Affordable Care Act - catastrophic plans cancelled

[sailorboy1]

It would seem that for a US cruiser living OUTSIDE the US that the only thing that has changed would be the fine (tax) you would owe for not having a ACA plan. My understanding is that fine is kind of small and there is nothing to stop one for getting some type of health insurance for major medical on the worldwide open market. It would seem to did depend on what excursions you are willing to have on your policy (like that you can not travel back to the US for treatment).

If the choice is between paying $400/mo etc more than what you are currently paying to get an ACA plan or to pay a fine of say $200/year to have some other plan that you are already using, well just pay the fine.

I've long known that the only way I could even afford to go cruising is to get out of the USA due to the health care cost issue.

[Paul L]

Originally Posted by rebel heart

Doesn't matter. At least for the next year, until they can provide better guidance, any expat policy that's a group plan (as opposed to you and your two friends squirreling away some cash) that requires you to be out of the country for six months counts.

http://www.dol.gov/ebsa/faqs/faq-aca13.html

What do you mean by doesn't matter? I'm buying a policy for health insurance, not to avoid a $95 penalty. Like they say,m never make investment decisions based on saving taxes.

[Paul L]

Originally Posted by sailorboy1

It would seem that for a US cruiser living OUTSIDE the US that the only thing that has changed would be the fine (tax) you would owe for not having a ACA plan. My understanding is that fine is kind of small and there is nothing to stop one for getting some type of health insurance for major medical on the worldwide open market. It would seem to did depend on what excursions you are willing to have on your policy (like that you can not travel back to the US for treatment).

If the choice is between paying $400/mo etc more than what you are currently paying to get an ACA plan or to pay a fine of say $200/year to have some other plan that you are already using, well just pay the fine.

I've long known that the only way I could even afford to go cruising is to get out of the USA due to the health care cost issue.

But that isn't the choice for most. The facts will be different for each person based on circumstances. What has changed for many US based cruisers is that they can get a policy for much less than before and not have pre-existing conditions exclusions applied.

[Paul L]

Originally Posted by Stu Jackson

Could someone explain how that would work?

I broke my leg skiing five years ago. There wasn't a whole lot of time between the break and surgery to fill out insurance applications.

Easy, you take pain meds till the next open enrollment period. With a little bit of luck it will be less than 6 months.

[SV THIRD DAY]

Originally Posted by Paul L

Easy, you take pain meds till the next open enrollment period. With a little bit of luck it will be less than 6 months.

Or just call the Dr and tell them you are a Cash payer...I did it last week when I broke my foot. At first they were booked up, told them I was paying cash and I walked right in past the 8 people sitting in the waiting room and walked out with an X-ray and cast-boot for less than the deductable anyway. no drama...no forms...no govenment handouts or programs needed.

[In Training]

Great Topic! Much appreciated.

[Stugots]

Originally Posted by Group9

That seems to be the best loophole in it for young, healthy, people (like many cruisers). Just pay the fine, and sign up if you do get hurt or get sick with something that is going to have a lot of medical bills associated with it.

I know that's my 28 year old stepson's plan.

The problem is, with finding anybody, government or private, who can give you a definitive answer on anything about the ACA. My brother is a CPA in a very large firm and he says after studying the act for three years, they are hanging caveats all over their advice to their clients, because they really are not sure how a lot of the provisions are going to be interpreted, especially by the IRS.

I've heard this strategy suggested by several people but I honestly don't understand the advantage. Isn't it better to just pay for healthcare rather than to pay a fine to have nothing? If you get hit by a car you'd be screwed. Seems like an extremely risky strategy... and not a free one either.

[Stugots]

Originally Posted by PamlicoTraveler

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.

Sorry if this has already been asked, but have you shopped around at all? $1200 is many times higher than any bronze plan I've heard quoted... it doesn't sound right. I went on and looked at costs for bronze plans in California and they were in the $200-300 range. If you're cruising I would imagine your income level is also low enough to get subsidies on top of that.

[CatInHand]

Originally Posted by Group9

That seems to be the best loophole in it for young, healthy, people (like many cruisers). Just pay the fine, and sign up if you do get hurt or get sick with something that is going to have a lot of medical bills associated with it.

I know that's my 28 year old stepson's plan..

Once the system is up and running, open enrollment will only be once a year without an insurance-changing event (like divorce or job loss). The stepson will need to plan to become ill in October and be able to hold out until January before seeking care.

[Paul L]

Originally Posted by SV THIRD DAY

Or just call the Dr and tell them you are a Cash payer...I did it last week when I broke my foot. At first they were booked up, told them I was paying cash and I walked right in past the 8 people sitting in the waiting room and walked out with an X-ray and cast-boot for less than the deductable anyway. no drama...no forms...no govenment handouts or programs needed.

We have a friend who had an unexpected and rare heart issue this summer. The bills are still rolling in, but so far it has exceeded US$600,000. Cash, check or insurance? You pick.

[Group9]

Originally Posted by CatInHand

Once the system is up and running, open enrollment will only be once a year without an insurance-changing event (like divorce or job loss). The stepson will need to plan to become ill in October and be able to hold out until January before seeking care.

Well, since you have the answers, what day will that be?

[keepondancin]

We have had health insurance all of our married years, most of them paid by ourselves because we were both self employed, one of the worst situations when you buy health insurance. We are now both on medicare, which, with a good supplemental and parts B and D, costs us about $650/month with no deductible and no co-pay. I tried to log in to NY program, and couldn't, because apparently I had to register, then get info, and got kicked back due to medicare eligibility. NY has signed into the Federal program. I tried Florida, which did the opt out, signed in, and for a Platinum program, which is very close to what we had prior to medicare, it was about $700 for two per month. It does seem that location plays a big part of it, as states seem to have much higher rates than others. It will force people into changing addresses, and as a cruiser, you have more flexibility. In our case, in 1971, due to a car accident, wife being hit by an uninsured driver, medical bills were over $40k.. Insurance paid 80%. I was making $7000 a year, I was responsible for about $9000. In 2003, wifey suffered a catastrophic fall, related to surgery because of the 1971 accident, and even with excellent coverage, it was almost $50k out of pocket, because we were out of network, and they insurance again paid 80%. A lot went on between 1971 and 2003, and if we didn't have insurance, we would be living in a cardboard box. I just couldn't imagine having no health insurance in todays world. The years we were cruising, we kept up with our policy,and after another severe incident, everything was submitted, mostly paid, and we didn't loose savings or our boat. The poster who kept $10,000 in emergency savings, well, that might pay for a broken arm.

[rebel heart]

Originally Posted by lorenzo b

Just come on down to Panama, or Malaysia, or the DR. You can get old, sick, and die for pennies on the dollar and eat great food, lay about in the sun, and swim in some beautiful seas.
Why do cruisers rush back to the USA to get lousy medical care at ridiculously high prices?

The US health care system (and the US Congress, and partisanship, and so much else) is obviously not well regarded these days, but there truly are some of the best medical providers in the world living with the US border.

We had a child in Mexico, had all of our pre and post natal work down there, and all the other medical considerations that a family with two children would deal with. But if someone was to get Parkinson's disease, leukemia, or a host of other issues requiring skilled surgery, I'd do it in the states.

If you're healthy enough to live as expat on a boat that's one thing. But if you got diagnosed with a possibly terminal illness, most people would choose to go home to where their family is.

[Brogan007]

Must be NC day!!!! Wake Forest here.
btw..I have a $5000 deductible, BCBS plan, love it, get to keep it and it only went up $25/mth...to $175...and I get not one cent of help/subsidy from anyone. The plans seem to be out there...for some of us anyhow.
Being a UK expat...often wonder if I'd still qualify for free NHS treatment in an emergency.

Originally Posted by KNoel

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!

[Stugots]

Originally Posted by Group9

Well, since you have the answers, what day will that be?

Open enrollment for 2014 is Oct 1, 2013 to March 31, 2014.
https://www.healthcare.gov/glossary/...llment-period/

And come on man, don't be like that.