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View Diary: Huh. ACA affects me after all (15 comments)

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  •  This is the top plan (0+ / 0-)

    does it exceed the minimum ACA mandate? So these people aren't even getting their healthcare insurance the thru the ACA, that is what U R sayin.....


    49 comments in 8 years? WTF is up with that?

    .................expect us......................... FDR 9-23-33, "If we cannot do this one way, we will do it another way. But do it we will.

    by Roger Fox on Tue Oct 29, 2013 at 03:08:38 PM PDT

    [ Parent ]

    •  this is what gets me (3+ / 0-)
      Recommended by:
      Lujane, MRA NY, Larsstephens

      I think it exceeds the minimum, in that deductables are only $25 per visit and $800 yearly (each) and yearly out of pocket max of $8K ($16K for the 2 of us).  I'm not sure it's a Cadillac plan, and even if so that part of the ACA doesn't kick in until 2018.  I think ACA fees are something like $70/year, and my point is they're hitting us with 10 times that much and blaming the ACA.  There's no doubt in my mind that my plan is far better than the <$100/mo. minimum plans I've heard about, but there can't be a penalty for just exceeding the minimum.

      Of course this plan is not through the ACA, but the ACA has fees on most (all?) large employer plans, and I'm afraid the greedy ones that run these companies are using the ACA as an excuse.  But I can't prove it.

      As for your WTF question, I can't read D-Kos as often is I like and certainly can't post very often.  But this really concerns me because I think the ACA is getting dumped on unfairly all over the place.  

      •  My company offers two major plans (1+ / 0-)
        Recommended by:

        And provides a careful financial analysis for you on what is better based on your exact situation.   Your plan looks like a kind of bad version of our PPO (especially that out of pocket max, ouch!) so I'm guessing your employer pool isn't as nice as the one our multinational with 50kish employees gets.

        The idea behind a PPO is that you try to keep deductible low but pay more monthly.   Your total expense if you hit out of pocket maximum is higher than with a HSA, but your expenses are much more predictable and if you don't have a lot of expenses, your total expense is usually less, especially if your tax rate is low.

        With a HSA you're going to pay a large deductible every year (in my case, me and my wife pay 2x what you do) before any benefit from insurance kicks in, but out of pocket max is lower (in my case, our out of pocket maximum is something like 40% of yours) and also the monthly payments are significantly less (about half of yours) but you have to add to that payment a contribution to a health savings account, from which all of your medical expenses are paid (aside from OTC drugs even if prescribed).

        So I pay about $300 a paycheck, but it's $300 of pre-tax money of which $200 is my money that I use to pay medical expenses.   On the PPO I pay less than $300 each paycheck but if I incur a medical expense, I'm paying out of my pocket with post-tax dollars.   If I don't do anything but (free) preventative maintenance doctor visits, medicines related to that and birth control, I'm clearly better off with a PPO.

        If I'm using moderate amounts of healthcare, the two come out similar, although the higher my tax rate, the sooner the HSA is attractive.

        If I have predictable amounts of expenses between the deductible and the out of pocket max, the HSA is a really freaking good deal and blows a PPO out of the water.

        I don't know about your choices, but it's important to look at how you use healthcare when choosing a plan.  Many people who use healthcare predictably every year do better on higher deductible plans, even without a HSA, because the lower monthly payment turns out to be a bigger savings than a lower deductible.

        •  Oh and IRRC deductible (1+ / 0-)
          Recommended by:

          If having to suddenly pony up the whole deductible is going to break you financially, you can't go with a high deductible plan.

          This will force some people into plans that on paper don't match their needs, just because a financial shock of $3000 is impossible, where one of $1500 they can manage with difficulty.

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