Shoulda thought about this before you had a kid

I'm Krallum and I approved this message.

10/2/2013 12:00:50 PM

Quote :

"mrfrog: Nothing about low-income people. So those people now have to face penalty and get nothing from this. Nothing changes for them aside from a new tax on being alive."

According to this tool, http://kff.org/interactive/subsidy-calculator/ , they'll be getting dirt cheap, heavily subsidized health insurance.

Right?

10/2/2013 12:25:51 PM

anyone been able to sign up yet? still can't get the security questions to show

10/2/2013 12:31:52 PM

^^are only for between 100%-400% of the poverty level, so i think there are still gaps under 100%. these gaps were intended to be covered by medicaid by expanding Medicaid to include most low-income people, but since that was kicked out by the supreme court now we have a coverage gap.

[Edited on October 2, 2013 at 12:33 PM. Reason : ^i'd wait a few days]

10/2/2013 12:32:44 PM

^I see!

10/2/2013 12:50:34 PM

hey if I already have health insurance thru my employer AND thru tricare, do I need to sign up for this shit?

10/2/2013 12:52:19 PM

Quote :

"OTHER COVERAGE OPTIONS Children and young adults under age 30 are eligible to purchase catastrophic coverage. With a catastrophic plan, you would pay out-of-pocket for most health services until you reach the annual limit on cost sharing ($6,350 in 2014). However, preventive services are covered with no cost sharing required."

I wonder what the cost of this would be. I've been to the doctor twice in the past 4 years and it was for a physical and one was from a minor injury, yet im paying 157 dollars a month in insurance premiums. I only have my health insurance in case of an unforeseen emergency so that i don't end up bankrupt from it.

10/2/2013 12:54:06 PM

^^no

in fact, you can't even get the subsidy if your employer offers you insurance, or if you qualify for a government health-insurance program (like TRICARE)

[Edited on October 2, 2013 at 1:04 PM. Reason : you can still look on the exchange, but you probably won't get a good deal

10/2/2013 1:03:55 PM

^^Catastrophic coverage has always been available. It should be what you have already if you picked the right plan.

10/2/2013 1:09:37 PM

Quote :

"in fact, you can't even get the subsidy if your employer offers you insurance, "

yes you can, if you earn less than 400% of poverty level and pay over 9.5% of your income on healthcare. but that's not going to be a typical situation.

10/2/2013 1:11:46 PM

Quote :

"^^are only for between 100%-400% of the poverty level, so i think there are still gaps under 100%. these gaps were intended to be covered by medicaid by expanding Medicaid to include most low-income people, but since that was kicked out by the supreme court now we have a coverage gap."

But are there requirements other than just income to get the subsidy?

In political discussion people throw out income requirement all the time, as if it's the end-all and be-all for any kind of government assistance. People who actually apply know this isn't the case, there is often a litany of requirements, not to mention the effort of filing the application in the first place. Not to mention, many eligible people either don't know or care enough to try to the assistance to begin with.

Are you just going to enter in your income within the web portal and get the subsidy? Yeah right.

[Edited on October 3, 2013 at 3:49 PM. Reason : ]

10/3/2013 3:48:59 PM

No, you don't have to be pregnant or anything like that, although if you have employer offered healthcare you don't qualify for a subsidy unless you are in that 100%-400% and spend over 9.5% on healthcare.

the answer to your question is in the links that I posted

10/3/2013 5:20:59 PM

got a letter from BCBS saying my new plan will be over 300% the cost of my previous plan that I'd been paying for

Thanks Obama

10/3/2013 5:49:09 PM

If you're right at poverty, you might be able to get a Bronze plan for free, or a Silver plan for about $230/year (both after subsidies, which cap post-subsidy premiums at 2% of income) with a cap on out-of-pocket expenses that gives it an effective actuarial value of 94%, higher than a Platinum plan would be for most people: http://kff.org/interactive/subsidy-calculator/#state=nc&zip=27695&income-type=dollars&income=11490&employer-coverage=0&people=1&adult-count=1&adults%5B0%5D%5Bage%5D=21&adults%5B0%5D%5Btobacco%5D=0&child-count=0&child-tobacco=0

These people, the ones near yet not below the poverty level, are the ones boosted the most by Obamacare.


I figured out that KFF's estimate of the 2014 poverty level, down to the dollar, was $11,490 for an individual, and I used age 21 and NCSU's ZIP Code, but age and location didn't seem to matter at this income level; they do matter on the other end, 400% of poverty or $45,960, where a 21-year-old would get no subsidy and pay about 5.52% of income for a Silver plan, while a 64-year-old would get 43% of a Silver plan subsidized and pay the post-subsidy cap of 9.5% of income in premiums...and such a person would need to at least get a Bronze plan, which would cost about 6.67% of income after subsidies, or else pay the penalty.

10/4/2013 9:56:21 PM

here's you guys' #1 problem ITT:

BCBS



seriously the worst insurance provider around

10/4/2013 10:33:13 PM

What do you suggest then? My #1 problem is Obamacare.



If I were to just pay the fine every year... Could I sign up with BCBS right after a major event since they can't deny me coverage? This is a serious question.

10/9/2013 7:15:16 AM

Quote :

"easiest way to save money on your insurance is to get sterilized"

iswydt.

10/9/2013 7:30:14 AM

Quote :

"If I were to just pay the fine every year... Could I sign up with BCBS right after a major event since they can't deny me coverage? This is a serious question."

you could, but you would be paying more and your major event would be an out of pocket expense

and since the penalties are capped at the national average price for bronze coverage, it doesn't make any sense

10/9/2013 9:02:00 AM

That's if I have a major event. What are the penalties again?

10/9/2013 3:10:55 PM

2014: $95 per adult and $47.50 per child (up to $285 for a faimly) or 1% of family income, whichever is greater

the penalty cannot be greater than the national average premium price for Bronze coverage and is pro-rated by month

10/9/2013 3:18:25 PM

so I read on the healthcare site that "catastrophic" plans are for low income only... I assume that the site is equating catastrophic plans with HDHPs? I looked on BCBS and found a HDHP that I liked... would that not meet some requirement for my insurance?

10/9/2013 3:18:38 PM

More importantly, catastrophic plans are for the under-30 set only

and you can't use subsidies on them

10/9/2013 6:48:59 PM

Lets just say we make $100k... 1% of that <<<<< $7k/year for a bronze plan. Right?

10/9/2013 7:21:57 PM

...and why would you want that?

10/9/2013 7:25:05 PM

if you are just trying to save money, then the penalty is less expensive. but then you don't have insurance.

10/9/2013 7:27:58 PM

But I can always get it right?

I could potentially pay $20k out of pocket per year.

[Edited on October 9, 2013 at 7:35 PM. Reason : T]

10/9/2013 7:32:45 PM

yes, but ACA doesn't change how insurance works, you can't purchase it and then apply it retroactively. it also doesn't mean they won't charge you more for something in your history.

[Edited on October 9, 2013 at 7:45 PM. Reason : $20k won't get you far in the hospital]

10/9/2013 7:43:12 PM

Just trying to figure out my best option. If this thing goes through we are forced by the govt to pay out nearly 35% of our income. Taxes and insurance. I'm not a fan

10/9/2013 7:47:08 PM

well this thing went through 3 years ago, its a done deal

10/9/2013 7:50:37 PM

Little false advertisement to a bunch of morons got us there

10/9/2013 7:52:09 PM

what was falsely advertised?

10/9/2013 7:54:17 PM

Can you give an example of the average family saving $2500 annually on this plan?

10/9/2013 8:23:35 PM

sure, a family with a household income between $15k (0 children) and about $100k (2 children)

10/9/2013 8:31:04 PM

You have numbers to back that up? My son and I pay $1600/year for insurance through BCBS. How could we save $2500/year when we aren't paying that much???

10/9/2013 10:04:06 PM

(because you get subsidies between 100% and 400% poverty)

10/9/2013 10:17:14 PM

Numbers please

10/9/2013 10:22:09 PM

http://benswann.com/exclusive-many-americans-suffering-sticker-shock-is-obamacare-really-affordable/

Quote :

"One family paid $180 per month under the Trader Joe’s plan for part-time workers, which covered him and his wife, who worked at the retailer. As directed, they searched on the exchanges, and to their surprise, they found worse coverage for more money. He writes, “MNSure [the State of Minnesota health insurance exchange] was able to find us 1 plan (had to change the date to 2014 just to get that!). 1 PLAN. The rate? $555.81 with a $6,000 DEDUCTIBLE. MORE than 3X what we were paying for a WORSE PLAN! And no, we are not eligible for any tax deductions, and NO we are not rich. In fact we have budgeted nearly every dollar we make to paying off debt BEFORE this happened!”"

I'm guessing Trader Joes workers maker >400% of the poverty line?

10/9/2013 10:23:10 PM

That story is clearly made up. They seem to be average and should be saving $2500 per year

10/9/2013 10:29:09 PM

He's not eligible for subsidies because he has employer provided insurance already, otherwise he would be unless Trader Joes pays a lot more than I think.

^^^
http://kff.org/interactive/subsidy-calculator/

[Edited on October 9, 2013 at 10:30 PM. Reason : .]

10/9/2013 10:29:38 PM

I'm asking you to show me a situation where someone saves $2500/year.

Or are you saying he meant the $2500/year is subsidy?

10/9/2013 10:50:48 PM

dtownral is trolling himself pretty hard in this thread

10/9/2013 11:08:45 PM

Quote :

"More importantly, catastrophic plans are for the under-30 set only and you can't use subsidies on them"

I obviously would not be asking if I was over 30 and needed/could get a subsidy.

I'm in the middle class, which means I get fucked by all sides.


still can't get a damn website right

10/10/2013 10:34:55 AM

Quote :

"I'm asking you to show me a situation where someone saves $2500/year. Or are you saying he meant the $2500/year is subsidy?"

you asked for a situation where someone saves money, i provided them

10/10/2013 10:45:05 AM

I continue to not understand this

Quote :

"You are guaranteed access to a Silver plan with an actuarial value of 70%. This means that for all enrollees in a typical population, the plan will pay for 70% of expenses in total for covered benefits, with enrollees responsible for the rest. If you choose to enroll in a Bronze plan, the actuarial value will be 60%, meaning your out-of-pocket costs when you use services will likely be higher. Regardless of which level of coverage you choose, deductibles and copayments will vary from plan to plan, and out-of-pocket costs will depend on your health care expenses. Preventive services will be covered with no cost sharing required. "

How is this "insurance" if you have to pay 30% of everything beyond the deductible? If you have a condition that runs 1 million in medical bills, you still can't pay your part. So what is it protecting you from?

[Edited on October 10, 2013 at 10:48 AM. Reason : ]

10/10/2013 10:46:55 AM

is that not how 70/30 plans have always worked?

10/10/2013 10:50:33 AM

^^coinsurance. as for your $1 million... there is an OOP maximum for each plan.

[Edited on October 10, 2013 at 10:54 AM. Reason : .]

10/10/2013 10:53:47 AM

and related to your OOP max, ACA also ended lifetime maximums (that limited what insurance paid out at a certain dollar value) that some plans had

10/10/2013 10:57:22 AM

BCBS Silver 0 plan, for example:

https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Platinum_500.pdf

No deductible
50% coinsurance (I/N)
OOP max:
For In-Network $6,350
person/$12,700 family For
Out-Of-Network $12,700
person/$25,400 family

(aka stay in network)

10/10/2013 11:01:30 AM

Quote :

"I obviously would not be asking if I was over 30 and needed/could get a subsidy. I'm in the middle class, which means I get fucked by all sides."

(not trolling here)

You probably are in the middle-class, by which I mean the real one, able to afford what we like to call a "middle-class lifestyle," if you expect to make a bit over 400% of the poverty level, a.k.a. "unable to get a subsidy."

(Many a politician likes to call the middle fifth of incomes, in nominal terms, "middle class," and that fits well within the range of 100-400% of poverty for all family sizes between 3 and 7, but a better consideration uses multiples of the poverty level, and families at maybe the upper end of that 100-400% range would be able to afford a middle-class lifestyle; of course, an even better idea would be to weight it by PPP, so that the poverty level would be higher in NYC than Raleigh, but so far the official figures only distinguish AK and HI from each other and from the rest of the US.)

Although I'd like to say you're not getting "fucked" the fact is that compared to people making a little less than you, you're definitely feeling that way (but it's still better than the individual market now lol), and the feeling won't go away unless you start making about 500% of the poverty level: http://pocketmint.net/2012/09/obamacare-and-affordable-health-insurance/

Quote :

"Calculations by MIT economist Jonathan Gruber suggest that 500% of FPL is a break point beyond which more than 99% of the population will be able to afford insurance premiums and typical out-of-pocket costs."

link to "Calculations" here: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Apr/1493_Gruber_will_affordable_care_act_make_hlt_ins_affordable_reform_brief_v2.pdf

10/10/2013 12:08:56 PM

Pretend you're a teacher, put in $35,000 into the calculator.

http://kff.org/interactive/subsidy-calculator/

This is 305% of the poverty level. There's no subsidy.

Quote :

"You could receive a government tax credit subsidy of up to: $0 (which covers 0% of the overall premium) "

I don't understand squat about this law, apparently.

10/10/2013 12:16:59 PM