Health Insurance?

[Not Neil_Armstrong]

So, it's ACA time. I've postponed that until next year even thought this years income is way down.

One things I've noticed is that it seems the more personified a topic gets, the more idiotic the discussion becomes.

I need to look into ACA. My insurance just doubled and lost my subsidiaries

[iceman]

English motherfucker, do you speak it?

The drugstore in this town is called the Westport Apothecary.

It's cute as a motherfucker. I guess that's the point? Not sure.

If their point was to come up with a name that my wife can't say, they succeeded.

[liv2ski]

Iceman, I just closed a home loan for a lady that owns a Health Insurance brokerage. I could PM you her phone number and you could call her and ask her what do do rather than asking a bunch of dentist.

[iceman]

Yeah I was kinda hoping for an insider tip, thanks I'd appreciate that.

Do me a favor and put your name in the PM so I don't sound like a lunatic when I contact her.

[yeahman]

Well we'll have no (or practically no) outside income next year but this year's tax return will show a lot, do you know if that can be finessed somehow? If you don't know I can just call them I guess, so no worries.

It doesn't matter what this year's income is because the ACA subsidies are based on what you predict your next year's income will be. This happened to me. I had a higher income, then it went down and I had to write a letter with a detailed explanation to the ACA telling them why my income was going down and doing my best to predict what it would be.

There's a little more to it...when you register for the ACA coverage, you need to select the option about having a "life changing" event or something like that, i.e. job loss, decline in income for whatever reason. If you don't do that, they won't read your explanation letter and they'll keep sending you notices that you're not qualified (based on your previous year's income).

Good luck with it. If you have no income next year, and you can convince them that's the case, you'll have some damn cheap health insurance for the time being.

[Cono Este]

We've always had insurance through my wife's job but the company is being broken up and sold off and our insurance is set to run out 12/31. We've never had to buy insurance before so I'm totally new to this. The wife's running a start-up but there really aren't any employees yet although that will probably change (will change if all goes as hoped).

Who has a clue on this? Should we do Obamacare? (we wouldn't qualify for subsidies) Go straight to a private company? Do Blue Cross/Blue Shield? Set up a company policy despite the lack of employees? Steer me in the right direction please, I have basically no clue what I'm doing here. Which is pretty normal for me, but this is a whole brand-new area of incompetence.

Thanks.

All individual plans are ACA plans/Obamacare, don't let that fool you. You don't need to go through the exchange you can call the carrier direct. It's too early to tell what will be available in your state next year, but I would start by calling your doctors and finding out what they take right now. Blue Cross, United healthcare etc. then in early dec. call up the appropriate carrier and just get silver plans.

Don't think too hard about it all. It's quite simple, but check your providers take your plan and that your drugs are on the formulary. And then learn to use your plan. Meaning, go to the preferred pharmacy, and providers. These are the #1 mistakes I see people make, and then bitch about.

[GeezerSteve]

All individual plans are ACA plans/Obamacare

Not quite true. As a general rule, HC insurance plans are required to be ACA-compliant, but there are exceptions, e.g., short-term plans (i.e., <1 year) need not be ACA-compliant

[iceman]

Not true

That didn't seem true from my research. Certainly there's plenty of companies that are willing to sell you a policy directly.

[Benny Profane]

Turn 65.

Seriously, if you're a more, ahem, mature gentlemen, check out what AARP has to offer. Just call them, can't hurt.

[iceman]

Yeah I got a few years left before that but thanks.

[GeezerSteve]

That didn't seem true from my research.

From https://www.ehealthinsurance.com/sho...alth-insurance:

Short-term plans are temporary coverage with limited benefits. They are not ACA-compliant, don’t cover pre-existing conditions and are not guaranteed-issue.

(emphasis supplied)

[byates1]

English motherfucker, do you speak it?

i am somewhat english, yates is a surname for gatekeeper.

i'd appreciate it, if you would not insult my mothers profession,

and the four generations behind her.

thank you.

[byates1]

ice, did you really just post a link of your wife and daughter mixing expensive feel good stuff?

this place must be in hell

[Mazderati]

Are you still in Boston? Looks like we're moving to Westport if we don't get divorced or someone gets murdered first. I think the company will work it's probably about a year early for a person of your caliber right now though.

Here's their site, it's only been up for a week or so, there's issues but they will get fixed: 2betties.com

Catchy name. Grabbed a sampler.

I know you're stoked about Westport sans homicide. Currently south of the Mason-Dixon but there is talk of heading back to the Hub pretty soon.

[Buster Highmen]

Don't think too hard about it all...check your providers take your plan and that your drugs are on the formulary.

I'm fucked.

[FLS]

No Pony for you?

[BFD]

I know people that do this. I will use the loophole myself.

https://www.cnbc.com/2016/01/27/they...subsidies.html

I anguished for a long time and went this route. My Bronze plan was $1400 a month I pay $2.65. That makes me smart.
I have a SEP , Roth and traditional IRA and am supposed to open up a 401 this year. I hope my finance guy is correct.. I am not an expert but I would be very careful about lapsing coverage if you may have a pre existing condition. Good luck the whole thing sucks.

[Cono Este]

That didn't seem true from my research. Certainly there's plenty of companies that are willing to sell you a policy directly.

You only must use the exchange is you qualify for a subsidy. I sell Obamacare plans to people, but usually they qualify for a subsidy so I do the righteous thing and set up an online acct for them. I get jack shit a way so I'd prefer not to attach my name to plans that generally confuse people anyway.

Steve is talking about short term plans or major medical policies, neither you want. You can call Assurant and get that if you want.

The key is in your meds. If you have anything but preferred generics then a bronze plan will leave you high dry on brands, and that's why inreccomend people pay more for a silver. On a silver you will have a copay for brands vs. 100% out of pocket.

Find out what your docs take, then call up the carrier and ask for a formulary to be emailed to you to check yourself. People on the phone are sales oriented idiots. Do you own homework.

[Conundrum]

A small business plan is the way to go. If your wife's start up will have an employee plus owners you should look into that. Every state has different regs. I'd be happy to chat but it would be generalities but I could at least give you the right questions and answers if you end up pursing s a business plan with a broker local to you.

[iceman]

Thanks Cono. Give me a couple days, just getting started here.

[Cono Este]

Another key is to use doctors and facilities attached to a major hospital. Do not use a doctor out on his own sending you to quest diagnostics etc. hospitals have contract rates with insurance companies and you will save a shit load using everything in house.

So much is negotiated under the table it's hard to figure out. I have the worst plan in Missouri, have been to the doct about 10 times this summer, had all kinds of tests, and although my plan reads that I owe it all until my deductible is met, I've owed like 5% because on contract discounts between the hospital and Cigna. I couldn't be any happier.

It's all about knowing how to use your plan.

[iceman]

It doesn't matter what this year's income is because the ACA subsidies are based on what you predict your next year's income will be. This happened to me. I had a higher income, then it went down and I had to write a letter with a detailed explanation to the ACA telling them why my income was going down and doing my best to predict what it would be.

There's a little more to it...when you register for the ACA coverage, you need to select the option about having a "life changing" event or something like that, i.e. job loss, decline in income for whatever reason. If you don't do that, they won't read your explanation letter and they'll keep sending you notices that you're not qualified (based on your previous year's income).

Good luck with it. If you have no income next year, and you can convince them that's the case, you'll have some damn cheap health insurance for the time being.

Good info, thanks.

[bobz]

If you're going to fall even moderately under par on income during the coverage period, ACA is going to be the way to go. Estimate your numbers and pay based on that; if you turn out to have estimated wrong (in either direction) there will be appropriate adjustments when you file taxes (yes, using ACA means there's an additional tax form to deal with). I'm not sure how competitive ACA plans are with stuff you'd get through a broker, if subsidies aren't an issue.

In terms of when to do it, open enrollment is coming up, but that doesn't matter to you if you're losing other coverage for some reason; that's all explained when you look into the ACA stuff.

No reason not to find out what your COBRA option is, but again, if you're going to be down some on income next year, there's a good chance that you can get subsidized ACA, and in that case, that's the way to go.

[iceman]

ice, did you really just post a link of your wife and daughter mixing expensive feel good stuff?

this place must be in hell

Yup. And yup. Hey I figure it's out there in the world, and you freaks aren't much worse than most other freaks, so why not?

Thanks a lot for all the good info fellaz.

[iceman]

Catchy name.

ha, yeah the name's my main contribution to the effort so far.