Health Care Switch

[Zee09]

Have ACA (Obama-care) now that is very expensive, and I no longer want any health care that is based on my earnings.
I found a better alternative but as usual they will not cover any pre-existing issues for one year.

To limit my liability here I am thinking of getting the new insurance and not using it for a year
and staying with ACA until the year is up and then dump ACA.
Thoughts?
Thanks!

 

[walterjay]

That is a tough decision. But it does sound like a plan, especially if you think that you may need it. Can't afford to be caught flat footed without insurance for a pre existing.

 

[Donald]

That sounds like a reasonable plan. There seem to be many things that need to be considered these days when picking a health plan.

It will only get worse when you are 65 and sign up for Medicare.

 

[AZjeff]

If you use ACA for a PEC instead of the other in that year you'd have to report it to the new company or not?

It will only get worse when you are 65 and sign up for Medicare.

About to go down that road and it's not as worse as you may think. The thing to do is go to a seminar that explains how it all works then you understand it.

 

[alarmguy]

That sounds like a reasonable plan. There seem to be many things that need to be considered these days when picking a health plan.

It will only get worse when you are 65 and sign up for Medicare.

This isnt correct.
Once you hit 65 you will find Medicare the biggest bargain in health care in this country and one that people look forward too.
If not, your doing something wrong. True there are many choices if that is what you are referring to?? but costs are low if you were implying they are not.

Medicare = you get health insurance that cost you $170 a month and pays 80% of your medical costs, even better, for around $200 a month Medicare C covers everything, prescriptions, dental, vision, hearing, gym membership AND $400 a year for any over the counter items delivered to your door (toothpaste, mouth wash, shower heads you name it) Plus no deductible and $4500 a year out of pocket limit for deadly serious aliments. Step it up even higher to less than $400 a month and never pay another medical bill, except dental, vision and hearing.

No requirements, no exclusion for pre existing conditions, Medicare and Social Security is the one saving grace of getting older. I dont know how anyone can ask anything more from a system, at some point one has to prepare for their own financial security but these two programs certainly make life easier.

TO the OP = One year pre existing conditions? I didnt even know that could be an exclusion anymore. I think you need to look into that, normally pre existing condition only applies if you didnt have health insurance for a period of more than 60 days...

 

[Blueshound]

That sounds like a reasonable plan. There seem to be many things that need to be considered these days when picking a health plan.

It will only get worse when you are 65 and sign up for Medicare.

I think you are saying that the decisions become more difficult, which is true.

OP, your idea for dual coverage sounds workable. One issue I think you're likely to run into during the overlap is, which insurance is "primary". It may take some work periodically but mostly your providers will handle the paperwork.

 

[walterjay]

My wife and I were spending about 13K a year for health ins. Had a huge deductible of something like 3.5K. So we had to spend almost 17K a year before ins kicked in . We have both reached Medicare age and were are loving it. Great coverage, no hassles and very low monthly premium and some basic meds are free. Nothing so far to not like.

 

[Zee09]

This isnt correct.
Once you hit 65 you will find Medicare the biggest bargain in health care in this country and one that people look forward too.
If not, your doing something wrong.

Medicare = you get health insurance that cost you $170 a month and pays 80% of your medical costs, even better, for around $200 a month Medicare C covers everything, prescriptions, dental, vision, hearing, gym membership AND $400 a year for any over the counter items delivered to your door (toothpaste, mouth wash, shower heads you name it) Plus no deductible and $4500 a year out of pocket limit for deadly serious aliments. Step it up even higher to less than $400 a month and never pay another medical bill, except dental, vision and hearing.

No requirements, no exclusion for pre existing conditions, Medicare and Social Security is the one saving grace of getting older. I dont know how anyone can ask anything more from a system, at some point one has to prepare for their own financial security but these two programs certainly make life easier.

TO the OP = One year pre existing conditions? I didnt even know that could be an exclusion anymore. I think you need to look into that, normally pre existing condition only applies if you didnt have health insurance for a period of more than 60 days...

I have been getting that everywhere although my conditions were now 6 years ago.
They used to say if you had these issues less than 5 years ago no insurance.
ACA may work for some but for people like me I get an inferior plan nobody wants to take
and the choices are limited and the price is bad.

I will have to look into that wait a year bit but I am hearing that all over

 

[Zee09]

I think you are saying that the decisions become more difficult, which is true.

OP, your idea for dual coverage sounds workable. One issue I think you're likely to run into during the overlap is, which insurance is "primary". It may take some work periodically but mostly your providers will handle the paperwork.

Agreed........ I hope to stay healthy for a year at least... that way less future drama

 

[alarmguy]

I have been getting that everywhere although my conditions were now 6 years ago.
They used to say if you had these issues less than 5 years ago no insurance.
ACA may work for some but for people like me I get an inferior plan nobody wants to take
and the choices are limited and the price is bad.

I will have to look into that wait a year bit but I am hearing that all over

Yes, do look into that, I found this with a quick search on a gov website and I stress look into it! I have no idea what coverage you are looking at, I was under the impression all companies have to follow the same rules BUT I HAVE NO IDEA IF I AM RIGHT *LOL*
But, even if whatever you are looking at skirts this rule "pre existing" conditions used to have a time limit on it like you stated AND if you had insurance within 60 days it would not apply at all. Again, like you say, look into it.

Pre-Existing Conditions

Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.

www.hhs.gov

 

[Zee09]

This thread is dog avatar city eh..?
I think they can't exclude you but they can put time limitations on you outside of ACA
Very confusing,

Health Insurance & Pre-Existing Conditions: ACA, HIPAA, & Changes

Pre-existing condition exclusions and proof of creditable coverage were part of the pre-ACA insurance application process. But the rules have changed.

www.verywellhealth.com

 

[Wolf359]

How about more details about this health insurance? Sounds like it it isn't health insurance and one of those health sharing ministries which actually won't cover your claims if they're too high. Real health insurance shouldn't be able to exclude pre-existing conditions which is why it's so high.

 

[MrGraybeard]

One of the benefits of the ACA is that polices have to meet certain standards of coverage. Yes, deductibles can be high, and you can be limited to certain medical groups (hint: find a plan that includes doctors you prefer). But when the rubber hits the road, you'll be covered when a biopsy comes back positive. In the bad old days, a lot of insurance providers worked overtime to screw you over when you needed them most.

My personal opinion after spending five years under ACA coverage: your primary care physician these days is like the oil jockey at Jiffy Lube. If you have diabetes or another chronic condition, look for a plan that has quality specialists in that area.

 

[CKN]

There are non-compliant plans (doesn't fall under ACA) that still have certain exclusions-one of them pre-existing conditions. If you are close to Medicare-your post is a little vague, stay with the plan under the ACA.

BTW-I just signed up for Medicare, using an agent with over 20 years of handling ONLY health insurance, primarily Medicare. And because I know I have pending issues I got the Cadillac of plans. After additional prescription, vision and dental coverage I'm still well over $300.00/month. So-if you plan on using it the (less expensive) 80% plans are not the answer.

 

[walterjay]

FWIW. Maryland is not the best place to get insurance coverage if you are self employed or a small business. Very limited selection. Not allowed to shop out of state for a good competing plan. Pared down menu with high prices.

 

[Zee09]

How about more details about this health insurance? Sounds like it it isn't health insurance and one of those health sharing ministries which actually won't cover your claims if they're too high. Real health insurance shouldn't be able to exclude pre-existing conditions which is why it's so high.

No this is not one of those.
Real health insurance excludes most things most of the time in my experience if you are not part of a group and self employed.

 

[Zee09]

FWIW. Maryland is not the best place to get insurance coverage if you are self employed or a small business. Very limited selection. Not allowed to shop out of state for a good competing plan. Pared down menu with high prices.

Exactly...!

 

[MrGraybeard]

There are non-compliant plans (doesn't fall under ACA) that still have certain exclusions-one of them pre-existing conditions. If you are close to Medicare-your post is a little vague, stay with the plan under the ACA.

BTW-I just signed up for Medicare, using an agent with over 20 years of handling ONLY health insurance, primarily Medicare. And because I know I have pending issues I got the Cadillac of plans. After additional prescription, vision and dental coverage I still well over $300.00/month. So-if you plan on using it the (less expensive) 80% plans are not the answer.

Good advice there -- look for an experienced health insurance broker who can give you unbiased opinions on health care plans. The insurance provider pays their commission, so their service is free to you. I've been a customer of a good broker for almost 10 years. He gave me solid advice on Medicare choices, too.

 

[CKN]

No this is not one of those.
Real health insurance excludes most things most of the time in my experience if you are not part of a group and self employed.

NOT UNDER an ACA plan-pre existing conditions must be covered.

 

[Zee09]

NOT UNDER an ACA plan.

Yes I know but ACA doesn't work for me unless I want to quit making money and use doctors nobody goes too.

I had over 40 cardiologist in my group. Only two would take it and as you can guess they were poorly rated doctors. I lived this for years and at $16k a year for horrible coverage it is time to move on.