A Question Regarding The ACA: AKA Obamacare

[easilyscan 1,013]

I have a friend who's been on it a couple of years because he retired @ 58 & his employer doesn’t offer healthcare insurance post retirement.

He's single, & his premiums averaged $150 a month in 2024 & 2025. The downside is that he has an annual deductible of $8000.00 & doesn't cover dental or vision even if the deductible has been met. His gross income is around 44K per year.

I see these ACA commercials & wonder how it works for these people, or if these are even real examples ?

 

The 1st family (man/woman/one child 3) gets healthcare for $57 per month *with financial help* 

Next is a single woman who gets coverage for $0.00 per month *with financial help*

Next is a single mom with one son. She gets coverage for $16 a month *with financial help*

Next is a single man who gets coverage for $0.00 per month *with financial help*

 

Question 1: The financial help they're referring to is the enhanced subsidies ?

The amount of subsidies you qualify for, are determined by your income. If the guy I know whose making 44K per year, has a premium of $150 per month, & the single man & woman featured on this ad get it for $0.00 per month, they must almost literally, have no income.

Question 2: Does anyone here know someone in that situation ?
Do they have a deductible ? If so, it certainly couldn't be anywhere near 8K per year like the guy I know. 

[Grace Under Pressure 166]

Actually the deductibles are likely 5K or more for plans with low premiums like those plans you listed. 

Premiums, deductibles, and copays are what patients pay. If your costs at the doctor and pharmacy are 5K per year or less, chances are you’re paying for all of that yourself, and paying for other people. 

As a 55 year old man, on a statin, who needs to see the doctor once a year. My costs should be around 500 bucks per year. 250 to see the doctor, 20 bucks per month for my prescription. 

In that scenario, paying more than 50 bucks a month for a monthly premium is crazy. And there’s a 5K deductible? C’mon.

They should just lower the Medicare age to 55. Healthy people like me, and your friend, can pay premiums into Medicare and make no claims for 10 years. I probably don’t even need to see a doctor for 10 years. I’ve gone that long before. 

[easilyscan 1,013]

39 minutes ago, Grace Under Pressure said:

Actually the deductibles are likely 5K or more for plans with low premiums like those plans you listed. 

Premiums, deductibles, and copays are what patients pay. If your costs at the doctor and pharmacy are 5K per year or less, chances are you’re paying for all of that yourself, and paying for other people. 

As a 55 year old man, on a statin, who needs to see the doctor once a year. My costs should be around 500 bucks per year. 250 to see the doctor, 20 bucks per month for my prescription. 

In that scenario, paying more than 50 bucks a month for a monthly premium is crazy. And there’s a 5K deductible? C’mon.

They should just lower the Medicare age to 55. Healthy people like me, and your friend, can pay premiums into Medicare and make no claims for 10 years. I probably don’t even need to see a doctor for 10 years. I’ve gone that long before. 

Thanks for the reply. I don't have time tonight, but I have a couple follow-up questions. Hopefully tomorrow.

[Strike 6,014]

41 minutes ago, Grace Under Pressure said:

 

They should just lower the Medicare age to 55. Healthy people like me, and your friend, can pay premiums into Medicare and make no claims for 10 years. I probably don’t even need to see a doctor for 10 years. I’ve gone that long before. 

You know the feds won't turn down extra money.  Feel free to send it in.  Lead by example.

[peenie 1,958]

It would be nice if ALL states offered Medicaid to people who have low income. States like California, Ohio, Michigan and New York do while states like: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming do not. You must be disabled or pregnant/have children in order to qualify. I think the rest will offer Medicaid to people who fall under the poverty line. Note: states with the most need don’t offer expanded Medicaid. It makes NO sense. 

Not to mention that it was Republicans that prevented the United States from getting universal healthcare when Obama and Democrats were fighting for it. Instead we have ACA.