ACA/Obamacare for American Cruisers Abroad MERGED THREADS

[Boatguy30]

In fairness you were the one saying you had no tax deductions or "loopholes"

I agree that it sucks that guys that just kick back are paying what 15% or whatever on carried interest or whatever they call it.

Getting off topic, but when I lived in New Zealand there is no capital gain taxes and property taxes are pretty low. So the higher income wage earners basically pay all the taxes as the rich pay little and the poorer workers get it all back in tax credits.

One thing for sure, what other country does a nurse not have great health insurance???

[jkindredpdx]

Oh, BTW. . . I put the $10,800 I haven't spent on premiums into a savings account. Since I have that high deductible, I wanted a cushion.

[jkindredpdx]

Originally Posted by DiverChick71

.

I would expect it to go up… My friend who is 38 and has the same type of coverage as you says her premiums will double. Healthy, no co-morbidities, runs marathons.

Why would it go up. If you are already covered by work or are insured by a personal plan, I don't think Obamacare makes you change anything.

[DiverChick71]

Originally Posted by jkindredpdx

Why would it go up. If you are already covered by work or are insured by a personal plan, I don't think Obamacare makes you change anything.

Seems logical to me, but the early returns seem to point to an increase for most people. Hopefully...I'm wrong.

I am covered at present, my company puts my benefits at $1200 a month that they "pay." (I work for a big HMO so it's in one pocket, out the other...but they like to put that on my paycheck stub as "employer-paid benefits." They probably get write-offs) I haven't checked what that coverage would be if I didn't have it thru my employer, but I will. They are one of the providers under ACA, and they were the Silver package that I mentioned at $711 a month and $6K deductible.

[Boatguy30]

The problem for you maybe that your yearly out of pocket can only be like 9% of your income. So if it's 10K plus the premiums I think are counted also, figure out what your income would need to be to make that 9% and then you'd be judged as having adequate coverage.

I don't see how anyone could have any idea how there premium is going to change at this stage. I do know that premium increases have slowed down over the last few years for a variety of reasons. Still going up a lot, but no longer double digits.

I guess maybe some state did not allow any age based rates and now you have a factor of 2.5:1 , but I think almost all states were way higher of so cap at all. It sound to me like OR must have a pretty low one.

[Doodles]

Originally Posted by DiverChick71

Are you asking me? I don't own a home...potential cruisers tend to downsize. And I don't get state tax paid credit, I paid 9% +2 grand to the state . I claim one child, my ex the other. I quit claiming my oldest kid so she could hopefully get financial aid… Which btw she didn't. 3.5 GPA honor student and a 29 on her ACT and she was offered $1500 in work study per semester. And loans. I'm not really sure why you would question my honesty… If anyone is intimately aware of my tax situation, it's me. I am the one that writes the check to the IRS every year.

To keep this thread on track, it's about Obamacare and how it would affect cruisers. For me personally, I haven't quite figured out how will affect me. I just know it can't be any worse, and hopefully being out of the country I will be exempt. Residency in coaster Rica looks like a good option for me.

Quick question because I'm confused. You said you support 3 children but you only claim one? When you went to check rates (I assume some place like the Kaiser calculator) did you request coverage for one or three? I'm sure that would impact a lot on the premium quote, i.e. the percentage of the poverty level figure.

[rebel heart]

Originally Posted by jkindredpdx

I'm well over 30 (about double) and I was laid-off for the first time in 2010. It annoyed me all those years, when I was working, that I paid for medical benefits that I didn't use. I've only gone to western doctors to get something sewed up.

Now I'm self-employed, I bought personal coverage with a $10k deductible for about $130/mo. I found my plan on ehealthinsurance. Yes, it's catastrophic and doesn't cover prescriptions. Of course I could pay $550/mo for a lower deductible and copay. It fits my needs and I don't see how Obamacare is going to effect me.

I looked at Cover Oregon: a new place to shop for health insurance they aren't fully open until October but one can run the calculator to see if you'll get financial assistance .

There are HSA plans similar to what you're talking about, and exchanges aren't the only places that sell insurance.

I have an HSA plan (through Anthem Blue Cross) that has worked quite well for me. It gives me the (tax free) dollars I need to pay for low cost coverage worldwide, and has a beefy fallback if we need high powered western medicine.

Speaking as a guy who works in insurance, there are generally two camps of insurance users:

a) People who dislike the payment and little benefit they get.
b) People who dislike the payments but have had the random turn of fate that landed them with cancer, MS, or something of that sort.

No one in my family has needed medical intervention in years, beyond child birth itself and a case of jelly-belly I picked up in Mexico that $30 later (and two shots into my ass) I was cured.

I guess I would just ask you to think about how your feelings might be different if you were diagnosed with testicular cancer or perhaps got a spinal injury in a car accident. When you're paying for something but not getting anything it's a hassle, pure and simple. But there's a reason the ambulances are always busy.

[Boatguy30]

Ok, so this isn't political.

In countries that have single payer, that's the nice thing, you just pay your taxes. And go to the doctor.

My first hand experience is in NZ. There are no special healtcare tax or monthly payment which ends up feeling like a screw job. You also don't have to worry about anyone deciding not to get coverage.

Now there are plenty of issues with all health systems, but when you look at the total amount of money the US spends on healtcare there is more than enough money being spent to give every American the VERY best care.

the problem for any approach is breaking the medical industrial complex we've built up. No doubt half those big yachts they can't build fast enough belong to implant CEOs, insurance CEOs, pharma, etc, etc

Again, there's no reason why we shouldn't have the best care and we already spend the money. but it's hard as hell to come up with a system when only 1/2 of the people are willing to try to fix the problem. and the other 1/2 spend literally billions to fight it.

[rebel heart]

Originally Posted by DiverChick71

Seems logical to me, but the early returns seem to point to an increase for most people. Hopefully...I'm wrong.

I am covered at present, my company puts my benefits at $1200 a month that they "pay." (I work for a big HMO so it's in one pocket, out the other...but they like to put that on my paycheck stub as "employer-paid benefits." They probably get write-offs) I haven't checked what that coverage would be if I didn't have it thru my employer, but I will. They are one of the providers under ACA, and they were the Silver package that I mentioned at $711 a month and $6K deductible.

I checked at 4 people, 3 kids, and $70,000 salary (just guessing, not trying to get into your personal business by any means).

Just looking at the "bronze" package which is $5k deductible, and $405/month but that's not across the board:

- no cost preventative care
- $45 copay on non-preventative primary care visits
- $19 copay for drugs
- no annual max
- no lifetime max
- $300 emergency room copay

It's still $400/month which isn't funny money, but it is four human beings who could be treated for the most serious and expensive illnesses, for years, by some of the world's best physicians.

Plus, you can get an income tax deduction on the premiums.

[rebel heart]

Originally Posted by Boatguy30

Ok, so this isn't political.

In countries that have single payer, that's the nice thing, you just pay your taxes. And go to the doctor.

My first hand experience is in NZ. There are no special healtcare tax or monthly payment which ends up feeling like a screw job. You also don't have to worry about anyone deciding not to get coverage.

Now there are plenty of issues with all health systems, but when you look at the total amount of money the US spends on healtcare there is more than enough money being spent to give every American the VERY best care.

the problem for any approach is breaking the medical industrial complex we've built up. No doubt half those big yachts they can't build fast enough belong to implant CEOs, insurance CEOs, pharma, etc, etc

Again, there's no reason why we shouldn't have the best care and we already spend the money. but it's hard as hell to come up with a system when only 1/2 of the people are willing to try to fix the problem. and the other 1/2 spend literally billions to fight it.

In the insurance business, we often joke that Americans won't buy a sandwich without knowing the price, but they'll sign up for knee surgery with a doctor that their friend used, never bothering to price shop. There's this mysticism that paying more means the doctor or clinic is better. All those ads and radio spots you see and hear for whatever oncology clinic: they're not buying that air time with magic beans.

Here's some real no-kidding data showing the procedure cost of a steroid injection to the right hip bursa. This is just for the procedure. The medical providers are within two miles of each other. There is zero correlation between cost and prognosis. A lot of what I've seen is that as long as there are no market forces being brought to bear on providers (clinics, hospitals, doctors, nurses, etc) there is no insensitive to lower cost.

And if we, as an insurance company, try to educate people about the costs of medical services we are branded as "getting between people and their doctors".

[Boatguy30]

When my son was a newborn they were worried he had hydrocephalus. They said he needed an MRI. My father-in-law and brother in law are surgeons and the doctor was a friend of theirs at the same hospital. I asked how much does that cost? They had no clue.


$1200 for a cash payer.

Ended up doing an ultra sound instead for like $200. He just had a big head.

[jkindredpdx]

Originally Posted by Boatguy30

The problem for you maybe that your yearly out of pocket can only be like 9% of your income. So if it's 10K plus the premiums I think are counted also, figure out what your income would need to be to make that 9% and then you'd be judged as having adequate coverage. . .

Thanks, I didn't know the 9% minimum. . . think I'll just wait until the exchange opens up and let them calculate the minimum for me. . . or I guess I could pay the $95

[monstads]

Originally Posted by rebel heart

A lot of what I've seen is that as long as there are no market forces being brought to bear on providers (clinics, hospitals, doctors, nurses, etc) there is no insensitive to lower cost.

I have not given the exchanges a huge amount of thought, and can't say for sure if they are good, but this thread, and your statement is showing one major change .. People are actually talking about it, and are able to actually compare what others are being charged. The ability to compare options, and make decisions they are comfortable with and understand is essential. Even if it's at a basic Platinum/Gold/Silver/Bronze level, that is huge.

Heck, just yesterday I heard that Minnesota has one of he lowest rates. How long before Wisonsonites start demanding lower rates too? ( and please refrain from answering that with the obvious political answer)

[jkindredpdx]

Originally Posted by rebel heart

There are HSA plans similar to what you're talking about, and exchanges aren't the only places that sell insurance. . .
Speaking as a guy who works in insurance, there are generally two camps of insurance users:

a) People who dislike the payment and little benefit they get.
b) People who dislike the payments but have had the random turn of fate that landed them with cancer, MS, or something of that sort. . .

I guess I would just ask you to think about how your feelings might be different if you were diagnosed with testicular cancer or perhaps got a spinal injury in a car accident. . .

I respect your prejudice... I mean judgement... I mean opinion, but you don't know squat about my values, convictions, or my financial means. So. . . I apologize for my defensiveness, guess your reply sounded just a little condescending.

[letsgetsailing3]

Originally Posted by rebel heart

In the insurance business, we often joke that Americans won't buy a sandwich without knowing the price, but they'll sign up for knee surgery with a doctor that their friend used, never bothering to price shop. There's this mysticism that paying more means the doctor or clinic is better. All those ads and radio spots you see and hear for whatever oncology clinic: they're not buying that air time with magic beans.

Here's some real no-kidding data showing the procedure cost of a steroid injection to the right hip bursa. This is just for the procedure. The medical providers are within two miles of each other. There is zero correlation between cost and prognosis. A lot of what I've seen is that as long as there are no market forces being brought to bear on providers (clinics, hospitals, doctors, nurses, etc) there is no insensitive to lower cost.

And if we, as an insurance company, try to educate people about the costs of medical services we are branded as "getting between people and their doctors".

That's an excellent point, but I haven't seen anybody on either side arguing for cost transparency.

Since Americans ALREADY pay double what other developed countries pay for care, it seems odd to add more subscribers without actually figuring out what the costs should be.