Affordable Health Insurance

...what an oxymoron.


As I feared, high-deductible insurance will become impossible to get. I noticed that MD has declared only people under age 30 can even buy it as qualifying coverage after the exchange goes in to effect.

Low-premium, high-deductible health plans are endangered by Affordable Care Act : Stltoday

I don't think that's something MD has decided, I think that limitation (i.e. the so-called catastrophic plans only qualify if they are only offered to people under the age of 30) is within the PPACA itself. I think you can also qualify for those plans if you have a certification that there aren't any other affordable plans available to you. But my memory isn't convincingly clear on those points, so I'll have to dig out the text of the PPACA and (find and) re-read the portion of it that applies. I'll let you know what I find when I get around to it.
 

StadEMS3

Well-Known Member
PREMO Member
I'm SO glad I did my 22yrs in the military. $269 annually for single rate Tricare at Johns Hopkins. I just say holy cow to those who are stuck with these outrageous healthcare costs.
 
I was looking at the high-deductible plans to keep my costs low. I was very pleasantly surprised to find my company subsidizes my retiree plan to the tune of $625/mo forever. My cost is about $225.

Of course, this is only until Obamacare changes everything and they'll make illegal to subsidize a retiree plan.
 

Gilligan

#*! boat!
PREMO Member
I don't think that's something MD has decided, I think that limitation (i.e. the so-called catastrophic plans only qualify if they are only offered to people under the age of 30) is within the PPACA itself..

MD has officially published that detail..lets put it that way. I could never find anything specific in the ACA with respect to HD catastrophic plans and even had some so-called experts try to convince me that I was worrying about nothing; that such plans would probably still be considered acceptable.

The point remains...that some weenie bureaucrat decided that I should spend 60 grand for 5 years of insurance bills instead of less than 10 grand.
 
I was looking at the high-deductible plans to keep my costs low. I was very pleasantly surprised to find my company subsidizes my retiree plan to the tune of $625/mo forever. My cost is about $225.

Of course, this is only until Obamacare changes everything and they'll make illegal to subsidize a retiree plan.

Mine is $98, Blue Cross, but they made me get Medicare at 65. That is not cheap.
 
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I don't think that's something MD has decided, I think that limitation (i.e. the so-called catastrophic plans only qualify if they are only offered to people under the age of 30) is within the PPACA itself. I think you can also qualify for those plans if you have a certification that there aren't any other affordable plans available to you. But my memory isn't convincingly clear on those points, so I'll have to dig out the text of the PPACA and (find and) re-read the portion of it that applies. I'll let you know what I find when I get around to it.

Okay, so this appears to be correct. Let's have some fun with the 'follow the cross references in U.S. Code far enough to be able to figure something out' game, shall we...

42 USC § 18022(a) tells us that "essential health benefits package" refers to a health plan that, among other things, provides coverage at either the bronze, silver, gold, or platinum level.

42 USC § 18022(d) tells us what the requirements for those coverage levels are.

But 42 USC § 18022(e)(1) tells us that a plan is treated as meeting the requirements of 42 USC § 18022(d), even if it doesn't, if it is a "[c]atastrophic plan" which means, among other things, that:

(A) the only individuals who are eligible to enroll in the plan are individuals described in paragraph (2)

And paragraph (2) reads:

(2) Individuals eligible for enrollment

An individual is described in this paragraph for any plan year if the individual—

(A) has not attained the age of 30 before the beginning of the plan year; or
(B) has a certification in effect for any plan year under this titlethat the individual is exempt from the requirement under section 5000A of title 26 by reason of—
(i) section 5000A(e)(1) of such title (relating to individuals without affordable coverage); or
(ii) section 5000A(e)(5) of such title (relating to individuals with hardships).

Oh, and we should also point this out:

(3) Restriction to individual market

If a health insurance issuer offers a health plan described in this subsection, the issuer may only offer the plan in the individual market.

So that all means that if you're under 30 you could be eligible for a high-deductible plan that meets the "essential health benefits package" requirement. But, what the hell does that mean? Does it get us anywhere?

Well, 42 USC § 18021(a)(1) tells us that in order to be a "qualified health plan" a plan has to, among other things, provide the "essential health benefits package". Okay, so we might now have a "qualified health plan", but what the hell does that mean?

Well, 42 USC § 18031(d)(2)(B) tells us that an "Exchange" can only make a plan available if it's a "qualified health plan". Okay, I'm going to skip a bit of stuff and just say that means that these kinds of plans can be offered in the individual market within a state. But why does that matter?

Well, 26 USC § 5000A(f)(1)(C) tells us that "[c]overage under a health plan offered in the individual market within a State" qualifies as "[m]inimum essential coverage" and that means... ding, ding, ding...

You don't have to pay the tax penalty for not having proper coverage in accordance with the requirements put in place by the ACA.


Boom baby! We're home. This #### really is easy to sort out.
 
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MD has officially published that detail..lets put it that way. I could never find anything specific in the ACA with respect to HD catastrophic plans and even had some so-called experts try to convince me that I was worrying about nothing; that such plans would probably still be considered acceptable.

The point remains...that some weenie bureaucrat decided that I should spend 60 grand for 5 years of insurance bills instead of less than 10 grand.

The under 30 requirement for getting (new) catastrophic plans is indeed in the ACA itself, see my post above.
 

stgislander

Well-Known Member
PREMO Member
Okay, so this appears to be correct. Let's have some fun with the 'follow the cross references in U.S. Code far enough to be able to figure something out' game, shall we...

42 USC § 18022(a) tells us that "essential health benefits package" refers to a health plan that, among other things, provides coverage at either the bronze, silver, gold, or platinum level.

42 USC § 18022(d) tells us what the requirements for those coverage levels are.

But 42 USC § 18022(e)(1) tells us that a plan is treated as meeting the requirements of 42 USC § 18022(d), even if it doesn't, if it is a "[c]atastrophic plan" which means, among other things, that:



And paragraph (2) reads:



Oh, and we should also point this out:



So that all means that if you're under 30 you could be eligible for a high-deductible plan that meets the "essential health benefits package" requirement. But, what the hell does that mean? Does it get us anywhere?

Well, 42 USC § 18021(a)(1) tells us that in order to be a "qualified health plan" a plan has to, among other things, provide the "essential health benefits package". Okay, so we might now have a "qualified health plan", but what the hell does that mean?

Well, 42 USC § 18031(d)(2)(B) tells us that an "Exchange" can only make a plan available if it's a "qualified health plan". Okay, I'm going to skip a bit of stuff and just say that means that these kinds of plans can be offered in the individual market within a state. But why does that matter?

Well, 26 USC § 5000A(f)(1)(C) tells us that "[c]overage under a health plan offered in the individual market within a State" qualifies as "[m]inimum essential coverage" and that means... ding, ding, ding...

You don't have to pay the tax penalty for not having proper coverage in accordance with the requirements put in place by the ACA.


Boom baby! We're home. This #### really is easy to sort out.

Ugh!!! May I be excused? My brain is full. :twitch:
 

Gilligan

#*! boat!
PREMO Member
The under 30 requirement for getting (new) catastrophic plans is indeed in the ACA itself, see my post above.

All I know is...I'm screwed. Been a looong time since I was "under 30".

But where in all that stuff you went through is the threshold age of 30 specified?
 
All I know is...I'm screwed. Been a looong time since I was "under 30".

But where in all that stuff you went through is the threshold age of 30 specified?

Have you spoken to your current agent or insurance provider and found out that they don't intend to continuing offering the coverage you have now? It wouldn't surprise me if they decided to no longer offer it (in part because some of new requirements would apply to that grandfathered coverage), but have you confirmed that with them?

If they continue to offer that coverage, you can keep renewing it and in so doing meet the minimum essential coverage requirement.
 

getbent

Thats how them b*tch's R
I hate our insurance plan. $1200 deductible per person $2400 per family. Hubby pays $200-300 every 2 weeks for our family of 4. We have never met the deductible so basically it's like not having insurance since we pay the whole bill. They don't do traditional write offs either. Usually a $1-5 "discount". Unfortunately this is the only medical plan they offer.
 

DynaDink

New Member
I'm SO glad I did my 22yrs in the military. $269 annually for single rate Tricare at Johns Hopkins. I just say holy cow to those who are stuck with these outrageous healthcare costs.

Obamacare will eventually replace Tricare by making it unaffordable. Watch and listen.
 
C

czygvtwkr

Guest
All I know is...I'm screwed. Been a looong time since I was "under 30".

But where in all that stuff you went through is the threshold age of 30 specified?

Maybe someone can help you out with a forged birth certificate, know anyone like that?
 

Lurk

Happy Creepy Ass Cracka
I'm SO glad I did my 22yrs in the military. $269 annually for single rate Tricare at Johns Hopkins. I just say holy cow to those who are stuck with these outrageous healthcare costs.

That rate is going to increase, in some cases quite significantly.
 

Wenchy

Hot Flash
I tried to get private health insurance through a USAA affiliate and was turned down. Why? I had visited a chiropractor in the prior six months.

I love USAA, and have all my insurance through them, but this made me question the state of the world and everything.

I have a medical appointment tomorrow and will pay out of pocket. Depending on the results of the tests, I might have to get a freedom card and medical assistance so I can pay the rent. Otherwise, I will apply for section 8.

F you Obama!
 
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MarieB

New Member
Just imagine how much companies and employers are paying to try to figure all of this #### out. Some even have to update their software/computer systems

This year we chose a higher deductible plan with an HSA. The letter we got this year from the company stated that they "believe" all plans they offer are compliant or will be grandfathered in
 
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