policy to review the pre-existing conditions definitions.

So, basically you were not truthful about qualifying for the insurance in the first place, and then picked a place as far as possible from good health care. You do realize this policy pays 100% of the cost to fly you to the nearest good hospital? You picked the middle of the Pacific. Will your "Obama" insurance fly you from French Polynesia to a Boston hospital for brain surgery? BUPA will.

It's political when you bring Obamas name into it, for starters. Read the thread title. But by all means, continue to give him credit for this great thing he's tried to do to us. But obvious poliltics aside,

We pay 7600 per year for two of us, in our 50's and 60's. That's $316 per month each. So for ACA plans to be 1/5 of what we pay, with better coverage than 100%, you're saying we could get the same or better for less than $63/month each, and they would give us money back over and above the cost of the insurance? Sure sounds like Chicago politics to me.

That's what you said. 1/5 the price and better coverage.

The price is 7600 a year for two, and the coverage is 100%.

What's the name of your plan, again?

[Paul L]

Originally Posted by sailorboy1

That looks to be the truth!

I just played on my State's site and if I put in an income of $30,000/yr the cost was $33/mo after the subsidy. But if I put in $10,000 the cost became $1,200/mo because I wouldn't be making enough to get a subsidy.

Not sure how that meets the "affordable" part, but sure seems important for a cruiser.

Its a screwy system and is state dependent. In your example, if you qualify for medicaid then it would be free, but you'd be under the medicaid rules which are certainly not cruiser friendly.

[Paul L]

Originally Posted by Canibul

So, basically you were not truthful about qualifying for the insurance in the first place, and then picked a place as far as possible from good health care. You do realize this policy pays 100% of the cost to fly you to the nearest good hospital? You picked the middle of the Pacific. Will your "Obama" insurance fly you from French Polynesia to a Boston hospital for brain surgery? BUPA will.

It's political when you bring Obamas name into it, for starters. Read the thread title. But by all means, continue to give him credit for this great thing he's tried to do to us. But obvious poliltics aside,

We pay 7600 per year for two of us, in our 50's and 60's. That's $316 per month each. So for ACA plans to be 1/5 of what we pay, with better coverage than 100%, you're saying we could get the same or better for less than $63/month each, and they would give us money back over and above the cost of the insurance? Sure sounds like Chicago politics to me.

That's what you said. 1/5 the price and better coverage.

The price is 7600 a year for two, and the coverage is 100%.

What's the name of your plan, again?

What location do you think I should put in to the quick quote to get a representative number for insurance for a full-time cruiser? The OP was looking for insurance while cruising, not as an ex-pat living on a specific island somewhere. Or is the policy you suggested not useful for a full-time cruiser? As far your costs go, I have no idea what you could get other insurance for. I already posted what I paid in the past and now for insurance.
What are the pre-existing conditions definitions and coverage on the BUPP policy?

[denverd0n]

Originally Posted by djmarchand

But I can't see why US insurance won't cover foreign care. Actually I think that it does.

I'm sure it depends on the specific policy, but yeah. My wife got ill in France a couple of years ago and required hospitalization. We were required to cough up the full payment in cash at the time, but after we got back home we submitted all of the paperwork to our insurance company and they paid their 80% or 90% or whatever it was (I don't remember exactly... most of it, anyway).

So, whoever said that American insurance companies will not pay for medical care overseas was simply wrong. They may have had a particular policy with such a condition, but it is most definitely not a universal thing with American health insurance companies.

[pistarckle]

My experience is only in the Carib . In Haiti we were never presented with a bill .
In Puerto Rico the bill came a year and a half later and we were never forced to pay .
Down island very few hospitals even send a bill . I was never led to believe that trouble would follow if I ignored the bill . If you choose to fly home , do not tell the airline that you are ill .

[w32honu]

Originally Posted by sailorboy1

That looks to be the truth!

I just played on my State's site and if I put in an income of $30,000/yr the cost was $33/mo after the subsidy. But if I put in $10,000 the cost became $1,200/mo because I wouldn't be making enough to get a subsidy.

Not sure how that meets the "affordable" part, but sure seems important for a cruiser.

Not positive but I believe if your income is $10,000 per year the insurance would be provided at no cost…………or medicaid.

Different states might not be the same tho…….

[w32honu]

Originally Posted by pistarckle

My experience is only in the Carib . In Haiti we were never presented with a bill .
In Puerto Rico the bill came a year and a half later and we were never forced to pay .
Down island very few hospitals even send a bill . I was never led to believe that trouble would follow if I ignored the bill . If you choose to fly home , do not tell the airline that you are ill .

This reinforces the pay as you go with some sort of catastrophic insurance as a back up. It seems universal that the quality of care outside the U.S. is as good or better at a far cheaper price. The insurance part of the equation, I still think, will have to boil down to cost, coverage, and the fine print regarding preexisting conditions. ACA plans may fit the bill for this. It seems to depend on income level…………

I do have some insight into flying while sick or ill. The above quote is accurate. The airline will likely require some sort of release signifying that you are capable of flying. I wouldn't fib or lie about this……..especially in the case of infectious disease. Ultimately if I "checked out" back in row 25……… well all of this insurance business wouldn't matter…….. Just saying.

[patoregon]

My husband and I retired at 58 in order to cruise. We used international insurance while we were traveling. It was only about $1200 a year, but I can't comment on the value because we never had to submit a claim.
We have lived in Oregon for 4 years now, and we jump from short term policy to short term policy. They cost about $210 per month each. The coverage is bad, of course, but what can you do. (When I was briefly working full time I had insurance through my organization. I broke my leg badly and my out of pocket costs were over $7,000. The U.S. system is broken.)
Affordable Care Act insurance would cost us about $780 per month, which is a little OVER 10% of our annual income. We will continue with short term insurance policies instead, even though this means we will also pay the penalties because they don't qualify under ACA. I was told the maximum penalty will be $285, but I know I should verify that fact.
It's sad to say, Medicare can't come soon enough!

[w32honu]

Question……..

Has anyone who is participating in an ACA sponsored insurance plan made a claim?

If so, I would be very curious what your experience was with regard to service…….etc.

Did they pay? Did they give you the run around? Strong attempts to avoid payment?

Kind of dumb questions I realize because all insurance companies seem to do this……… Just curious if there was any difference……... Insurance pre ACA vs. Insurance post ACA.

Tx

[keepondancin]

I don't think there is actually insurance supplied by the AHCA, it is offered by private companies to conform to the requirements. You can buy better. Like so many other things, you get what you pay for. When cruising, we carried a very good policy, that would cover 80% when out of the country, but it was $1800 per month for two. My late wife had issues with her leg, and was always concerned about when a problem would occur. Now on Medicare, it is the same thing. I could have a Medicare Plus policy, at no cost, it replaces part A, but it limits where it will cover in the US. The nearest hospital that would take it is over an hour away. There are no local doctors that accept it. Instead, I have part B, $105 per month, Part D, $45 per month, and AARP supplemental that pays everything that A&B don't pay, and no deductable, for $208 per month. So it still costs me about $360 per month, but there is no out of pocket expenses. I am lucky, I enjoy good health, but with my wife's history, I would have been bankrupt 3 times due to medical expenses. My wife had to get xrays in St Vincent after a fall on the boat, the clinic in Bequeia couldn't do it. We had to pay for the xrays, $15 US, but the doctor was at no charge. Then again, they only had three thermometers with no way to sanitize them, so temp was taken under the arm.

[Greenhand]

Originally Posted by w32honu

Question……..

Has anyone who is participating in an ACA sponsored insurance plan made a claim?

If so, I would be very curious what your experience was with regard to service…….etc.

Did they pay? Did they give you the run around? Strong attempts to avoid payment?

Kind of dumb questions I realize because all insurance companies seem to do this……… Just curious if there was any difference……... Insurance pre ACA vs. Insurance post ACA.

Tx

There are no "ACA sponsored insurance" plans. Insurance is still run by the same private insurance companies as always. ACA just lays out minimum coverages and a means of comparing prices.

If you have any of the issues you mention, that is an issue with private insurance, not ACA.

[letsgetsailing3]

I was under the impression that some patients receive government subsidies for their care under the ACA. Then there is also the mandate, which implies that some younger patients will also be signing up and paying their own way, which is in essence a subsidy for older, less healthy patients.

[keepondancin]

Originally Posted by letsgetsailing3

I was under the impression that some patients receive government subsidies for their care under the ACA. Then there is also the mandate, which implies that some younger patients will also be signing up and paying their own way, which is in essence a subsidy for older, less healthy patients.

That is actually amortizing the risk factor over the broad spectrum of lower risk to higher risk participants, so the cost is also averaged out. With an influx of younger, healthy clients, it helps drive the overall costs down.

[letsgetsailing3]

Originally Posted by keepondancin

That is actually amortizing the risk factor over the broad spectrum of lower risk to higher risk participants, so the cost is also averaged out. With an influx of younger, healthy clients, it helps drive the overall costs down.

Yes, that's what I said. Younger, healthier customers are subsidizing older, less healthy customers.

"Averaging out the cost" is just a nice way of saying that healthier patients are paying more than they should, and less-healthy patients are paying less than they should.

Since it's a mandate, the younger patients are being forced into the subsidy. This is the reality of it.

You could claim that's political, but there really is no debate about that part.