Went to the ACA site to get an idea of my cost for affordable healthcare.

reply to post by Libertygal

I also believe that the poster that said that 7% was the cap was only referring to ONE plan, because I have seen, myself, Gold plans that had a deductible alone, of 10k, with an 80/20% copay, and then I do not recall the cap, but I think it was 20k. So, not sure what they were actually quoting from, but certainly not the plans I have seen.

I saw that 7% of income figure and wondered about it, because my premiums and deductible would be far, far, far more than 7% of my income.
So, I did some research and it seems to me that the 7% refers to the fact that you cannot be forced to pay more than 7% of your income for premiums.
Not premiums AND deductibles.
Also, there are taxes to be paid on top of the premiums....in my case they are about $50 a month.

Those who make 100 percent of the federal poverty level aren’t supposed to spend more than 2 percent of their income on a health policy. Those who make 200 percent aren’t supposed to spend more than a bit more than 6 percent of their earnings on insurance.

For incomes that are 300 percent of the poverty level, you’re supposed to spend about 8 percent on Obamacare. If you make 400 percent of the poverty level, the cap is 9.5 percent.

www.csmonitor.com...

My 2 ameros, anyway.

reply to post by sarra1833

I figured I HAD to get ACA coverage and wasn't about to have two different insurances.

You won't be subject to the tax penalty if your premium would be more than 8% of your income.

Others will be subject to the mandate but exempted from the penalty tax—for example, because they will have income low enough that they are not required to file an income tax return, because they are members of Indian tribes, or because the premium they would have to pay would exceed a specified share of their income (initially 8 percent in 2014 and indexed over time).

s337.photobucket.com...


Sounds like you might want to reconsider your company plan if you can. Twenty seven bucks is really cheap, are they footing part of the bill for you or is it just a really crappy plan?

reply to post by Phage


It's definitely a 'you get what you pay for' kind of plan. One of those 'being without is much better than having it'.

Libertygal
reply to post by undo

 

i swear, you are having reading comprehension problems

And you asked why I was insulting you, which I never did.

Way to show how to practice what you preach!

we were talking about the same things the entire time and you kept acting as if you had to criticize me, repeatedly, for holding a different view. there wasn't a different view. i just made the comment that 7k was nothing compared to what i had to pay at even 25% for a catastrophic injury, 20 years ago. i realize that's not going to help people who don't have the 7k to begin with.

sheesh.

reply to post by calstorm


Thanks for clarifying that. I live in Washington State and my two daughters qualified for medicaid and make about $10/per hr.
One had diabetes and one has gall bladder problems and now get care for those conditions and are healthier already.

reply to post by sarra1833


Health insurance is kind of like a mafia racket. If you look at medical care in the 70's it was affordable because most people did not have health insurance. If the doctors made it too expensive no one would go. So they charged what the market would bear.
Little by little insurance crept in. Affordable at first. So much so that Many employers began adding it to compensation packages for their employees.
Essentially what insurance co's were doing was taking money from more and more people and then paying the docs LESS. A LOT LESS. Billing became IMPOSSIBLE to manage and added to office overhead.
Plus, at the same time malpractice INSURANCE PREMIUMS began to skyrocket. Quite literally double dipping on both sides.
When one considers the TREMENDOUS LOAD the for profit health care RACKET puts on the health care SYSTEM one can easily understand why the cost are as insane as they are.
Mandatory, for profit, health insurance is only going to make it worse. Greedy corporations can not help themselves, ever, and obviously wrote every word of this legislation themselves.


VinMan

I'm on medicare and medicaid I pay $0 for doc/hospital/meds I'm on plavix which was nearly 200/month but when my disability started everything went zero. I'm in my 30s and got my packet from medicaid and medicare and my drug plan telling me to ignore Obama Care as it will not pertain to me.

Medicaid pays all my medicare copays and I get my income from medicare so I can live in a 300/mo apt

reply to post by Cito


Back when I lived in Illinois I was on medicaid for 2 years until my son turned 19 and they stopped it for us. Once you reach 19 there, it's done which I guess makes sense in an odd way. Then once you reach like 60 I think you can get on Medicare. Im not too versed on what age one is allowed to start getting medicare but I'm sure it's for older individuals? If I'm wrong, do correct me!

But I was so grateful to be on it when I was. I had major surgery that saved my life and gave me full quality of life back. It was something like 48,000 dollars and I paid zero for it. Medicaid is the best in my opinion and how it SHOULD be for everyone. Dr's still get paid, patients get quality care and don't have to kill their wallets to save their lives. That is how it should be for all. of course Im sure there's more to it than that. There has to be. I'm not the brightest crayon when it comes to anything insurance.

reply to post by sarra1833


Medicaid in Illinois is now for anybody that qualifies.

Kids are no longer a requirement.

It's based on income level (138% of poverty)

And Federal Medicare is 65 or some cases with disability SSI.

reply to post by MOMof3


While I am happy that people like your daughters can now get care, it is troubling that while this country [or should I say states] are providing health care....many, many, many more can NO LONGER afford to go to doctors.
Other have fallen through the cracks and cannot get any coverage....ACA or medicaid.


ACA is nothing more than an insurance company bailout.
The government is now cutting reimbursements to Medicare....to make them on par with medicaid reimbursements....hurting doctors and small practices....while still lining insurers pockets.....according to my former doctor.

reply to post by sarra1833


You dont have to be 65 to get medicare, I'm 37 and have full medicaid (state) and medicare (federal) medicare pays all but 20% and medicaid pays the final 20% regardless of cost leaving me $0 to pay.

But I filed for disability at age 30, I get free healthcare plus $1000/mo disability income. Which is based on your previous job.

reply to post by DontTreadOnMe


Yeah, I know. I am 63 and two more years before I can get medicare. I pay for my own doctor visits and pray I don't get sick the next two years.

But I am still happy for my girls and others.

I do not like ACA. I always wanted single payer, medicare for all.

Cito
reply to post by sarra1833

 

You dont have to be 65 to get medicare, I'm 37 and have full medicaid (state) and medicare (federal) medicare pays all but 20% and medicaid pays the final 20% regardless of cost leaving me $0 to pay.

But I filed for disability at age 30, I get free healthcare plus $1000/mo disability income. Which is based on your previous job.

Actually, a couple of things to clarify. Certain illnesses qualify anyone for Medicare, at any age, but it is generally considered for the elderly. However, as I said, certain diseases such as cystic fibrosis, renal failure requiring hemodialysis, and other specific illnesses will qualify a person of any age to have Medicare, as you stated, as the primary, with Medicaid as the secondary to cover that 20%. You generally will qualify for disabiity at the same time, if this is the case. Blind and/or deaf generally qualify by default.

Also, disability is generally based on your work history, not specifically your last job. You can actually get online and request a letter be sent to you every year that shows how many credits that you have earned for your work history. Disability is based on this, as well. Social Security will then mail you a letter every year, based on your tax return, updating your status.

If you do not file taxes, even if you have taxes deducted, your credits will not be updated.

Here is the page that helps explain credits, and how they work.


www.ssa.gov...

This page is how many credits you must have to retire, which is generally 40.

www.ssa.gov...

You can go here to set up your own account and see where you stand on your credits.

www.socialsecurity.gov...

reply to post by sarra1833


That's Strange? I went to the KFF calculator as you suggested?

This is what I got when I entered your numbers?

Your State is Expanding Medicaid

States have the option to expand Medicaid coverage to everyone under 138% of the poverty level. If a state expands Medicaid, most of the costs are covered by the federal government under the health reform law. Because your state decided to expand Medicaid, your income (which is 90% of the poverty level) makes you eligible for the program.

Perhaps you live in a state with a GOP Governor who has chosen to refuse to cover the poor to make a political statement?

Can you tell me what state you entered?

sarra1833

The actual 14k a year me (hi guys n gals!) is NOT in the poverty range period and has to pay $6350 something a year which is 43% of my yearly income. Zero subsidy. No help. I make far too much to be considered poverty or need help. OH WOW REALLY?????? not in the poverty range. where's my lamborghini then since Im so rich?

So I also ran numbers in Texas, which is one of the states that has refused to participate in the Medicaid portion of ACA/Obamacare (Which would have covered you 100%)...Illinois for example where I posted above. GOP Governors opposed to ACA/Obamacare fought for and won the right to not participate in the Medicaid expansion. Unfortunate for the poor in those states.

Here is what they have you at in TX? Still much lower than the 6K you cited? Either way...looks like you got screwed over by a GOp Govenor trying to score political points?

Your State Has Not Decided to Expand Medicaid

States have the option to expand Medicaid coverage to everyone under 138% of the poverty level. If a state expands Medicaid, most of the costs are covered by the federal government under the health reform law. At this time, your state has not decided to expand Medicaid.

Depending on your state’s eligibility criteria, you or some members of your family may still be eligible for Medicaid. Children under the age of 19 at this income are likely eligible for coverage under Medicaid or the Children's Health Insurance Program (CHIP). Contact your state’s Medicaid office or exchange for more information.

Because your income is equal to 90% of the poverty level, you will not be eligible for tax credits in the exchanges. Tax credits are only available to people who make between 100% and 400% of the poverty level. Keep in mind that these results are estimates and you can still apply for exchange coverage if you are interested in receiving a tax credit. The information below is about unsubsidized exchange coverage:

Household income in 2014:90% of poverty levelMaximum % of income you have to pay for the premium, if eligible for a subsidy:None Health Insurance premium in 2014 (for a silver plan, before tax credit): $3,646 per year You could receive a government tax credit subsidy of up to:$0 per year
(which covers 0% of the overall premium) Amount you pay for the premium:$3,646 per year
(which equals 26.04% of your household income and covers 100% of the overall premium) .
Additional Assistance

Children under the age of 19 at this income level are likely eligible for coverage under the Children's Health Insurance Program (CHIP) or Medicaid. If your children are eligible for one of these programs, they would not be eligible for subsidized exchange coverage and should instead enroll in CHIP or Medicaid. To get the most accurate estimate for your family's tax credit and premium amounts, you should not include children who are eligible for CHIP or Medicaid in the number of children enrolling in exchange coverage. For more information on CHIP eligibility, see the FAQ.

Other Levels of Coverage

The premium amounts above are based on a Silver plan. You could purchase other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive).

For example, you could enroll in a Bronze plan for about $2,493 per year (which is 17.81% of your household income). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.

Out of Pocket Costs

Your out-of-pocket maximum for a Silver plan (not including the premium) can be no more than $12,700. Whether you reach this maximum level will depend on the amount of health care services you use. Currently, about one in four people use no health care services in any given year.

A Silver plan has an actuarial value of 70%. This means that for all enrollees in a typical population, the plan will pay for 70% of expenses in total for covered benefits, with enrollees responsible for the rest. If you choose to enroll in a Bronze plan, the actuarial value will be 60%, meaning your out-of-pocket costs when you use services will likely be higher. Regardless of which level of coverage you choose, deductibles and copayments will vary from plan to plan, and out-of-pocket costs will depend on your health care expenses. Preventive services will be covered with no cost sharing required.

Other Coverage Options

Because Bronze level coverage would cost more than 8% of your household income, you may instead opt to purchase catastrophic coverage. With a catastrophic plan, you would pay out-of-pocket for most health services until you reach the annual limit on cost sharing ($12,700 in 2014). However, preventive services are covered with no cost sharing required.

Indigo5
reply to post by sarra1833

 

That's Strange? I went to the KFF calculator as you suggested?

This is what I got when I entered your numbers?

Your State is Expanding Medicaid

States have the option to expand Medicaid coverage to everyone under 138% of the poverty level. If a state expands Medicaid, most of the costs are covered by the federal government under the health reform law. Because your state decided to expand Medicaid, your income (which is 90% of the poverty level) makes you eligible for the program.

Perhaps you live in a state with a GOP Governor who has chosen to refuse to cover the poor to make a political statement?

Can you tell me what state you entered?

Im in Indiana in Gibson County

reply to post by sarra1833


you need to move to a state with medicare, it sounds like.

reply to post by undo


I just moved here. I haven't the funds to move again.

reply to post by carewemust


I am one of those people who is mad as hell that I have to buy insurance, however, I will say your link, and the calculator made me feel much better, and was much cheaper than what I saw through the ACA site.

I'll have to dig deeper into it.

Even though I am mad as hell,
if I can do it for 30 bucks a month, I won't be nearly as mad...lol

That is a lot cheaper than the almost 200 I was seeing before.

Where the states stand on Medicaid expansion