Author Topic: Obamacare Master thread  (Read 199597 times)

Online aygart

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Re: Obamacare Master thread
« Reply #560 on: August 14, 2018, 02:45:43 PM »
https://www.nytimes.com/2018/08/14/opinion/trump-obamacare-illegal.html

Desperation ahead of the implode.
Doesn't he know that only Obama is allowed to issue waivers in order to make the law gain popularity and not the other way?
Feelings don't care about your facts

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Re: Obamacare Master thread
« Reply #561 on: August 14, 2018, 02:59:00 PM »
Doesn't he know that only Obama is allowed to issue waivers in order to make the law gain popularity and not the other way?
Hey, this is SOP for the left wing. Tolerance is only a one way street, as are many other things.
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Re: Obamacare Master thread
« Reply #564 on: October 11, 2018, 11:54:30 AM »
Just received the Fidelis 2019 individual market rate sheet.

Interestingly, Mid-Hudson is the highest priced region, with NYC coming in second (and Long Island third).
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Re: Obamacare Master thread
« Reply #565 on: December 03, 2018, 09:18:30 PM »
For many healthy people, a catastrophic plan might make sense (it's by far the simplest plan in most cases, with a high deductible and everything covered thereafter). The catch is that the ACA makes it only available to people up to the age of 30.

However, in certain circumstances one might be able to get a hardship exception and be able to purchase a catastrophic plan even if one is over the age of 30.

I've been reading the exceptions, and it seems to me like one of them can be relatively easily "manufactured". That exception is for people that have a utility shut-off notice. I am not recommending this to anyone (though I wouldn't mind attempting this myself if I were in a position where it would make sense for me). Falling behind a month or two on a utility bill will usually result in a shut off notice. There would usually be a minor late fee, but once one gets the exception to purchase a Catastrophic plan, one could pay up (and probably even get an interest free installment arrangement to repay the outstanding balance).

Did anyone around try this?
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Re: Obamacare Master thread
« Reply #566 on: December 03, 2018, 09:22:02 PM »
For many healthy people, a catastrophic plan might make sense (it's by far the simplest plan in most cases, with a high deductible and everything covered thereafter). The catch is that the ACA makes it only available to people up to the age of 30.

However, in certain circumstances one might be able to get a hardship exception and be able to purchase a catastrophic plan even if one is over the age of 30.

I've been reading the exceptions, and it seems to me like one of them can be relatively easily "manufactured". That exception is for people that have a utility shut-off notice. I am not recommending this to anyone (though I wouldn't mind attempting this myself if I were in a position where it would make sense for me). Falling behind a month or two on a utility bill will usually result in a shut off notice. There would usually be a minor late fee, but once one gets the exception to purchase a Catastrophic plan, one could pay up (and probably even get an interest free installment arrangement to repay the outstanding balance).

Did anyone around try this?
Will it hurt one's credit to do that?

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Re: Obamacare Master thread
« Reply #567 on: December 03, 2018, 09:25:23 PM »
Will it hurt one's credit to do that?
In Brooklyn I haven't seen utilities reported on credit reports, except if there's a judgment.
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Re: Obamacare Master thread
« Reply #568 on: December 05, 2018, 03:54:36 PM »
In NY you are able to be assigned as a broker on the exchange? I didn't know that. I guess I wouldn't know if it is like that in NJ either.

I am can now be assigned as a broker also in NJ when purchasing on-exchange by entering my NPN (anyone wanting to assign me, please PM), as well as sell on individual plans on- and off-exchange (as well as employer plans off exchange).
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Re: Obamacare Master thread
« Reply #569 on: December 11, 2018, 09:26:11 PM »
In regard to the catastrophic plan how does oscar compare to fidelis?
This past year I was on fidelis but when I checked to re-sign for the coming year I see that Oscar is $48 cheaper a month. I called my doctor and they said as far as they are concerned oscar and fidelis are the same. Is there any reason to not go with Oscar?

If G-d forbid one does need to take advantage of their insurance greater than the deductible amount, will oscar cover at all the major hospitals? Or are they narrow then too.

TIA

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Re: Obamacare Master thread
« Reply #570 on: December 12, 2018, 01:25:32 PM »
In regard to the catastrophic plan how does oscar compare to fidelis?
This past year I was on fidelis but when I checked to re-sign for the coming year I see that Oscar is $48 cheaper a month. I called my doctor and they said as far as they are concerned oscar and fidelis are the same. Is there any reason to not go with Oscar?

If G-d forbid one does need to take advantage of their insurance greater than the deductible amount, will oscar cover at all the major hospitals? Or are they narrow then too.

TIA
BUMP.. I know it's soon. I just have to sign up by the 15th so if anyone has any info it would be greatly appreciated.
Thank you

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Re: Obamacare Master thread
« Reply #571 on: December 12, 2018, 01:50:17 PM »
In regard to the catastrophic plan how does oscar compare to fidelis?
This past year I was on fidelis but when I checked to re-sign for the coming year I see that Oscar is $48 cheaper a month. I called my doctor and they said as far as they are concerned oscar and fidelis are the same. Is there any reason to not go with Oscar?

If G-d forbid one does need to take advantage of their insurance greater than the deductible amount, will oscar cover at all the major hospitals? Or are they narrow then too.

TIA

There is absolutely no comparison in network size and doctor access between Oscan and Fidelis. Fidelis has one of the best networks in NYC, whereas Oscar has a comparatively subpar network. A quick look at https://www.hioscar.com/individuals/network/ny doesn't seem to show NYU Langone (which is one of the biggest systems networks in NYC) or Northwell (think Staten Island University Hospital) as part of their network.

Don't be penny smart and pound foolish. You're getting Catastrophic not for the small things, but if G-d forbid you need something major, you want access to the best doctors and facilities.

Oscar would supposedly pay me a commission if you use me. Fidelis said in the past that they won't pay any more commissions, but have paid, so I don't know what they will do in 2019, but if you were my client I would steer you away from Oscar and into Fidelis.
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Re: Obamacare Master thread
« Reply #572 on: December 14, 2018, 01:12:16 AM »
PSA - December 15th (Shabbos!) is the end of open enrollment period. It isn't easy to get coverage outside of open enrollment!
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Re: Obamacare Master thread
« Reply #573 on: February 17, 2019, 03:40:34 AM »

PSA - December 15th (Shabbos!) is the end of open enrollment period. It isn't easy to get coverage outside of open enrollment!

In New York open enrollment is through January 31st.
« Last Edit: February 17, 2019, 03:52:34 AM by Moe Ginsburg »

Offline Moe Ginsburg

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Re: Obamacare Master thread
« Reply #574 on: February 17, 2019, 03:43:31 AM »
Modified Adjusted Gross Income.

For most people it's the same as AGI on their tax return.

You can contribute to a (Roth) IRA to reduce your MAGI (and receive a larger APTC or even to qualify yourself for cost-sharing reductions on a Silver Plan.)
« Last Edit: February 17, 2019, 03:54:14 AM by Moe Ginsburg »

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Re: Obamacare Master thread
« Reply #575 on: February 17, 2019, 03:50:31 AM »
For many healthy people, a catastrophic plan might make sense (it's by far the simplest plan in most cases, with a high deductible and everything covered thereafter). The catch is that the ACA makes it only available to people up to the age of 30.


The Catastrophic Plan does not qualify for any tax credit. Thus, anyone who qualifies for a tax credit (which means the majority of marketplace plan participants) would generally not find it beneficial to consider a catastrophic plan.

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Re: Obamacare Master thread
« Reply #576 on: February 17, 2019, 11:52:38 AM »

Catastrophic plans offer excellent INSURANCE. They are the simplest to understand, and are excellent financial tools for healthy eligible people. There's a predefined high deductible, after which everything is covered at 100% (as well as one well visit per year, or some other extremely limited coverage prior to reaching the deductible).

Catastrophic Plans are essentially the same as any of the other plans. It really could be considered a metal plan one level below Bronze. The only difference between Bronze and Catastrophic is that Catastrophic has a lower premium and a higher deductible than Bronze.

Those are the differences as far as the insurance are concerned. Obviously Catastrophic is unavailable to most people over age 30. And Catastrophic does not qualify for any tax credits even for those who can purchase it, unlike all the other metal on-exchange marketplace QHP.
« Last Edit: February 17, 2019, 11:58:09 AM by Moe Ginsburg »

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Re: Obamacare Master thread
« Reply #577 on: February 17, 2019, 11:56:44 AM »
Catastrophic Plans are essentially the same as any of the other plans. It really could be considered a metal plan one level below Bronze. The only difference between Bronze and Catastrophic is that Catastrophic has a lower premium and a higher deductible than Bronze.

Those are the differences as far as the insurance are concerned. Obviously Catastrophic is unavailable to most people over age 30. And Catastrophic does not qualify for any tax credits even for those who can purchase it, unlike all the other medal plans.
You are correct in stating that tax credits are not available to people who have a Catastrophic plan, but for those who aren't eligible for tax credits and are young and healthy, Catastrophic plans are often a very good choice due to low premiums and a straightforward structure (high deductible, and then everything covered).
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Re: Obamacare Master thread
« Reply #578 on: February 17, 2019, 12:01:16 PM »
There's one test for that IINM. Are you claimed on their tax return as a dependent. Even if you were in the past, no one says it can't change mid year.

As a matter of fact, I've had people apply for Medicaid without any income, and in response to the question of how they support themselves, the response is support from parents/family members.

Remember, the ACA made financial test for Medicaid qualification only one: MAGI!

Does your understanding of Medicaid qualification indicate that an 18 year old student with zero income should qualify for Medicaid in any of the 50 states as long as his parents (and anyone else) do not claim him as a dependent for tax purposes?

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Re: Obamacare Master thread
« Reply #579 on: February 17, 2019, 12:15:16 PM »
Does your understanding of Medicaid qualification indicate that an 18 year old student with zero income should qualify for Medicaid in any of the 50 states as long as his parents (and anyone else) do not claim him as a dependent for tax purposes?
The way I understand things, the question would be "is he part of the household?". I'm not sure if tax dependent is what makes the difference. So if this answers your question, if the 18 year old lives with others, that's what consists of the household, regardless of tax filing status.

For example. A person over 18 resides in NY and has no income of their own. Their family resides in FL. They apply on the NY exchange and indicate no income. A question will pop-up asking how they pay for regular expenses, and one of the options is to reply: help from family members. In my experience, such person will be found eligible for Medicaid in NY (the only that will need establishing is NY residency).

Disclaimer: I am stating the above based on my understanding and experience. I do not render legal or tax advice.
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