My Experience With The Affordable Care Act (AKA Obamacare)

[easilyscan 563]

Wondering if anybody else has had experience with this ?
For those who haven't, some of the information might be valuable in the future.

I worked for a fortune 500 packaging/container company for 30 years. Never had any children, & because my company was one of those rare ones in the private sector that still offers a defined benefit pension, I was fortunate enough to be able to retire early in June 2015. With all the controversy/confusion surrounding the ACA, I decided to purchase cobra insurance for 18 months. 

For anyone who isn't sure what COBRA is, here's a brief explanation.

Anytime you leave an employer, (not sure if this counts being fired ?) You have the right to continue with the same healthcare insurance they offered for 18 months. The catch is that you have to pay for it yourself. In my case, that was $500.00 per month for the remainder of 2015, & $600.00 per month in 2016.

Looking back, it's funny how I thought that was outrageously expensive. More than one person at work told me I was crazy to pay that much.
As I would learn later, this was a ‘real’ health insurance plan. Minuscule deductible, small co-pays, & I could visit any doctors, dentists, ophthalmologist’s, etc. that I chose to. They didn't have to be in ‘the network’ 

In December 2016, when my 18 months of cobra was up, I had to go to the Obamacare exchange & find a plan for myself.

Here's what I ended up with.

2017
Premium: $273.17
Deductible: $6,000.00
Zero coverage for dental & vision even if the deductible is met.

I'll skip 18-19-20

2021
Premium: $430.00
Deductible: $6,700.00
Zero coverage for dental & vision even if the deductible is met.

So if you have ongoing medical issues/prescriptions you need throughout the year, total out-of-pocket would be $11,860.00
Or around $988.00 per month. 

 

However, there are a couple silver linings.

1: For my plan, there's a maximum of $7,000.00 out-of-pocket expense for the year.
According to the Medica representative I talked to Friday, your monthly premiums count towards that out-of-pocket maximum amount for the year.
This would bring the total monthly amount down to $583.00 (if you were someone who had health issues, and/or needed prescriptions throughout the year)

2: Anyone who has to purchase their own high deductible health care insurance, is eligible to open an HSA account.
This is very similar to an IRA, only better. If you're under 55, you can contribute up to $3,000.00 per year & it comes right off the top for tax purposes. 
If you're over 55, you can contribute up to $4,500.00

I have just under $18,000.00 in mine now & as far as I know, you can invest it in anything you want. I keep mine in very conservative holdings.  
You're issued a credit card for the account, & as long as you only use it for healthcare related transactions, it's not taxable. 
(you can't use it to pay your premiums)   

And yes, you can use it for dental & vision care.
You do have to keep the receipts because these transactions are reported on your tax form the following year. 
Another nice feature: You can choose to pay out-of-pocket & let the money grow. In that case, you save the receipts, & at a later date, can use the money to pay yourself back.

Once you turn 65, if you still have funds available, you can use it to pay part of your Medicare premiums.

Here's where I have to bring politics into the discussion.
I've been a conservative my entire adult life, & no one was more happy than me on election night 2016.

However, with Trump threatening to get rid of the ACA, I have to admit I'm a little apprehensive. 

He says he only wants to get rid of the individual mandate. 
“a requirement of the ACA that most citizens & legal residents of the United States have health insurance. People who do not have health insurance must obtain it or pay a penalty”

I don't trust 'any' politician any further than I can throw him. 
I'm not one of those that thinks healthcare should be free, but who knows how much it might cost if they totally eliminated the ACA ?

 

 

[Hawkeye21 1,874]

Does Trump have a plan for healthcare?  Other than him talking about getting rid of the ACA I'm not sure I know what his plan is after that.

[Hardcore troubadour 12,792]

14 minutes ago, easilyscan said:

Wondering if anybody else has had experience with this ?
For those who haven't, some of the information might be valuable in the future.

I worked for a fortune 500 packaging/container company for 30 years. Never had any children, & because my company was one of those rare ones in the private sector that still offers a defined benefit pension, I was fortunate enough to be able to retire early in June 2015. With all the controversy/confusion surrounding the ACA, I decided to purchase cobra insurance for 18 months. 

For anyone who isn't sure what COBRA is, here's a brief explanation.

Anytime you leave an employer, (not sure if this counts being fired ?) You have the right to continue with the same healthcare insurance they offered for 18 months. The catch is that you have to pay for it yourself. In my case, that was $500.00 per month for the remainder of 2015, & $600.00 per month in 2016.

Looking back, it's funny how I thought that was outrageously expensive. More than one person at work told me I was crazy to pay that much.
As I would learn later, this was a ‘real’ health insurance plan. Minuscule deductible, small co-pays, & I could visit any doctors, dentists, ophthalmologist’s, etc. that I chose to. They didn't have to be in ‘the network’ 

In December 2016, when my 18 months of cobra was up, I had to go to the Obamacare exchange & find a plan for myself.

Here's what I ended up with.

2017
Premium: $273.17
Deductible: $6,000.00
Zero coverage for dental & vision even if the deductible is met.

I'll skip 18-19-20

2021
Premium: $430.00
Deductible: $6,700.00
Zero coverage for dental & vision even if the deductible is met.

So if you have ongoing medical issues/prescriptions you need throughout the year, total out-of-pocket would be $11,860.00
Or around $988.00 per month. 

 

However, there are a couple silver linings.

1: For my plan, there's a maximum of $7,000.00 out-of-pocket expense for the year.
According to the Medica representative I talked to Friday, your monthly premiums count towards that out-of-pocket maximum amount for the year.
This would bring the total monthly amount down to $583.00 (if you were someone who had health issues, and/or needed prescriptions throughout the year)

2: Anyone who has to purchase their own high deductible health care insurance, is eligible to open an HSA account.
This is very similar to an IRA, only better. If you're under 55, you can contribute up to $3,000.00 per year & it comes right off the top for tax purposes. 
If you're over 55, you can contribute up to $4,500.00

I have just under $18,000.00 in mine now & as far as I know, you can invest it in anything you want. I keep mine in very conservative holdings.  
You're issued a credit card for the account, & as long as you only use it for healthcare related transactions, it's not taxable. 
(you can't use it to pay your premiums)   

And yes, you can use it for dental & vision care.
You do have to keep the receipts because these transactions are reported on your tax form the following year. 
Another nice feature: You can choose to pay out-of-pocket & let the money grow. In that case, you save the receipts, & at a later date, can use the money to pay yourself back.

Once you turn 65, if you still have funds available, you can use it to pay part of your Medicare premiums.

Here's where I have to bring politics into the discussion.
I've been a conservative my entire adult life, & no one was more happy than me on election night 2016.

However, with Trump threatening to get rid of the ACA, I have to admit I'm a little apprehensive. 

He says he only wants to get rid of the individual mandate. 
“a requirement of the ACA that most citizens & legal residents of the United States have health insurance. People who do not have health insurance must obtain it or pay a penalty”

I don't trust 'any' politician any further than I can throw him. 
I'm not one of those that thinks healthcare should be free, but who knows how much it might cost if they totally eliminated the ACA ?

 

 

The mandate is already gone and your plan is terrible. Why you cling to it is weird. You don’t pass the smell test. 

[Herbivore 915]

not perfect, but the ACA was/is a good thing.  the individual mandate is also a good thing, everyone uses healthcare, everyone should pay some for healthcare.  

[Hardcore troubadour 12,792]

Just now, Herbivore said:

not perfect, but the ACA was/is a good thing.  the individual mandate is also a good thing, everyone uses healthcare, everyone should pay some for healthcare.  

You think paying hundreds a month and having a 7k deductible is good? Why? 

[Herbivore 915]

1 minute ago, Hardcore troubadour said:

You think paying hundreds a month and having a 7k deductible is good? Why? 

is that all you are going on...looks like there is a whole bunch more to it in the op post.  

[FlyinHeadlock 459]

Go back to work. 30 years is not a long time to work. Sounds like you retired too early.

[Hardcore troubadour 12,792]

8 minutes ago, Herbivore said:

is that all you are going on...looks like there is a whole bunch more to it in the op post.  

Yes. I read the rest. I understand the rest. It sucks. All of it 

[Herbivore 915]

2 minutes ago, Hardcore troubadour said:

Yes. I read the rest. I understand the rest. It sucks. All of it 

I don't think you do

[RaiderHaters Revenge 3,615]

Well I will trust Trump on healthcare, since hes already lowered prescription costs thru the favored country act

 

[Strike 4,025]

Ugh

[Hardcore troubadour 12,792]

2 minutes ago, Herbivore said:

I don't think you do

So you get a tax break so you can pay for your ridiculous premium. It’s still coming out of your pocket. Whats so great about that? 

[Strike 4,025]

Until 2012 I was an independent contractor.  I paid $355/month for very good health insurance with something like a $25 copay for office visits.  It was an HMO (my choice) and I loved it.  The ACA decimated the individual health care market and caused individual premiums to skyrocket.  BTW, OP, you didn't need to go on the exchange.  You could have just gone to the private market. 

The ACA does NOTHING to address the real problem, which is the cost of health care.  If we focused on that the the other issues would largely take care of themselves.

The FACT that the ACA was largely written by the health care industry, the same industry Obummer/Biden BLAMED for the problem, should be your first clue that it wasn't going to really address the problem.

 

[easilyscan 563]

1 hour ago, Hardcore troubadour said:

The mandate is already gone and your plan is terrible. Why you cling to it is weird. You don’t pass the smell test. 

Normally a comment like that would irritate me, but since I left out the most important part, you had every right to say it.
I forgot to add that what you pay in premiums is based on your income. More specifically, you're MAGI (modified adjusted gross income)

Late in 2018, Pinnacle foods was acquired by ConAgra. This resulted in unexpected capital gains of $4,000.00 
Since I had already contributed the maximum amount to my HSA & had no losses to offset the $4000.00, I was trapped.

The income cliff as they call it, related to whether or not you receive any premium subsidies, was $48,240.00
The $4000 in unexpected capital gains put my MAGI @ $48,440.00 

This changed my federal return from a refund of $150.00, to owing an additional $5,496.00
It wouldn't have mattered if I had only went one over by one cent. The penalty is the same. You have to pay back all the subsidies you receive during the year.

Ironically, if the stock acquisition had occurred in 2019, I would've been fine, because they raised the income cliff to $49,960.00 that year.

If my annual gross income was 20K instead of 50, the monthly premiums & deductible would be minuscule.
 

[easilyscan 563]

7 minutes ago, Strike said:

Until 2012 I was an independent contractor.  I paid $355/month for very good health insurance with something like a $25 copay for office visits.  It was an HMO (my choice) and I loved it.  The ACA decimated the individual health care market and caused individual premiums to skyrocket.  BTW, OP, you didn't need to go on the exchange.  You could have just gone to the private market. 

The ACA does NOTHING to address the real problem, which is the cost of health care.  If we focused on that the the other issues would largely take care of themselves.

The FACT that the ACA was largely written by the health care industry, the same industry Obummer/Biden BLAMED for the problem, should be your first clue that it wasn't going to really address the problem.

 

I heard many stories similar to yours. Spot on how the ACA decimated the individual healthcare market. It seems like I checked into the private market and it's no better than the plan I have now. That was a while ago though, I'll look into it again. And thank you from the bottom of my heart for paragraph 2.

We had a plaque in the cafeteria at work.

 

Identify root cause

Take corrective action

Follow up/monitor

No one  has the balls to identify the root cause & take action.

No different than higher ed costs.

 

 

[posty 2,304]

@easilyscan

It isn't called that any more, Biden calls it "Badakathcare" now...  Please fix your thread title...

TIA

[easilyscan 563]

28 minutes ago, FlyinHeadlock said:

Go back to work. 30 years is not a long time to work. Sounds like you retired too early.

You sound like Dave Ramsey.

Never cared for him.

[FlyinHeadlock 459]

Whenever the government gets involved the costs always go up. The drug costs are high because we are subsidizing other countries lower prices. We fixed it some with NAFTA but it's still unfair. And the pricing is all over the place. We have to have transparent pricing. ACA did nothing for those two pressure points.

[FlyinHeadlock 459]

2 minutes ago, easilyscan said:

You sound like Dave Ramsey.

Never cared for him.

Bet you would not be complaining about healthcare online if you were working again with a good health plan.

[easilyscan 563]

1 minute ago, FlyinHeadlock said:

Bet you would not be complaining about healthcare online if you were working again with a good health plan.

OK, I'll give you that, but I have no desire to go back to work, & I don't believe the whole post was complaining. 

Towards the end, I stated that there are silver linings. 

Like the $7,000.00 max out-of-pocket costs, & the fact that I can contribute to an HSA.

 

You're absolutely right when you say whenever the government gets involved the cost always goes up. Look at higher ed costs over the past 40 years.

 

 

 

 

 

 

 

[EternalShinyAndChrome 2,593]

1 hour ago, Hardcore troubadour said:

The mandate is already gone and your plan is terrible. Why you cling to it is weird. You don’t pass the smell test. 

Agreed.  Sounds like he was paid by the Harris/Biden campaign to hit as many message boards as possible.

The ACA is terrible.

[EternalShinyAndChrome 2,593]

42 minutes ago, Strike said:

Until 2012 I was an independent contractor.  I paid $355/month for very good health insurance with something like a $25 copay for office visits.  It was an HMO (my choice) and I loved it.  The ACA decimated the individual health care market and caused individual premiums to skyrocket.  BTW, OP, you didn't need to go on the exchange.  You could have just gone to the private market. 

The ACA does NOTHING to address the real problem, which is the cost of health care.  If we focused on that the the other issues would largely take care of themselves.

The FACT that the ACA was largely written by the health care industry, the same industry Obummer/Biden BLAMED for the problem, should be your first clue that it wasn't going to really address the problem.

 

@Strike on point once again. 

[easilyscan 563]

26 minutes ago, EternalShinyAndChrome said:

Agreed.  Sounds like he was paid by the Harris/Biden campaign to hit as many message boards as possible.

The ACA is terrible.

That's hilarious. You didn't even read the post did you. 

Like the part where I mentioned going over the income cliff by only $200 in 2018 & how it cost me over $5,500.00

https://resilienteducator.com/classroom-resources/ten-free-reading-comprehension-exercises-online/

 

[Cdub100 3,417]

Interesting thanks for sharing.

I believe Trump will address the root cause of health being so expensive and if he can get a plan pushed through it will be better for everyone.

[nobody 2,065]

I had a similar experience except I'm not happy about going form good insurance where I don't pay much out of pocket to having the same healthcare, but I have a max of thousands out of pocket on top of my now more expensive premiums.

You also probably didn't get to the part I experienced.  The insurance companies don't want to foot bills either.  I had an accident and had an expensive surgery and hit the out-of-pocket max, except - wait the ER in the hospital was supposedly out-of-network, so tack on a few more thousand there.  And then I had my surgery in September of 2019, but they decided to save some of the bills until Feb 2020 so tack on a few more thousand.  So my supposed $4500 out-of-pocket max was actually closer to $10,000 out of pocket.

Oh and they assigned me a random hand surgeon to perform the Tua surgery on my hip.  When I said I'd prefer to go to my own doctor, they gave me the run-around throwing up obstacles until finally after 4 days, someone with some conscious said, "look, we're never going to let you leave here.  Your options are to hire your own private ambulance or have surgery here.  We'll never sign the release paperwork."

[Goggins 146]

You may want to get a second opinion about the premiums counting towards the annual out of pocket max. I have never heard of an insurance company doing that, but I suppose you may have found a unicorn.

[wiffleball 4,656]

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