Health Insurance

[beelbill]

So, I have the 5th wheel on the site and am waiting for it to dry out enough I can get under it to hook up the water and sewer. I am also waiting for Kansas City Power and Light to hook me up. Then I am ready to move into the 5er full time. Spent the day there and it felt like I was on vacation even though I still have full time job. My plan is to winter here and then semi-retire and work a few months in one area and a few in another.

Everything is working out except I don't know what to do about health insurance. I don't ever use it but if I dropped it, I would suddenly need it. Are any of the rest of you fulltimers less than 65 years old? Without work insurance, what do you do for insurance, pay ridiculous rates? Please don't even suggest Obamacare.

[travelalot2some]

The ACA can and does provide insurance that can well be affordable. Given that the COBRA through dh employer was $1400./month and the comparable policy thru BCBS was $870. without subsidy on the exchange, it was easy for us to see which was more affordable for us. For years we never paid a penny for our insurance because dh employer covered the cost. But for 5 years or so before he retired, employees started to pay a percentage of the cost. A company I worked for struggled yearly to find insurance plans that were affordable for employees because the employee paid the bulk of the cost and this goes back 16 years.

I don't complain one bit about the cost of our insurance. It has covered us for very significant health issues...and I am thankful for the fact that insurance companies must cover pre-existing illness. (I can remember back in the 70-80's women didn't dare change jobs because if you were pregnant, the new policy didn't cover the pregnancy!)

Please don't judge those of us who have purchased health insurance through a state exchange and DON'T assume that everyone receives a subsidy or medicaid.

[TechWriter]

BarbaraOK wrote:
I'd be very leery of the 'health share' type of coverage. Make sure you know what happens if someone has a heart attack and requires 3-4 bypasses or is diagnosed with cancer requiring surgery, radiotherapy and chemotherapy. You will approach ½ million rather quickly. Unless there is some form of underwriting for this type of thing, the whole arrangement could go south very, very fast.

Didn't say I liked it (in fact just the opposite) -- it's just another option.

BTW, where have you been lately? Kicked out of Escapees forum?

[magicmantx]

I have been unable to buy insurance for the last several years because of a preexisting condition Rhumathoid Arthritis. I also don't make near as much as I used to so the ACA has allowed us to get insurance that we can actually afford . I am not an Obama Fan by any means but this has allowed us to actually get insurance that we can actually use.

[BarbaraOK]

I'd be very leery of the 'health share' type of coverage. Make sure you know what happens if someone has a heart attack and requires 3-4 bypasses or is diagnosed with cancer requiring surgery, radiotherapy and chemotherapy. You will approach ½ million rather quickly. Unless there is some form of underwriting for this type of thing, the whole arrangement could go south very, very fast.

Barb

[TechWriter]

westernrvparkowner wrote:

But it (the ACA) is really the only game in town.

Not true. Some folks swear by religious-based health services, like Liberty HealthShare.

Other folks, like myself, don't swear by them, but it's another choice for OP.

[BarbaraOK]

westernrvparkowner wrote:
My problems with the ACA is first of all it is very misleading.
ACA stands for Affordable Care Act. Unless you are at the very lowest income levels, the coverages are no where near affordable for the average American. A couple in their 50s making around $50,000 gross a year would have a subsidized premium in excess of $500 per month and deductibles around $5000 per person, per year. Factor in taxes on their income of around 20% that would bring total costs of healthcare for a year to nearly 40% of their take home pay. That cannot be called Affordable in anyone's book.j

. Why are you mixing income tax with health care cost? You just didn't see the health care costs before because they were paid by your employer, with less income to you. No pre-existing illness making you uninsurable, no lifetime caps, etc. make things better for those that need individual plans.

My second problem is the subsidies appear to be very stair-stepped. Make 1 penny more than some percentage of the poverty level and you suddenly find your deductible going from $500 to $5000. Make less than the poverty level you get dumped into Medicaid, which has a federally mandated clawback provision meaning the government will come after your estate for the benefits paid, that isn't insurance.

If you have assets then yes, that will get 'clawed back, Medicaid is for those without assets & income. The poorest of the poor. Always has been.

The ACA basically uses premiums that are too high for the younger workers to subsidize the premiums that are too low for the older workers. To many that is patently unfair. Furthermore, the law requires coverage that many people find morally offensive.

. Spreading the risk is what ALL insurance is about.

Single payer would be best, but that requires everyone to get on board and so far people aren't frustrated enough to demand that their legislatures listen to them instead of the lobbyists.

[sdianel_-acct_c]

If you don't get health insurance you will pay a fine when you file your taxes next time and the fine goes up every year you don't get health insurance. I don't think you have many choices. Missouri doesn't have a healthcare exchange. You must go through www.healthcare.gov unless you go through an independent company that sells health insurance in your state. I would look into a company like Blue Cross Blue Shield that will cover you when you travel. Expensive yes, alternatives, not many.

[Big_Katuna]

I don't disagree with much of what you said. To repeat we have been paying for our own healthcare for 25 years and have required hospitalization a few times.

It is not cheap but at least the ACA required ins co to now pay for annual visits, many Diags eg blood work, basic X-rays and better prescription coverage so it is proactive for us as I use to not get annual physicals, etc because it cost so much out of pocket.

Our coverage has gotten better and deductibles and out of pocket costs are lower.

The big culprit is profit. Our procedure costs are among the highest in the world. And it's only because we can afford to pay it.

I would love to see single payer with supplemental policies available.

[westernrvparkow]

My problems with the ACA is first of all it is very misleading.
ACA stands for Affordable Care Act. Unless you are at the very lowest income levels, the coverages are no where near affordable for the average American. A couple in their 50s making around $50,000 gross a year would have a subsidized premium in excess of $500 per month and deductibles around $5000 per person, per year. Factor in taxes on their income of around 20% that would bring total costs of healthcare for a year to nearly 40% of their take home pay. That cannot be called Affordable in anyone's book.
My second problem is the subsidies appear to be very stair-stepped. Make 1 penny more than some percentage of the poverty level and you suddenly find your deductible going from $500 to $5000. Make less than the poverty level you get dumped into Medicaid, which has a federally mandated clawback provision meaning the government will come after your estate for the benefits paid, that isn't insurance.
The ACA basically uses premiums that are too high for the younger workers to subsidize the premiums that are too low for the older workers. To many that is patently unfair. Furthermore, the law requires coverage that many people find morally offensive.
Finally, the whole system doesn't address the root causes of our healthcare cost crisis. There is no addressing the skyrocketing costs of care. The high costs of malpractice claims, both legitimate, and more importantly, illegitimate. The high costs of drugs. The inefficiencies in the system and on and on.
But it is really the only game in town. The law requires your coverage meet ACA standards, or you pay a penalty. I am not opposed to the premise of the ACA, that healthcare should be subsidized for those who cannot afford it. It is a morally correct thing to do.
We paid that subsidy in the past through high hospital costs and high medical costs since treatment cannot be legally or morally withheld from those who cannot pay. What we haven't seen is those costs come down on the premise that now all patients should have insurance, so the hospitals, doctors and clinics shouldn't be treating patients without insurance, hence they should have no uninsured care losses to recover. The system needs a big tuneup, to say the least.

[fitznj]

I find it odd when people make these 2 comments:

"I don't ever use it but if I dropped it, I would suddenly need it"
You are using you health insurance policy every day, 24 hours per day - it's an INSURANCE policy, it's there in case something goes wrong. Just because you don't go to the doctor or emergency room does not mean you don't use it - it means you're not collecting on it but you ARE using it.

"Please don't even suggest Obamacare" do you know what ACA is? because thsi statement make me wonder. The ACA is a subsidy for those whose yearly income is below a certain amount. It's NOT a totally separate healthcare system. I retired this year and needed health insurance - I did my research and the SAME policy from BSBS WITHOUT ACA subsidy is $1600/month - with the subsidy, it lowers the monthly payment to $600/month for the EXACT SAME POLICY. So please explain your comment about ACA?

G

[wildtoad]

As I understand it there are non Obamacare policies available, but they must still meet the same set of standards, and their availability may vary by state. We too make too much to qualify for taxpayer funded subsidies. Our policy has high deductibles, high out of pocket, and the premiums are about $1,250 a month for two. Out of network coverage does exist but it costs much more. It's all expensive and very little is being done to reduce the cost of healthcare thus the high cost of insurance.

[TechWriter]

darsben wrote:

If I were you I would pay the high price instead of taking the Obamacare policy that way your integrity will not suffer although you pocket book will.

I'm not sure why your integrity would suffer, but to each his own.

I retired at 63 (my wife 62) and we both used my company's COBRA (medical + dental + vision) for 18 months which was about $1100/mon for the two of us.

Then I bought an Arizona BCBS policy for one month (~ $600) which got me to 65. I'm on Medicare now, but my wife now has an AZ BCBS plan for about $700/mon which she bought through the the ACA (aka Obamacare) web site healthcare.gov.

While my wife could have purchased a cheaper plan, we selected BCBS because it's a very "portable" health plan -- that is, we can use the BCBS network in almost all the states. Cheaper plans may limit you to only the in-state physicians.

We make too much money to qualify for an ACA health care plan subsidy, so we pay full price. Unless taking a subsidy will hurt your integrity, I strongly encourage trying to get one which means staying under the maximum income limit while you're under 65.

As someone previously mentioned, check out rverhealthinsurance.com. I bought a Medicare supplement plan through them.

If you're thinking of changing your domicile, visit healthsherpa.com. You can enter the ZIP code of any place and find out what ACA plans are available.

By the way, subsidies are only available if you buy your health care through the "marketplace" -- healthcare.gov or a state health plan exchange.

[Old-Biscuit]

Tax penalties for not having Obamacare

[PawPaw_n_Gram]

The one thing you really have to research and make sure about is coverage outside your 'home' area.

Many insurance policies are tied to a specific area, set of providers. If you will be traveling across the country - you might not be able to find insurance in your area that will give you the ability to go to doctors no matter where you are located.

Some of the more popular residence states, Texas & Florida, have many insurance companies which offer policies with nationwide coverage.

Investigate the details.

If you explain your needs to an independent insurance agent, they will try their best to find you a policy that meets your needs. Otherwise they won't get a commission and get paid.