Obama Care Question

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?
Schmalts what you describe sounds similar to the little known and less understood Medicaid claw back for people 55+ at 129% of Federal Poverty Level or below who are required to enroll in Medicaid. Read this.
http://seattletimes.com/html/localnews/2022469957_medicaidrecoveryxml.html
If anyone fits in this category they should probably discuss with an attorney or accountant specializing in issues of the elderly.

You can also google "medicaid clawback aca"
 
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.
This, for me, is why I will always have health insurance. I have only been uninsured for 30 days in my entire life. That said, my family was doubled covered for 2012, but we dropped my wife's insurance at the end of the year as we are now in a place we can fully pay the annual deductible of mine in the event something really bad happens.

Two weeks ago, my youngest had to be taken to the ER as he got into the childrens Tylenol unsupervised. No treatment was given and they only say the Dr. for about 10mins and were there for 3hrs waiting for the results of the blood test. The bill was $1200. Can you imagine what it would have been had he had to be admitted and treated for a few days? Often we have discussions on this board about how to best save money for retirement or certain hunts, etc, but one illness or mishap could drain that in a hurry!
 
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?

Most definitely not. The IRS can barely keep track of your wages and stock sales; a few years ago they were lacking the computing power to process Bill Gates' tax return. So, to think that they could somehow start tracking millions of peoples' health insurance credits over their lifetimes is giving the IRS way more credit than they deserve. Now if they were somehow able to get the NSA in on the deal, different story.;)
 
Nemont is the resident expert!

Nemont, my employer provides me with an amazing health care package, I don't pay a dime for it, I pay 20% of the contracted rates between a PPO and the insurance provider, no deductible and my max out of pocket per year is $1200.00. The words "Cadillac Plan" are used when people talk about it. I am constantly told that once Obamacare is fully in place somehow either my work or myself will be penalized for this. Is that true? If so what will the affects be? Thanks in advance for taking the time to answer.
 
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?

For those who qualify for a tax credit, that is not tracked for you because the IRS "evens" up the tax credit every year that you file. So instance for those who get a tax credit (not medicaid) and you make more or less then the assumed adjusted gross income that you put on your exchange app, your credit is either increased or decreased at the time you file.

The issue of medicaid is completely different. The medicaid recovery act applies mainly to what Medicaid pays for long term care stays which gets into complicated formulas and timelines.

Nemont
 
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Nemont, my employer provides me with an amazing health care package, I don't pay a dime for it, I pay 20% of the contracted rates between a PPO and the insurance provider, no deductible and my max out of pocket per year is $1200.00. The words "Cadillac Plan" are used when people talk about it. I am constantly told that once Obamacare is fully in place somehow either my work or myself will be penalized for this. Is that true? If so what will the affects be? Thanks in advance for taking the time to answer.

A "Cadillac Plan" rule has nothing to do with the coverage provided by you employer but rather the premium charged.

Beginning in 2018 there will be a 40% excise tax on high cost health plans. High cost health plans are defined as those having an annual premium of $10,200 for an individual or $27,500 for a family. The tax is paid by the employer.

Now given the fact that both sides hate this excise tax and given the waivers already granted I cannot imagine a case where this excise tax is not waived or changed. The unions are especially opposed to implementing this tax.

Nemont
 
Can you imagine what it would have been had he had to be admitted and treated for a few days?

$7,120...to be exact. Yup we had to take our son to the ER (in jan when we figured out he was Type 1) and then he was admitted for three days. Our insurance covered the ER portion of the bill, but nothing once he was admitted because it didn't cover anything related to diabetes. :(
 
A "Cadillac Plan" rule has nothing to do with the coverage provided by you employer but rather the premium charged.

Beginning in 2018 there will be a 40% excise tax on high cost health plans. High cost health plans are defined as those having an annual premium of $10,200 for an individual or $27,500 for a family. The tax is paid by the employer.

Now given the fact that both sides hate this excise tax and given the waivers already granted I cannot imagine a case where this excise tax is not waived or changed. The unions are especially opposed to implementing this tax.

Nemont
That is not how it was explained to me at all - but perhaps I just don't understand what you are saying. Basically the tax is levied on plans where the employers covers too much of the costs, thus shielding the employees from the true cost of healthcare. It is based on how much the value of the benefit the employer provides (if over "X" amount of dollars), not on the cost of the actual plan. Obviously if the employer only pays for a real cheap plan they wouldn't be subject to the tax. Also, if the employer offers an expensive plan but only covers "X" amount for it (passing the rest onto the employee) he will not be subject to the tax.

The reason the unions are upset is that they want the employer to pay for everything.

To me, this sounds like a good idea because I think much of our problems are caused because people don't understand the true cost of healthcare due to the fact that their employer pays for most of it - especially stuff that really isn't needed but the patient thinks, "well I might as well get it because insurance pays for it." It also makes it hard for self employed people to compete when they have to buy their own insurance. I actually think if everyone bought their own insurance and saw the problems a much improved ACA would have been implemented long ago.
 
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A 40 percent excise tax will be assessed, beginning in 2018, on the cost of coverage for health plans that exceed a certain annual limit ($10,200 for individual coverage and $27,500 for self and spouse or family coverage). Health insurance issuers and sponsors of self-funded group health plans must pay the tax of 40 percent of any dollar amount beyond the caps that is considered "excess" health spending.

http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=99

This language is straight from the Administrative Rules as they were issued by the Dept of Health and Human Services and CMS

Nemont
 
This language is straight from the Administrative Rules as they were issued by the Dept of Health and Human Services and CMS

Nemont

......and it will remain so unless and until my former governor, the honorable Secretary of Health and Human Services Kathleen Sebelius changes it up ("as the Secretary deems necessary"), or President Obama says so.....".
 
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......and it will remain so unless and until my former governor, the honorable Secretary of Health and Human Services Kathleen Sebelius changes it up ("as the Secretay deems necessary"), or President Obama says so.....".

I agree but I suspect there will be a long line of Senators and House members from both party's lining up to undo this through legislation. It will be a bipartisan effort to kill this tax.

Nemont
 
This language is straight from the Administrative Rules as they were issued by the Dept of Health and Human Services and CMS

Nemont
Yeah, and as you presented it is out of context, although I guess I don't care that much. My description pretty much is backed up by the article, which everyone should take a look at.

rg
 
Can anyone explain whether there would be an advantage to dropping my employer's health coverage and signing up under ACA? As much as I am against ACA as it currently stands, I think I might actually be able to get a better plan. I am currently paying over $1100/month for my family plan through my company with $500 deductible, 20% copay, and $2000/$6000 max out of pocket. I should be able to get a plan on the exchange for $300-$400 less with lower deductible and less out of pocket. I'm unsure what the ACA will look like in a few years and if the rate will go up significantly. Also, my payment for my employe'rs plan is pre-tax, but my understanding is that if I drop my employers plan and sign up under ACA, the money I make will all be taxed. I am definitely NOT eligible for any kind of subsidy or gov't help. thanks!
 
If you are note eligible for a tax credit why go through the exchange. Just go to the carrier and buy it direct off exchange?

Nemont
 
If you are note eligible for a tax credit why go through the exchange. Just go to the carrier and buy it direct off exchange?

Nemont

Guess I never considered that...I've always just gone along with my employer's policies. I'm 36 now and had cancer when I was 30...so I never looked into other coverage options because of the pre-existing factor
 
Pre existing no longer applies. Off exchange We basically ask you three questions: who are you, do you use tobacco and where do you want us to send the bill
 
Since I'm on Medicare and don't have to purchase any insurance under Obamacare, most of this thread doesn't have any direct bearing on me. However, Obamacare has increased all of my co-pay and deductables as well as limiting some of my benefits. I have to pay a monthly fee for my C-Pap machine which I had to replace and which I've been on since 1985, my diabetes test strips are limited to one per day with a refill of only 100 strips every 6 months, even though I'm supposed to test my blood sugar 3 times per day, and compared to three years ago when all of my deductables and co-pays were met by the middle of October, this past year the co-pays for prescriptions was never met due to the increased cap. Also, certain medications that were previously covered are no longer covered........even if they are listed as covered in the Formulary, and the drugs that are still covered have increased in the price of the co-pay by as much as 154%. Under the Medicare guidelines I'm required to see my General Practitioner a minimum of once every 3 months so he can refill my prescriptions. Now I have to pay at least $29.00 per visit and as much as $119.00 for some of the visits, where prior to Obamacare, the cost of each visit was $3.00. I don't know how much the co-pays will be for my Neurologist, Urologist, Neurosurgeon, Cardiologist, ENT, Retina Specialist, and all of the MRI, X-rays, blood work, and CAT Scans; since I don't begin the rounds of visits to all of those Doctors until next month. I do know that last year each of the co-pays increased by a minimum of 30% over the previous year so I'm expecting at least that much of an increase this year.
 
Not trying to one up Nemont, but I expect a lot of people are like I was before I started researching this, so I'm just so itchen to tell everyone the insurance options, prices, etc are exactly the same regardless of whether you buy them on or off the exchange (at least in MT). The ONLY reason you would buy it off the exchange is to qualify for the tax credit if your income drops below the threshold.

I bought it through the exchange because I'm self employed and never know how much work I'll have. The website worked fine and it really wasn't that big of a deal - they need your SSN and a few other things to match it against your tax return and to set up your payment which could be reduced if you choose to use your tax credit in advance.

My agent was very helpful... go talk with one or two, they are free. Before ACA they were compensated by how expensive a plan they sold you. Complain all you want, but ACA stopped that conflict of interest so now their advice is less biased. That's a dang good thing.

Personally a high deductible approach pencils out better for my family. I invest the savings (and then some) in Vanguard mutual funds in an HSA.. HSAs are a total tax dodge if you have the money to fund one: you deduct the money you put in, but unlike an IRA you don't pay taxes when you take it out. The money has to be used for medical expenses, but there is no statute of limitations. You just save all the receipts and when you want the money you cash them in. The longer you wait, the more your money will grow.

Hope this helps...
rg
 
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