Obama Care Question

[sweetnectar]

Some friends and I were kicking around ideas reguarding the new health care changes and I figured this would be a good place to get some ideas so any input is appreciated...even the wise cracks.

So here is the question(s): Can a healthy 40 yr old choose not to be insured, not make enough to be penalized, find out she/he has cancer or other major illness at age 45 or whenever and then purchase heath insurance for treatment? What risks does the uninsured person take or can she still walk into an ER and recieve treatment for a sudden illness? Ethics?

 

[A-con]

This is one of many "Catch 22s" in Obama Care.
Right now, yes you would/could get care.
Next year, who knows. Five years from now, they will throw you in jail for tax evasion.

 

[putm2sleep]

Until our country is really, really, broke - it's going to get interesting.

 

[Nemont]

So here is the question(s): Can a healthy 40 yr old choose not to be insured, not make enough to be penalized, find out she/he has cancer or other major illness at age 45 or whenever and then purchase heath insurance for treatment? What risks does the uninsured person take or can she still walk into an ER and recieve treatment for a sudden illness? Ethics?

You have to answer all of these questions with a "it depends". As of today if you do not qualify for group insurance and want to purchase an individual policy you must do that no later than March 31, 2014. After that date you cannot buy a plan unless you have a qualifying event, which a cancer diagnosis is not one.

You would have to wait until the next open enrollment period and the earliest effective date would Jan. 1 of the year following.

Risks are that you could get a diagnosis of a critical illness or have a major injury or medical emergency that would not be paid if it happened during a time that you could not access an open enrollment period to get your coverage or have a qualifying event.

In 5 years, who knows what the laws will look like but if you believe in personal responsibility or have assets to protect or loved ones who you want covered you should explore the your options with a certified application counselor, a Navigator or a licensed Agent.

If your income was low enough to avoid a penalty then it most likely would be low enough to get a very large tax credit to pay for the premium anyway.

For instance a family of Dad age 40, Mom Age 40 and 2 kids under age 21 with an AGI of $50,000 could buy a silver level benefit for approximately $280 a month.

The math looks like this Total Monthly premium is $722 minus your tax credit of $442 equals you monthly premium of $280. The insurance carrier gets the full $722, $442 paid as an advance tax credit and the $280 you pay as your share.


Nemont

 

[MKotur325]

Wow... Not to sound ungreatful... But I'm 27, healthy, active and not overweight and I'm paying something like $190/mo for an individual plan with a $6500 deductible. Am I overpaying? or may there be any tax credits I can take advantage of???

 

[putm2sleep]

Nemont is the resident expert!
That deductible stinks, but your monthly premium is fair enough.

 

[TLC]

Some friends and I were kicking around ideas reguarding the new health care changes and I figured this would be a good place to get some ideas so any input is appreciated...even the wise cracks.

So here is the question(s): Can a healthy 40 yr old choose not to be insured,(yes. but you're not being a good american by not helping out those that need subsidies.) not make enough to be penalized, (penalty applies to all income levels. even Big Fins) find out she/he has cancer or other major illness at age 45 or whenever and then purchase heath insurance for treatment?(yes. which is the main reason that this was never going to work in the first place.) What risks does the uninsured person take(not being able to get your birth control paid for) or can she still walk into an ER(yes, but you run the risk of being run over by a group of illegals) and recieve treatment for a sudden illness?(again, yes. remember and repeat the following - no habla englise.) Ethics?(ethics? ethics? you don't need no stinkin ethics.)

hope this helps. if not, you're on your own. also, there is no guarantee that the rules will still be the same next year. hell, next week, or even tomorrow.

 

[TLC]

Wow... Not to sound ungreatful... But I'm 27, healthy, active and not overweight and I'm paying something like $190/mo for an individual plan with a $6500 deductible. Am I overpaying? or may there be any tax credits I can take advantage of???

gracias amigo. illegals everywhere are rejoicing.

 

[Nemont]

Wow... Not to sound ungreatful... But I'm 27, healthy, active and not overweight and I'm paying something like $190/mo for an individual plan with a $6500 deductible. Am I overpaying? or may there be any tax credits I can take advantage of???

It ALL depends on what your Adjusted Gross income will be in 2014 and how big your household size is.

You are on a catastrophic plan that is available to only those age 30 and under. If you have any kind of income you most likely won't qualify for a tax credit due to you being so young. Without knowing you personal circumstance I can offer you a better answer.

Nemont

 

[Ben Lamb]

Wow... Not to sound ungreatful... But I'm 27, healthy, active and not overweight and I'm paying something like $190/mo for an individual plan with a $6500 deductible. Am I overpaying? or may there be any tax credits I can take advantage of???

Take a look at the exchange and see if there is something that fits better, but I'd love to have your plan for what you pay. Our premium went up 32% (About $570/Mo) and our total out of pocket went up 50%. We did get a much better plan, and there are some significant cost-savers for us in terms of co-pay for meds, etc.

it's also nice that the ACA lets me pay Jenny Craig for "weight loss" programs.

You should be able to write off a significant portion of your insurance expense. Depending on where you fall within the subsidy range, you could see some significant savings.

 

[rhomas]

Like TLC said, only speak Spanish and don't provide any documentation and you wont even be asked to pay the bill if you need any type of ER treatment.

 

[one ate E grain]

You can't get chemotherapy or radiation treatment at the ER. An ER will make you so you are not in danger of dying right then and discharge you with a suggestion to see your specialist.

Getting treatment from an Oncologist without insurance can be very pricey. Two or five times the normal insured rate. If you want to live you will pay until all your money is gone then you can wait to go on Medicaid. Many states will streamline the process for Medicaid if you are dying.

I'd go ahead and get insurance. There is a sliding scale of affordability, you might not like paying for insurance, no one does, Most single people of limited income are finding out that with the subsidy insurance is almost free. (premiums) and with assistance for deductibles and co pays there really is very little reason not to have insurance. I also know that many single yuppies are finding out that $80K really isn't low income, no matter how impoverished they might feel. Find a "navigator" close to where you live and use their services, it's free.

Illegals long ago figured out the ER as mentioned above. Eventually, if they have cancer, they go home to die in Mexico. Mexico has universal insurance. They might not like the wages but they can go to the hospital for more than emergency care. States like mine also cut off the free clinics for illegals. Kind of harsh but then I can't go to Mexico and get treated for free either.

 

[huntergirl_19]

Why would you ever consider not having insurance?

 

[Ben Lamb]

Why would you ever consider not having insurance?

For a lot of folks it's cheaper to take the tax penalty than it is to have insurance.

 

[fowladdict]

For a lot of folks it's cheaper to take the tax penalty than it is to have insurance.

Until something goes wrong at least!!

But...I did learn even with insurance things can be a PIA financially. This January I discovered that my insurance didn't cover anything diabetes related. Imagine how elated the wife and I were to find this out when my four year old became Type 1. Shame on me, I guess, for not knowing. Or, maybe I did know at the time and did not think we ever needed to worry about it. It had been pretty good insurance otherwise. It was nice to be able to put our son on a much better plan (Beginning March 1st) without having the carrier deny or hike up the rates due to his now pre-existing condition. Type 1 diabetes supplies are not cheap.

 

[schmalts]

Nemont, is it not true that any subsidy you get in Obamacare is tracked for your life by the IRS and when you die they will take all of it back out of your estate before your family gets it?

 

[sweetnectar]

There is so much I don't understand about this subject. I really appreciate reading your responses on things.

As of today if you do not qualify for group insurance and want to purchase an individual policy you must do that no later than March 31, 2014

Can a person with a bronze plan switch to a gold plan before March 31, 2014? Also what are some examples of a "qualifying event."?

 

[RobG]

Nemont, is it not true that any subsidy you get in Obamacare is tracked for your life by the IRS and when you die they will take all of it back out of your estate before your family gets it?

No, that's absurd. Is that the latest hoax being circulated?

As far as getting treated, the hospital will treat you, but you will get a bill. That bill could bankrupt you. What Nemont said and perhaps was missed is that if you don't have insurance you won't have an opportunity to buy it until January of the next year (open enrollment). So if you decide to decline insurance and you get in a car accident tomorrow all the bills you incur will be your responsibility.

I know several people who've been bankrupted by not having insurance, perhaps thinking they could buy it if they get sick. Preventing bankruptcy is what insurance should be about.

For those poo-pooing the open enrollment part of ACA because you can buy insurance after you are sick, bear in mind this is the same option you have with most employer sponsored plans. Somehow they make that work...

If you want to estimate your tax credit this calculator may help: http://kff.org/interactive/subsidy-calculator/

Have fun, stay healthy...

 

[RobG]

As an aside... if you have kids they are supposed to have dental insurance. As far as I can tell the insurance is just an expensive way to pay for teeth cleaning as it doesn't pay for much else. If you don't feel it is your patriotic duty to purchase it, and aren't a devout christian that would never fib, inquire with an insurance agent and they might just tell you it is against the law, but it turns out there is no penalty for breaking the law. At least that is how I understand it, right Nemont?

 

[JohnCushman]

Man am I glad I retired from the Army and have my Tricare and VA benefits