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Health Insurance

Posted: Fri Apr 18, 2014 5:16 pm
by LC475
Hi, everyone!

Let's say that one were young and healthy and self-employed.  How would one go about getting catastrophic health insurance?  Or even semi-catastrophic?  Is there something affordable out there?  What do you guys do?

Re: Health Insurance

Posted: Fri Apr 18, 2014 5:33 pm
by Xan
I've been in exactly that situation for quite some time.  I've had catastrophic policies from United/Golden Rule, and more recently Humana.  Obama keeps threatening to take it away, but so far keeps delaying that.  (I'll leave how asinine all that is for another time...)

For me and my wife both, it was something like $150/month, $10K deductible, 100% coverage post-deductible.  And it lets me do an HSA.  So it's pretty good.

A couple months ago when my boy was born, the costs went up, but that's quite understandable!

Re: Health Insurance

Posted: Fri Apr 18, 2014 5:35 pm
by LC475
Xan wrote: I've been in exactly that situation for quite some time.  I've had catastrophic policies from United/Golden Rule, and more recently Humana.  Obama keeps threatening to take it away, but so far keeps delaying that.  (I'll leave how asinine all that is for another time...)

For me and my wife both, it was something like $150/month, $10K deductible, 100% coverage post-deductible.  And it lets me do an HSA.  So it's pretty good.

A couple months ago when my boy was born, the costs went up, but that's quite understandable!
This might be perfect!  $150/mo sounds a lot better than $1,000!! How much did it go up to with the boy?

Re: Health Insurance

Posted: Fri Apr 18, 2014 5:41 pm
by Xan
He's an additional $100/month or so.  It's not bad.  Fills the need perfectly to cover us in case of something unexpected that could ruin us.  Which is exactly what insurance is supposed to be!

Oh, one other thing we found is that there's no such thing as a policy you can go out and buy which covers maternity.  Which I'm actually okay with...  Maternity is NOT something unexpected, so something that's actual insurance as opposed to a cost-sharing thing shouldn't cover it.

We did sign up with Christian Healthcare Ministries, which IS a cost-sharing program, and they did cover it.  It was fantastic.

Re: Health Insurance

Posted: Fri Apr 18, 2014 6:07 pm
by dualstow
I had catastrophic for years, first thru Assurant and now from Golden Rule.
Next year, I think we're just going to buy Obama bronze, since we're not as young as we used to be.

Re: Health Insurance

Posted: Fri Apr 18, 2014 7:44 pm
by Reub
I am retired from the federal government so that I don't have to be concerned with Obamacare in any way. Present and retired federal workers are all exempt from it. Ironic, isn't it?

Re: Health Insurance

Posted: Fri Apr 18, 2014 7:53 pm
by Reub
LC475 wrote: Hi, everyone!

Let's say that one were young and healthy and self-employed.  How would one go about getting catastrophic health insurance?  Or even semi-catastrophic?  Is there something affordable out there?  What do you guys do?
Do they still offer those high deductible plans that allow you to put all of your premium into an account (HSA) that you still own and grows tax-free like an IRA? I know that Aetna use to offer one. Yes, here it is:

http://www.aetna.com/individuals-famili ... count.html

Re: Health Insurance

Posted: Fri Apr 18, 2014 7:54 pm
by rickb
Reub wrote: I am retired from the federal government so that I don't have to be concerned with Obamacare in any way. Present and retired federal workers are all exempt from it. Ironic, isn't it?
"Exempt" is the wrong word.  Obamacare does not apply to anyone who already has employer provided insurance (as you do, even as a retiree).  There's no special "exemption" for federal employees (even Congress).

Re: Health Insurance

Posted: Fri Apr 18, 2014 7:58 pm
by Reub
rickb wrote:
Reub wrote: I am retired from the federal government so that I don't have to be concerned with Obamacare in any way. Present and retired federal workers are all exempt from it. Ironic, isn't it?
"Exempt" is the wrong word.  Obamacare does not apply to anyone who already has employer provided insurance (as you do, even as a retiree).  There's no special "exemption" for federal employees (even Congress).
Except for the 6 million or so who were dropped because their plans no longer met federal standards?

Re: Health Insurance

Posted: Fri Apr 18, 2014 8:29 pm
by clacy
After the smoke clears from the 2014 midterms, there will have to eventually be some fixes to Obamacare in 2015, and from what I've read, one of the first changes will be to add a "copper" plan which would basically be a very bare bones version of insurance.  The catastrophic insurance version of Obamacare.

Re: Health Insurance

Posted: Fri Apr 18, 2014 8:38 pm
by Pointedstick
Maybe they can keep adding lower and lower tiers until they finally achieve the long-promised goal of affordability.

"I'll take the Wood plan, please! Or maybe I could save a few bucks and go with the PVC plan…"

Re: Health Insurance

Posted: Sat Apr 19, 2014 1:29 am
by Mark Leavy
In about 6 months my current health care will run out.  I'm currently on COBRA, after taking myself off of the employee list for the company that I started.

I'm required to buy health care, but I haven't seen any Obamacare policies that cover me for the 75% of the year that I will be in Mexico, Thailand, Germany, Croatia...

If I don't buy the policies that won't cover me, I have to pay a fine/tax.

Pretty damn funny.

Re: Health Insurance

Posted: Sat Apr 19, 2014 1:45 am
by foglifter
Reub wrote:
LC475 wrote: Hi, everyone!

Let's say that one were young and healthy and self-employed.  How would one go about getting catastrophic health insurance?  Or even semi-catastrophic?  Is there something affordable out there?  What do you guys do?
Do they still offer those high deductible plans that allow you to put all of your premium into an account (HSA) that you still own and grows tax-free like an IRA? I know that Aetna use to offer one. Yes, here it is:

http://www.aetna.com/individuals-famili ... count.html

Yes, HSA-compatible plans are still alive and well (and I hope they will survive Obamacare). My wife and I are covered through my employer under UnitedHealthCare plan with 6K family deductible and 12K out-of-pocket maximum. I pay $0 for the medical part and around $80 for dental+vision (the latter can be dropped). I'm maxing out my HSA at HSABank every year and most of the balance sits in EDV (part of my PP).

Re: Health Insurance

Posted: Sat Apr 19, 2014 1:48 am
by RuralEngineer
The nasty thing is now you have to be careful about trying to buy insurance outside of the open enrollment period.  Even if you manage to find a catastrophic plan, which are rare these days as Obama killed most of them off, all the insurance companies are conforming to his open enrollment schedule so if you don't have a qualifying life event, you're boned.

Re: Health Insurance

Posted: Sat Apr 19, 2014 5:36 am
by ns3
Mark Leavy wrote: I'm required to buy health care, but I haven't seen any Obamacare policies that cover me for the 75% of the year that I will be in Mexico, Thailand, Germany, Croatia...

If I don't buy the policies that won't cover me, I have to pay a fine/tax.

Pretty damn funny.
I've been wondering about this too since my wife and I plan to retire overseas and pay our own medical expenses. It's not an issue for me because I just received my medicare card but my wife is 17 years younger so I wonder if we are going to have to make the Obamacare tax shared responsibility payment for her. If so, the only solution to that might eventually have to be giving back her U.S. citizenship.

(But then again since we won't be having much income maybe we'll get a subsidy from the U.S. taxpayers to pay for the health plan we aren't going to be using but are required to buy. That makes a lot of sense, doesn't it?)

Re: Health Insurance

Posted: Sat Apr 19, 2014 5:58 am
by MachineGhost
LC475 wrote: Hi, everyone!

Let's say that one were young and healthy and self-employed.  How would one go about getting catastrophic health insurance?  Or even semi-catastrophic?  Is there something affordable out there?  What do you guys do?
You need to go to your state's (or Fed's) health insurance exchange website and you can get catastrophobic coverage only if you're under 30.  As part of the signup process, the site will determine whether or not you're qualified for Medicaid coverage (under $16K modified adjusted gross income or so which is 150% of the Federal Poverty Level), or how much subsidies and cost-sharing you will get for exchange provided insurance up to 400% of the FPL.  The modified means that non-taxable income is included.

It's a fantastic deal all around unless you're over that 400%, have Medicare or stuck on employer plans (not true insurance).  And it does very little to reign in healthcare costs.  But one thing at a time, I guess...

Re: Health Insurance

Posted: Sat Apr 19, 2014 8:25 am
by Xan
ns3 wrote:I've been wondering about this too since my wife and I plan to retire overseas and pay our own medical expenses. It's not an issue for me because I just received my medicare card but my wife is 17 years younger so I wonder if we are going to have to make the Obamacare tax shared responsibility payment for her. If so, the only solution to that might eventually have to be giving back her U.S. citizenship.
My understanding is that the only mechanism they have for collecting that tax is to garnish your refund.  Make sure you don't have one, and you might be okay.

Re: Health Insurance

Posted: Sat Apr 19, 2014 10:41 am
by ns3
Xan wrote:
ns3 wrote:I've been wondering about this too since my wife and I plan to retire overseas and pay our own medical expenses. It's not an issue for me because I just received my medicare card but my wife is 17 years younger so I wonder if we are going to have to make the Obamacare tax shared responsibility payment for her. If so, the only solution to that might eventually have to be giving back her U.S. citizenship.
My understanding is that the only mechanism they have for collecting that tax is to garnish your refund.  Make sure you don't have one, and you might be okay.
The only problem with that idea is that they withhold 30% of Social Security if you live outside the U.S. so it might be hard to avoid getting a refund.

Re: Health Insurance

Posted: Sat Apr 19, 2014 12:30 pm
by MachineGhost
Mark Leavy wrote: If I don't buy the policies that won't cover me, I have to pay a fine/tax.
The tax penalty doesn't generally apply to non-residents: http://blogs.angloinfo.com/us-tax/2013/ ... obamacare/

Re: Health Insurance

Posted: Mon Apr 21, 2014 3:49 pm
by LC475
So when is this Open Enrollment period?  I can only get it then?  Hmmm...

MachineGhost, what if one were slightly over 30?  Still possible? Other posters sound like they're saying it is.

Re: Health Insurance

Posted: Mon Apr 21, 2014 6:20 pm
by above the herd
Here is a site that has some interesting alternatives to Obamacare exchanges:
http://www.theselfpaypatient.com/

Re: Health Insurance

Posted: Tue Apr 22, 2014 1:37 am
by MachineGhost
LC475 wrote: So when is this Open Enrollment period?  I can only get it then?  Hmmm...

MachineGhost, what if one were slightly over 30?  Still possible? Other posters sound like they're saying it is.
You must have really been asleep at the wheel!  Open enrollment on the new health care exchanges was from beginning of October to end of March.  Next time it will be middle of Nov to middle of Feb.  There's an enrollment period so people can't game the system by waiting until they get sick, acquire guaranteed insurance, get treated, drop it, rinse, repeat, etc..  Although I think there is a caveat to that that if you're sick you can get insurance outside the enrollment period, so gaming is still doable.  But most people won't do it...  its just the small minority of rotten apples in every barrel, as usual.

If you're over 30, catastrophobic is not available on the health care exchanges and I'm not sure how it can be off exchange with insurers conforming to the same federal regulations.  At the bronze level (40% copay/coinsurance, etc.) on the exchange the premium is all but free for you after the tax subsidies, so you really dont need to worry about getting just catastrophic.  Unless you're over 400% FPL, then you got expensive problems.

Re: Health Insurance

Posted: Tue Apr 22, 2014 2:00 am
by Mark Leavy
MachineGhost wrote: The tax penalty doesn't generally apply to non-residents: http://blogs.angloinfo.com/us-tax/2013/ ... obamacare/
Of course.

But I *am* a US resident.  I just spend 75% of the year outside of the country.
Statistically, any obamacare policy is useless to me.  Yet, if I refuse it and choose to buy a policy that meets my needs,  I pay a tax/penalty.

Not really a problem.  I understand the Danegeld.  The same way I understand paying the young Mexican boy to ensure that no one keys my car.

But I do find it hilarious.

Re: Health Insurance

Posted: Tue Apr 22, 2014 2:32 am
by MachineGhost
Mark Leavy wrote: But I *am* a US resident.  I just spend 75% of the year outside of the country.
Statistically, any obamacare policy is useless to me.  Yet, if I refuse it and choose to buy a policy that meets my needs,  I pay a tax/penalty.
Are you sure that's correct?  We're not talking about the "resident" in tax terms here, but a non-resident U.S. citizen.  I didn't read the article that closely, but so long as you get coverage elsewhere, you don't need to worry about the Obamacare tax penalty.  Just get it from the insurance companies for international expats.  There's a couple.

Re: Health Insurance

Posted: Tue Apr 22, 2014 2:40 am
by Mark Leavy
MachineGhost wrote:
Mark Leavy wrote: But I *am* a US resident.  I just spend 75% of the year outside of the country.
Statistically, any obamacare policy is useless to me.  Yet, if I refuse it and choose to buy a policy that meets my needs,  I pay a tax/penalty.
Are you sure that's correct?  We're not talking about the "resident" in tax terms here, but a non-resident U.S. citizen.  I didn't read the article that closely, but so long as you get coverage elsewhere, you don't need to worry about the Obamacare tax penalty.  Just get it from the insurance companies for international expats.  There's a couple.
I'm not 100% sure.  I'll check a little closer - thanks for the prodding.

I *am* sure that my preferred policy is cash on the barrelhead for services rendered - but that doesn't seem to be a recognized option in the USA.  It seems to be readily and openly available in all but the most advanced countries.  And discretely available in advanced countries.  Funny that.