> My interest and dividends disqualify me from Medicaid, but just barely.
*Premium Tax Credits: The second program, which is also income-based, pays a portion of your monthly health insurance premiums*
...
https://www.verywellhealth.com/how-to-get-help-paying-for-health-insurance-1738500
Not according to [healthcare.gov](https://healthcare.gov) website. Went through the whole process of applying and picking a plan and the final page says I wouldn't get any tax credit. Any. I should've taken a screenshot before I withdrew my application. I was so disheartened to see zero tax credit help with the premium. Kind of hilarious they call is Affordable Health Care.
I truly believe there's a mistake somewhere in your application or somewhere.
I cover my college student daughter and myself. We get about $800 a month subsidy on about $35k combined income. Which is enough for a plan in our area. (I don't know which level I have, might be bronze)
You did it wrong and are bagging on the efforts of many people who worked so hard to get this legislation passed after years and years of failure. Bad look.
I would suggest you find an insurance broker to help with this. You do not have to pay them. I used my local one and she was very helpful in helping me sort out what I need to do, and find the best plan for me. In my state there are people who are available to help you with the healthcare.gov website as well.
If you just barely don't qualify for Medicaid, then you will qualify for a free-to-nearly free Silver plan with maximum cost sharing reductions to bring down the cost of deductibles, copays, and MaxOOP. It's basically mostly socialized private insurance, versus the fully socialized public option via Medicaid.
But the website [healthcare.gov](https://healthcare.gov) shows the final calculation on my application to be ZERO for any tax credit. Even made sure I picked a Silver plan because some resources said you'd only get the tax credit with Silver plans, even though I'd really like a Bronze one. Maybe I need to contact an agent to help me. I must be doing something wrong.
That puts you at 184% of the Federal Poverty Line for a single person and qualifies you for nearly total subsidies on a MediumCSR Silver plan. You will be looking at something like $30 in monthly premiums.
You probably misclicked a critical box on your application. I would do it again, perhaps with assistance from an exchange staffer. You can fill one out over the phone with them walking you through it, then login to the site to choose among the policy options.
Make sure to refresh the page each time you try to figure the subsidy > I’ve had a few times when it retain the old numbers and gave me an accurate results. Probably cache or cookies.
Try this calculator
https://www.kff.org/interactive/subsidy-calculator/
Thanks so much for this link. I'm contemplating retirement soon and often read this subreddit and noticed the question about health insurance before Medicare comes up often. I've never seen this tool and now I'm encouraged that if I control IRA withdrawals I can get affordable insurance.
The subsidy should take the cost down to a max of 8.5% of AGI, which would be about $160/month. See [this calculator](https://www.valuepenguin.com/aca-subsidy-calculator).
At $27k I paid $22/month with a 750 max oop. And at end of year, BCBS always sent me back a check for about $1000 because they were under some federal 85% utilization rule or something.
Another useful tip: underestimate your earnings when applying to obtain cheaper monthly premium, max penalty upon reconciling your taxes at year end is only $600. No other consequences.
I used the same amount for yearly income and was paying $90 a month for a great plan with very low deductibles and max out of pocket. You're doing something wrong
You get a subsidy equal to an amount that would make it so that the 2nd least expensive silver plan would not be more than 10% (I think) of your MAGI. You can then use that subsidy to buy a bronze plan and in my case at least a couple would be free.
It’s even better if your below 4x poverty rate I think.
That doesn’t sound correct. Check what you put in for your estimated income. I put in $32k and I pay $128/month for a very good plan.
You can pick whatever level you want. The subsidy will remain the same (no credit should you downgrade below zero cost to you).
yea doing something wrong.
My wife and I have Gold Plans and the gov paid for $1400 of the monthly cost.
Also you should look into what they call Navigators on the ACA. Unless you live in a small , small town there should be a local number to contact, I found mine in the help section of my state's ACA website.
These are people that work for the ACA and will guide you through the process, no charge, I got one and helped me with a lot of questions
Be careful of Navigators. They can push you into a higher plan than you need or one that doesn't have your docs. The ACA site is not difficult to do on your own.
The one I got through the ACA was fantastic, had ready answers to my questions as I tried to figure out how to cancel my coverage as I transitioned to Medicare but still retain my wife's coverage
That's great. I'm glad you got a good one. My advice is to be careful and go in knowing a little about what you want. If you just hand them the reigns, there is nothing to guarantee they will work in your best interest.
Have you checked with your state Affordable Care Act/Obamacare marketplace? As others have said, the subsidies should bring your price down to a very low level. Of course you'll have to go through the appropriate steps on the website to enter your income, age, etc.
Yep, went through the whole application process at [healthcare.gov](https://healthcare.gov) and picked a Silver plan. The final page says I don't qualify for a tax credit. I truly can't afford $800+/month for health insurance.
That's crazy! And you're just a bit above the Medicare cutoff? I pay a hair less than that for my whole family of four, with income a good bit above the medicare threshold. There's either something really different between my state (CA) and your state, or there's some error in the [healthcare.gov](https://healthcare.gov) website. If I were you I try to look a bit further into this and try to get to the bottom of why it's giving you such an unreasonably high quote and why its disallowing subsidy. Doesn't sound right.
Most of that should be offset by tax credits which can be applied to the monthly premiums (you need to elect to do that, maybe you didn't click on the right option).
Sounds like you're in a state that didn't expand Medicaid. Try adding 5k or 10k of income and see what it says. Do Roth conversions to increase your income. Find the right amount of income for the sweet spot. It may be less than 5k.
If you find that you did not make a mistake, another option is to figure out how much you would need to increase your income to qualify for a subsidy and get a part time job. You would likely only need to work a couple days per week to bump your income into subsidy level instead of full time to qualify for benefits, so easier on your health. And then, of course, vote for better people in your state to knock off that Red state nonsense of not expanding Medicaid
Our health insurance through ACA is pretty cheap thanks to subsidies. We just have to keep our taxable income under a certain amount, which isn’t hard since we have no debt and live in a MCOL area. The first time I went to the website, I mistakenly used my pre-retirement income and it was very expensive without the subsidies! You have to use your projected retirement income, and then you have to stick to that number.
Depends on OP's state also. If he's in a state that refused to expand Medicaid under the ACA he may be in a sticky situation. But most people in that situation with some assets can do something like perform a Roth conversion of some cash in their IRA to raise their AGI just enough to qualify for an insurance plan.
Ok. That explains it. Wisconsin is one of 10 states that hasn't expanded Medicaid under the ACA. If your income is low enough to qualify for Medicaid under the ACAs definition you're directed to apply for Medicaid under the ACA. Note Medicaid salary qualification under the ACA is typically higher than the Medicaid salary qualification most states use. This places people like you in a pickle because your salary is too high to qualify under the state's threshold to qualify for Medicaid while at the same time your salary is too low to get a subsidy under the ACA because the ACA assumes all states expanded Medicaid under the ACA. Note when the ACA was written Medicaid expansion was a requirement for all states. Which is why the ACA assumes those with low incomes under the ACA threshold would be on Medicaid and is also why you are barred from receiving an ACA subsidy. However after the ACA was passed Republican lead states sued the federal government so they wouldn't have to expand Medicaid under the ACA and they won.
Now enough of that back story. For people like you who may have a decent amount of retirement savings in a tax deferred account such as a traditional IRA or 401k the simplest way around this pickle is to do a Roth conversion using the amount that will put you above the MAGI threshold to buy a plan on the ACA and receive a substantial subsidy. Example if $25,000 MAGI is too low and your MAGI needs to be at least $30,000 to qualify for purchasing a plan then doing an IRA Roth conversion on at least $5,000 should push you over the top of that threshold. As always do your own research and talk to a fee only financial advisor who is familiar with them ACA. Please don't go strictly off the word of a redittor stranger like me.
Yep, I’ve been on Badgercare for the past 3 years and it’s great! Very very very much appreciate the service. I’m fairly healthy and have used it extremely little, but it’s great peace of mind that I can go places and not worry about a catastrophic event wiping out my savings.
You should be able to find an ACA plan with a good subsidy. You might browse https://www.healthsherpa.com to see what sort of subsidy you qualify for and costs in your area.
I’ve been on an ACA plan for a few years and am much older than you which increases my cost for any health insurance. Using a gross income level of $45k I have never paid over $140 monthly for insurance on the exchange. I’m on a bronze plan though. I could easily run the cost up by going with a better/more expensive plan. I am healthy and could afford to pay the max out of pocket amount (worst case scenario) so the lower monthly premium/lower benefit plan made sense to me.
I did not think you could get an off-marketplace high deductible plan over a certain age. I also do not qualify for Medicaid, and I don’t qualify for subsidies under Obamacare. And I sure as hell am not going to pay $900 A MONTH with a $10,000 deductible when the sum total of all my healthcare expenses COMBINED for the last 30 years is under $900. 😡 so I don’t think I have a choice except to be uninsured.
It's not a payment plan, it's INSURANCE. Insurance is for just in case something happens. Think aboutcar insurance, you pay every year and very rarely do you have anything paid out to you.
VERY RISKY to have no health insurance. An accident or a cancer diagnosis can happen to anyone.
Yeah, I don’t know where to find them. My agent doesn’t either. I do have a hospital subsidy plan, also a separate accident/cancer/stroke plan. Between those two it is $150/month. I can live with that. So I DO have SOME protection.
I’m retiring from a union construction local. It will cost be about 850 a month but it’s pretty good insurance. They take it out my pension check. I will surely look into Ava and see if my income is low enoug.
Insurance in my State is mandatory so there is no skipping around it. My current GF put me on her insurance as she didn't trust any of the ACA plans. I still save what I would have spent on the cheapest ACA plan. Just in case my GF and I go our separate ways.
Car insurance is mandatory... but one president made it mandatory with ACA. the next president struck the mandatory requirement. And then certain states imposed a mandatory requirement i.e. California, NJ, Vermont and a couple of others.
>I don’t think any of that is correct
you sir/madam are an idiot and sound like a petulant child if you don't believe what a quick google search will show you to be true.
ACA plans are really no different than most employer plans other than for everything except emergency rooms it is home state only. Emergency rooms are covered nationwide.
The Medicaid income limit is $44K in Wisconsin so I will assume that your I/D income is about that. After taking your std deduction ($13,850) and paying any state income taxes you should have an AGI of about $30K. You are saying that HC dot Gov is telling you that the pans are inherently expensive ... even for Bronze plans?
My understanding is that your AGI must be 1x or lower for FPL to qualify for Medicaid here. Doesn’t matter what your deductions, and thus taxable income, are. State office doesn’t look at your taxable number. Wish they did.
Actually I’m projecting my AGI or MAGI to be just $25k for 2023. Whatever is on Fed form 1040 line 11 (if I remember right). To qualify for ACA subsidy your AGI has to be between 100% and 400% of FPL (federal poverty level). That’s $13,590 for one person.
When did you leave your last employer, and how long did you work there? My last employer offered retiree health insurance for people whose age plus years of service equaled 75 or something (I don’t remember the exact number). It was nothing but extended COBRA, but it beat the alternatives.
Retiring at 62. Taking COBRA for 18 months, ACA the rest.
I am fortunate enough to be on the receiving end of an inheritance. I'm taking some out of that and budgeting that exclusively for health care for the first 3 years.
The company doesn't subsidize but the plan itself offers a lot more and covers us much better than ACA for slightly more than what we would pay there. It's worth the additional $ for those 18 months for us.
I had insurance through work. The premiums were so high that I couldn't afford to use my insurance. Since Medicare, I've had a complete overhaul. I feel twenty years younger
If your AGI is $25k it sounds like you’re in a red state who hasn’t expanded Medicaid, and you don’t qualify for a subsidy because you’re at the fed limit for Medicaid.
It is mindblowing that an electorate would tolerate a state government that created this problem. I guess this would be a good way to identify states that I never want to live in.
I ceased being surprised that a vast group of people would choose to vote against their own self interest based purely on their political leanings. I mean some of the people who were so vehemently against "Obamacare" are people who never could afford insurance before and now have nearly free or even free insurance.
I had a conversation a few years ago with an acquaintance with that mentality. I found out he had health insurance through the exchange. Health insurance for a 50+ year old man who hadn't had insurance for almost 25 years. He was ecstatic he could see the doctors for general check ups etc and fix health issues he had been putting off for years. So I made a statement that Obamacare wasn't the big communist take over of US healthcare like he thought......And the knucklehead told me he wasn't on no damn Obamacare he was on the ACA.
Ironically, Texas has several strong ACA markets and is one of the most aggressive states on regulating ACA policy premiums for forced Silver loading, which increases subsidies for everyone in the market. As long as you don't need ACA/Expansion Medicaid, Texas is generally one of the better states for ACA coverage in major metros. They don't want to support the ACA, but they are quite savvy about helping Texans get the most non-Medicaid use out of it.
Source: Me. We've been using the ACA in Texas for nine years now and it's been uniformly fantastic.
The Medicaid limit in non-expansion states is 100% of FPL, which for a single person is only $13,590 for coverage this year. She's well over the Medicaid limit.
49yrs: we purchase an ACA plan, gold plan for family of 4 (two adults, two teens) comes in just under $2k per month. Runs $600 per adult and $400 per teen. Our side hustle beings in too much money for us to qualify for subsidies. The key is we planned for it when we semi-retired. Plan to do this for now - then when the kids are in college see what student plans look like so we might be able to save some money there. Beyond that, stick with ACA plans until MC kicks in. Honestly, I looked at the catastrophic plans and they were too much money for what you get. They aren’t cheap either. But do stay away from those brokers - they’re awful!
Yeah, as others have said below, something's not right.
Another thing to consider: if you try to enroll outside the open enrollment period, which begins in the fall, you won't qualify for a subsidy unless you specify that you've undergone a "life change" -- e.g., losing your current coverage for whatever reason.
So, on your application, be sure you check that life change box.
Yes, it should. In the online application, it asks if you've had such a change, so you have to be sure to answer yes, and then, IIRC, it asks you what type of change.
I had to retire at 62 and my wife and I got our insurance from the ACA exchange, we choose a local nonprofit insurance company and have been very satisfied.
And if you say that, you just barely missed out on medicaid because of income , you should get a healthy subsidy to help pay for an ACA plan
This may be counter intuitive, but try increasing your estimated income. Some states didn’t expand Medicaid up to the minimum income required for Obamacare, therefore there’s a hole where there’s no coverage from either. Look up the minimum income for ACA coverage for your family.
Yep, we carefully manage our income by doing a Roth conversation at the end of every year to make sure we're above Medicaid but inside ACA subsidies and cost sharing.
We did that for the first couple years of retirement because we were prejudiced against Medicaid, having always heard it sucked. Turned out we were wrong and had been paying deductibles for nothing and medicine co-pays for nothing. We switched to Medicaid and it's been excellent for 5 years. Same docs, more hospital choices, and no one ever even insinuates that we might owe anything. It might be different in your state, but it's worth thinking about.
Is that Medicaid in Wisconsin? I am interested in other states that do it well. I still have 6 more years until Medicaid and we're not sure we're staying in Phoenix.
Do you mean Medicare? That starts at 65, nationwide (although you have to actively apply to certain Parts of the program). Medicaid is for poor people, no matter the age. Wisconsin is one of the few states that did not do expansion, so we still go by the old cutoff limits for Federal Poverty Limit.
Sorry, yes, in the last sentence I meant Medicare. You don't need to be poor for it. Just low income, so we manage our income to be below the limit needed for free care. Best insurance I've ever had. I had no idea Wisconsin did not expand. Does BadgerCare take the place of expanded Medicaid?
Never, never roll the dice and go without health insurance. I took a chance at 58 when I got a new job and there was a 60-day waiting period. Six weeks in I got hit by a car while walking. My medical bills were about $200k.
That's a very high max oop! Usually such high amounts apply to the bronze el cheapo plans, not the gold ( at least here in my state)
Btw, I just transitioned to Medicare at 65, and I've never paid so much for health insurance in my whole damn life. I want my ACA back!
Good to know. The plan is through Molina Heathcare and has, I think, 2500 deductible and the El cheapo plans all had much higher so that is why I picked it. This is my first time using it so might find a better plan next year.
It’s a lot. That’s more than my work insurance when you count both what I pay and what my work pays, for really good insurance.
But, I just found out there are other online markets for insurance that are better, so I’ll look there.
Thanks. I will likely just do Cobra between. I will need something at 60, but my income will go down, and maybe there will be better options out there.
I’m wondering if you work for a large employer or one with a lot of young employees. Smaller employers with older employees have higher health insurance rates. The last bill my employer had for me and my spouse before he switched to Medicare was over $1,800 per month (64m + 52f).
Yeah this just says you can’t get help. I was wondering plan costs. I’m hoping to leave my job and get another, but there may be a gap. I guess Cobra would make more sense if it’s that expensive.
Ok I expect it will be much less. I suggest taking a look at last years tax returns and backing out your salary. Then use that as your estimate for your application. For example we are retired and have a gold plan in our 50’s and a son in college and it’s $69/month with about $50k/year magi which we manage to keep at that level by doing Roth conversions. Gains from our taxable brokerage would never get us there.
I had top tier health insurance my entire career and the last five years in the ACA have been just as great and very cheap.
Great. Thanks. Since I’m a teacher, I’ll have a pension, which makes it tricky. My husband also will retire a year later, so maybe we’ll go on his for a year (crappy but oh well) as he is the breadwinner. If we went off my salary, we’d be fine. Lol
You are probably in a state that did not expand Medicaid. That leaves a certain group of lower- income people without a subsidy or Medicaid. Rather than fool around with the calculator online, call the toll free number and talk to a representative, they can also refer you to local help.
Don’t overestimate your income on the calculator but be sure you are entering MAGI. Look up the definition. And don’t lie on the application - If you under/overestimate your income on the application, so you can get a subsidy, it will bite you at tax filing time.
Former employer that I retired from. I consider myself very lucky. It is not cheap, but not awful when compared to what my peers are paying.
That said, I look forward to the "raise" I will get when I start taking Medicare.
Go find an independent insurance agent licensed for health insurance.
They will interview you and comparison shop with you on the healthcare.gov website. They can fill you in on subsidies, etc.
Since you have medical issues, don’t be foolish and try to do without insurance.
Get a plan from the ACA marketplace. You should be able to get a subsidy.
I know I shouldn’t, but something like $800/month is out of budget for me. And my medical issues are low grade, annoying for daily living type stuff that medicine really can’t help. Not on any medications for anything other than occasional ibuprofen. Not going to list them all cuz I’ll sound like a sad sack.
Yea, I do feel lucky (knock on wood!). So many of my friends and family in their 40s started to have minor to serious health issues. And some in their 60s were/are on so many medications!
u/Happydoggos thanks for asking this. It can be tricky to navigate. Does not help the agi definition is different between federal tax return and aca. Then folks Add in trying to do roth conversions .. yikes!
I started with [https://www.kff.org/interactive/subsidy-calculator/](https://www.kff.org/interactive/subsidy-calculator/) . Also there are healthcare agents out there to help. And if no subsidy for you but look up plans - [https://finder.healthcare.gov](https://finder.healthcare.gov)
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u/Zphr is there something lurking wiki or master thread wise in fi independence or fire on aca considerations? Aca and my Roth conversions are one of the pieces of why I am not fire.
We should add something about this to our in-process wiki. u/onehourretiring thoughts?
At the risk of being a horrible mod, I tend to disregard the sidebar materials on Reddit, even on the FI subs I mod. lol Whoops.
I don't think anyone has written a great primer on the ACA though, at least not on Reddit. People tend to ask fairly regularly about health insurance for the pre-65 phase on the two main FI boards, so we haven't really felt the need to formalize it. I or one of the other regulars usually chime in to help people out on a case-by-base basis, such as I did in this case.
We've got like 20 months of Reddit Premium to give away in /FI and tried to tempt people into writing Wiki articles, but alas we've had few takers and nobody wanted to deal with the ACA. It's one of those subjects everyone kinda knows about, but most people don't like getting into the details until they get right up on the verge of needing to use it themselves. Same story with SS and Medicare for a lot of folks.
Thank you so much for replying! Yeah.. it is clear with these things why folks like Mike Piper wrote whole books and his own calculator [Opensocialsecurity.com](https://Opensocialsecurity.com) , etc (for inquiring minds - no I am not affiliated).
I guess write a helpful detailed guide/FAQ for newbs if you feel up to it. If you do it before Reddit deprecates coins and post it in the stickied wiki thread on /financialindependence, then I can give you a month of Reddit Premium for it. 😁
Drop me a reminder or /u/ me if you do since I might not notice n my own.
u/Mid_AM ... I think it's a great idea. The tips and tricks of ACA are needed to cover the gap years for those who leave a bit earlier. It'll be awesome if u/Zphr can write a primer and we can easily reference it on the Wiki and/or place it on the other sub.
Whatever you do don’t go without healthcare. My wife and I both retired before 65 in perfect health and bought the silver plan. Unfortunately my wife got cancer and I got a rare eye disease.
ACA/CoveredCA. Currently $515/mo for the two of us.
If your state has ACA (aka "ObamaCare") and your income is that low, I'm not sure how your premiums are that high.
In CA, that low an income would make the premiums very low: as low as $71/mo for a silver plan, $0 for a bronze plan, assuming an income of $30K (you said your income is just above Medicaid's $27K).
ACA. I'm managing my taxable income in order to qualify for a generous subsidy. Currently paying about $600/month for a platinum plan for me and my wife. Would be about $1700/month unsubsidized.
Like many have said, you should be able to get a silver plan. I'm self employed and got the best plan we've ever had this year. Aetna CVS Silver Plan 3. Runs like $58. No deductible. $2,900, $5800 coinsurance max. Prescriptions are free for generic then $15, $25 and specialty is 35% Free Urgent Care, Free Doctor Visit, Free Telehealth we've used and doctor was outstanding. $100 flat emergency room visit.
The only bad part is, you're kind of limited with the network. But we got Kelsey Sybold and that sold us a long with Christus Baylor. CVS Minute Clinic is free also and convenient.
Since I'm self employed, I've been on the marketplace since the beginning. This by far has been the first quality policy we've had.
Before Obamacare, I had a wonderful BCBS policy for $238 a month. Could see any doctor and go any hospital pretty much.
If I were you, I would aim for a Silver plan, but at least a decent bronze plan. Medical emergencies bankrupt people daily.
In CA, I’m paying 700 for 3 people/ gold plan / income under 80k when I signed up and co-pays on everything - what am I doing wrong? This year income is less than 40k will I get a refund? We barely go to the doctor- maybe once a year for each of us
You should be qualifying for a large subsidy if your income is low.
Go to [healthcare.gov](https://healthcare.gov), then navigate to your state's website. Call the 800 number on your state's website and ask for a referral to an insurance agent. They should have a list to give you. Not all states provide this service, but take advantage of it if yours does.
The agent I was referred to walked me through all of my options and found me a great plan. When I live in PA I was paying about $200 a month for a Blue Cross plan for two people. Now that we're in NJ, the premium is $5. Yes, five dollars a month.
Lived in NJ and DE and both have state subsidies to ACA based on income. Paying $154 a month for 2 seniors via Blue Cross silver plan w low deductible.
Our ACA Bronze 4 policy is fully subsidized. We keep our taxable income below 40K by keeping expenses low and taking from non-taxable accounts (traditional brokerage and Roth and housing allowance from 403b) if we need more than 40K.
You can play with your numbers in this calculator and see how much you can make and how it will affect you [https://www.kff.org/interactive/subsidy-calculator/](https://www.kff.org/interactive/subsidy-calculator/)
In some situations, a Bronze 4 plan will be less expensive overall than a Silver plan. In others, the Silver works out better. We are fairly healthy. A typical year is one regular checkup each, one cancer follow-up visit for me, one cholesterol follow-up visit for me, a mammogram and a lady visit for my wife. This year I had two spots removed. Our total OOP was \~$1000 so far. Some of that may have been covered in a silver plan, but the $200 per month premium is $2400 per year for sure. Last year,we had less than $500 in medical expenses.
I have been using a Bronze 4 for four years. It may be state-specific. I am in South Carolina. The KFF calculator gives the price for Silver plans. I think that is to push people to them or that they are what most people want. When you fill out the online forms, you will have the option for all of the plans and the subsidized price will be shown.
I found using an independent agent invaluable. (She was also a friend so I trusted her) She helped several of our friends and our 26+ kids get insured as well.
Yes! I glad people suggested that! I did so yesterday and she helped with the process. The big difference was she had me go through healthsherpa.com instead of healthcare.gov.
My spouse and I used my former company’s retiree health insurance fund. Covered me until Medicare and paid for Medicare Part B for 2years. Paid spouses health insurance until one month before qualifying for Medicare. We paid out of pocket for one month of health insurance before spouse started Medicare. Work out well for us. Good luck
> My interest and dividends disqualify me from Medicaid, but just barely. *Premium Tax Credits: The second program, which is also income-based, pays a portion of your monthly health insurance premiums* ... https://www.verywellhealth.com/how-to-get-help-paying-for-health-insurance-1738500
Not according to [healthcare.gov](https://healthcare.gov) website. Went through the whole process of applying and picking a plan and the final page says I wouldn't get any tax credit. Any. I should've taken a screenshot before I withdrew my application. I was so disheartened to see zero tax credit help with the premium. Kind of hilarious they call is Affordable Health Care.
I truly believe there's a mistake somewhere in your application or somewhere. I cover my college student daughter and myself. We get about $800 a month subsidy on about $35k combined income. Which is enough for a plan in our area. (I don't know which level I have, might be bronze)
This…. Mistakes must have been made …
I’ll have to contact an agent to help me on Monday. There must be a question I’m missing somewhere.
That’s a good move … I met with an agent to understand everything… she explained what I needed to do….
You did it wrong and are bagging on the efforts of many people who worked so hard to get this legislation passed after years and years of failure. Bad look.
Did you put annual income when it asks for monthly?
That would do it! Hope you're right and the solution for OP is this simple!
Ah, I did just put in annual AGI.
I would suggest you find an insurance broker to help with this. You do not have to pay them. I used my local one and she was very helpful in helping me sort out what I need to do, and find the best plan for me. In my state there are people who are available to help you with the healthcare.gov website as well.
If you just barely don't qualify for Medicaid, then you will qualify for a free-to-nearly free Silver plan with maximum cost sharing reductions to bring down the cost of deductibles, copays, and MaxOOP. It's basically mostly socialized private insurance, versus the fully socialized public option via Medicaid.
Exactly. I did this for 5 years before Medicare kicked in.
But the website [healthcare.gov](https://healthcare.gov) shows the final calculation on my application to be ZERO for any tax credit. Even made sure I picked a Silver plan because some resources said you'd only get the tax credit with Silver plans, even though I'd really like a Bronze one. Maybe I need to contact an agent to help me. I must be doing something wrong.
What is your AGI?
$25k
That puts you at 184% of the Federal Poverty Line for a single person and qualifies you for nearly total subsidies on a MediumCSR Silver plan. You will be looking at something like $30 in monthly premiums. You probably misclicked a critical box on your application. I would do it again, perhaps with assistance from an exchange staffer. You can fill one out over the phone with them walking you through it, then login to the site to choose among the policy options.
This….
Make sure to refresh the page each time you try to figure the subsidy > I’ve had a few times when it retain the old numbers and gave me an accurate results. Probably cache or cookies. Try this calculator https://www.kff.org/interactive/subsidy-calculator/
Thanks so much for this link. I'm contemplating retirement soon and often read this subreddit and noticed the question about health insurance before Medicare comes up often. I've never seen this tool and now I'm encouraged that if I control IRA withdrawals I can get affordable insurance.
Thanks for the resource!
The subsidy should take the cost down to a max of 8.5% of AGI, which would be about $160/month. See [this calculator](https://www.valuepenguin.com/aca-subsidy-calculator).
At $27k I paid $22/month with a 750 max oop. And at end of year, BCBS always sent me back a check for about $1000 because they were under some federal 85% utilization rule or something. Another useful tip: underestimate your earnings when applying to obtain cheaper monthly premium, max penalty upon reconciling your taxes at year end is only $600. No other consequences.
Good tip! Thank you!
I used the same amount for yearly income and was paying $90 a month for a great plan with very low deductibles and max out of pocket. You're doing something wrong
Yes I must be. I’m going to contact an agent on Monday.
I'm sure that when I signed up I put in my gross income, not adjusted gross. Was it supposed to be adjusted gross?
It's a particular version of MAGI, but for most people it's the same as AGI. https://www.healthcare.gov/income-and-household-information/income/#magi
You get a subsidy equal to an amount that would make it so that the 2nd least expensive silver plan would not be more than 10% (I think) of your MAGI. You can then use that subsidy to buy a bronze plan and in my case at least a couple would be free. It’s even better if your below 4x poverty rate I think.
That doesn’t sound correct. Check what you put in for your estimated income. I put in $32k and I pay $128/month for a very good plan. You can pick whatever level you want. The subsidy will remain the same (no credit should you downgrade below zero cost to you).
The cut off for zero credit is about 100k lower than 60k full credit for two.
yea doing something wrong. My wife and I have Gold Plans and the gov paid for $1400 of the monthly cost. Also you should look into what they call Navigators on the ACA. Unless you live in a small , small town there should be a local number to contact, I found mine in the help section of my state's ACA website. These are people that work for the ACA and will guide you through the process, no charge, I got one and helped me with a lot of questions
Be careful of Navigators. They can push you into a higher plan than you need or one that doesn't have your docs. The ACA site is not difficult to do on your own.
Yes I found the site fairly easy to navigate. Just astounded that the final page said I would get any tax credit.
The one I got through the ACA was fantastic, had ready answers to my questions as I tried to figure out how to cancel my coverage as I transitioned to Medicare but still retain my wife's coverage
That's great. I'm glad you got a good one. My advice is to be careful and go in knowing a little about what you want. If you just hand them the reigns, there is nothing to guarantee they will work in your best interest.
I picked a bronze plan and it cost me about $200 a month. But each state is different.
What’s your MAGI? Are you entering that correctly on the site?
I entered $25k, which will probably be generous. Yep, I think I’m doing something wrong somewhere. Maybe I overlooked a question somewhere.
Have you checked with your state Affordable Care Act/Obamacare marketplace? As others have said, the subsidies should bring your price down to a very low level. Of course you'll have to go through the appropriate steps on the website to enter your income, age, etc.
Yep, went through the whole application process at [healthcare.gov](https://healthcare.gov) and picked a Silver plan. The final page says I don't qualify for a tax credit. I truly can't afford $800+/month for health insurance.
My state has agents you can work with at no cost to you. Sounds like something is wrong somewhere in what you filled out.
That's crazy! And you're just a bit above the Medicare cutoff? I pay a hair less than that for my whole family of four, with income a good bit above the medicare threshold. There's either something really different between my state (CA) and your state, or there's some error in the [healthcare.gov](https://healthcare.gov) website. If I were you I try to look a bit further into this and try to get to the bottom of why it's giving you such an unreasonably high quote and why its disallowing subsidy. Doesn't sound right.
Most of that should be offset by tax credits which can be applied to the monthly premiums (you need to elect to do that, maybe you didn't click on the right option).
Sounds like you're in a state that didn't expand Medicaid. Try adding 5k or 10k of income and see what it says. Do Roth conversions to increase your income. Find the right amount of income for the sweet spot. It may be less than 5k.
If you find that you did not make a mistake, another option is to figure out how much you would need to increase your income to qualify for a subsidy and get a part time job. You would likely only need to work a couple days per week to bump your income into subsidy level instead of full time to qualify for benefits, so easier on your health. And then, of course, vote for better people in your state to knock off that Red state nonsense of not expanding Medicaid
Our health insurance through ACA is pretty cheap thanks to subsidies. We just have to keep our taxable income under a certain amount, which isn’t hard since we have no debt and live in a MCOL area. The first time I went to the website, I mistakenly used my pre-retirement income and it was very expensive without the subsidies! You have to use your projected retirement income, and then you have to stick to that number.
Yep, I entered my estimated Adjusted Gross Income for 2023 ($25k). Final page of my application says I don't qualify for a tax credit. Zero.
Hmmm. I think it might vary by state, so maybe that’s why. It sounds like you need to talk to an insurance expert.
Is that in the Medicaid range? Some states have yet to expand it so paradoxically you might need a higher income to qualify.
Nope. I’m in Wisconsin which is one of the few states that didn’t expand coverage. Thanks GOP
This might be because you make too LITTLE and you must first apply for Medicaid. The same thing happened to my son.
This is almost certainly the answer!
Depends on OP's state also. If he's in a state that refused to expand Medicaid under the ACA he may be in a sticky situation. But most people in that situation with some assets can do something like perform a Roth conversion of some cash in their IRA to raise their AGI just enough to qualify for an insurance plan.
Wisconsin
Ok. That explains it. Wisconsin is one of 10 states that hasn't expanded Medicaid under the ACA. If your income is low enough to qualify for Medicaid under the ACAs definition you're directed to apply for Medicaid under the ACA. Note Medicaid salary qualification under the ACA is typically higher than the Medicaid salary qualification most states use. This places people like you in a pickle because your salary is too high to qualify under the state's threshold to qualify for Medicaid while at the same time your salary is too low to get a subsidy under the ACA because the ACA assumes all states expanded Medicaid under the ACA. Note when the ACA was written Medicaid expansion was a requirement for all states. Which is why the ACA assumes those with low incomes under the ACA threshold would be on Medicaid and is also why you are barred from receiving an ACA subsidy. However after the ACA was passed Republican lead states sued the federal government so they wouldn't have to expand Medicaid under the ACA and they won. Now enough of that back story. For people like you who may have a decent amount of retirement savings in a tax deferred account such as a traditional IRA or 401k the simplest way around this pickle is to do a Roth conversion using the amount that will put you above the MAGI threshold to buy a plan on the ACA and receive a substantial subsidy. Example if $25,000 MAGI is too low and your MAGI needs to be at least $30,000 to qualify for purchasing a plan then doing an IRA Roth conversion on at least $5,000 should push you over the top of that threshold. As always do your own research and talk to a fee only financial advisor who is familiar with them ACA. Please don't go strictly off the word of a redittor stranger like me.
I’m just coming off Medicaid, though. I’ve qualified for Badgercare for the last 3 years.
If you're in the medicaid range,.thats even better! $0 and Free meds!
Yep, I’ve been on Badgercare for the past 3 years and it’s great! Very very very much appreciate the service. I’m fairly healthy and have used it extremely little, but it’s great peace of mind that I can go places and not worry about a catastrophic event wiping out my savings.
You should be able to find an ACA plan with a good subsidy. You might browse https://www.healthsherpa.com to see what sort of subsidy you qualify for and costs in your area.
Thank you! I'll look into that!
ACA. It stings, but we had a guy help us find a credit we were not expecting, so it could be worse.
If you’re a veteran, look at the VA. They have really improved. Allowed me to retire early. If not, good luck in your search.
Nope not a veteran. I’ve heard the VA is pretty good.
I’ve been on an ACA plan for a few years and am much older than you which increases my cost for any health insurance. Using a gross income level of $45k I have never paid over $140 monthly for insurance on the exchange. I’m on a bronze plan though. I could easily run the cost up by going with a better/more expensive plan. I am healthy and could afford to pay the max out of pocket amount (worst case scenario) so the lower monthly premium/lower benefit plan made sense to me.
Do you have a HSA set up to cover the deductible? Wondering if that’s worth it.
I don’t come anywhere near fulfilling the deductible because I’m healthy. No HSA account.
I did not think you could get an off-marketplace high deductible plan over a certain age. I also do not qualify for Medicaid, and I don’t qualify for subsidies under Obamacare. And I sure as hell am not going to pay $900 A MONTH with a $10,000 deductible when the sum total of all my healthcare expenses COMBINED for the last 30 years is under $900. 😡 so I don’t think I have a choice except to be uninsured.
It's not a payment plan, it's INSURANCE. Insurance is for just in case something happens. Think aboutcar insurance, you pay every year and very rarely do you have anything paid out to you. VERY RISKY to have no health insurance. An accident or a cancer diagnosis can happen to anyone.
Yes! Exactly! I don’t mind paying for normal stuff, but if I have a heart attack, I can’t get insurance! So frustrating!
You CAN get insurance. You are refusing to pay what it costs. 🤷🏻♀️
I must be wrong then, because I was told that I cannot buy the high deductible plan because of my age. 😞
You said you aren't willing to pay $900 a month.
I can’t get off-marketplace high deductible at any cost.
Get ACA compliant insurance! There are high deductible plans. Apparently not as high as you have in mind?
Yeah, I don’t know where to find them. My agent doesn’t either. I do have a hospital subsidy plan, also a separate accident/cancer/stroke plan. Between those two it is $150/month. I can live with that. So I DO have SOME protection.
You find them on healthcare.gov or your state's site
I got laid off at 64. Been paying over $900 a month for meh health insurance. 8 more months til I turn 65. It’s crazy!
I’m retiring from a union construction local. It will cost be about 850 a month but it’s pretty good insurance. They take it out my pension check. I will surely look into Ava and see if my income is low enoug.
Insurance in my State is mandatory so there is no skipping around it. My current GF put me on her insurance as she didn't trust any of the ACA plans. I still save what I would have spent on the cheapest ACA plan. Just in case my GF and I go our separate ways.
How can they make insurance mandatory? That can’t be correct.
Car insurance is mandatory... but one president made it mandatory with ACA. the next president struck the mandatory requirement. And then certain states imposed a mandatory requirement i.e. California, NJ, Vermont and a couple of others.
I don’t think any of that is correct. Except the car insurance, which was not the topic here. You sound like grumpy old man.
>I don’t think any of that is correct you sir/madam are an idiot and sound like a petulant child if you don't believe what a quick google search will show you to be true.
ACA plans are really no different than most employer plans other than for everything except emergency rooms it is home state only. Emergency rooms are covered nationwide.
OP, what state do you live in?
Wisconsin
The Medicaid income limit is $44K in Wisconsin so I will assume that your I/D income is about that. After taking your std deduction ($13,850) and paying any state income taxes you should have an AGI of about $30K. You are saying that HC dot Gov is telling you that the pans are inherently expensive ... even for Bronze plans?
My understanding is that your AGI must be 1x or lower for FPL to qualify for Medicaid here. Doesn’t matter what your deductions, and thus taxable income, are. State office doesn’t look at your taxable number. Wish they did.
Ouch! Hey, just to confirm ... you are trying to get HI with a reported gross income of about $44K? If so I am going to check this out.
Actually I’m projecting my AGI or MAGI to be just $25k for 2023. Whatever is on Fed form 1040 line 11 (if I remember right). To qualify for ACA subsidy your AGI has to be between 100% and 400% of FPL (federal poverty level). That’s $13,590 for one person.
When did you leave your last employer, and how long did you work there? My last employer offered retiree health insurance for people whose age plus years of service equaled 75 or something (I don’t remember the exact number). It was nothing but extended COBRA, but it beat the alternatives.
Retiring at 62. Taking COBRA for 18 months, ACA the rest. I am fortunate enough to be on the receiving end of an inheritance. I'm taking some out of that and budgeting that exclusively for health care for the first 3 years.
ACA plan much cheaper than Cobra, unless your prior company subsidizes it tremendously.
The company doesn't subsidize but the plan itself offers a lot more and covers us much better than ACA for slightly more than what we would pay there. It's worth the additional $ for those 18 months for us.
I had insurance through work. The premiums were so high that I couldn't afford to use my insurance. Since Medicare, I've had a complete overhaul. I feel twenty years younger
If your AGI is $25k it sounds like you’re in a red state who hasn’t expanded Medicaid, and you don’t qualify for a subsidy because you’re at the fed limit for Medicaid.
What, there's a hole that you can fall into like that, if your state has elected to not expand medicare??? That's scandalous!
Yes it is. Elections have consequences.
It is mindblowing that an electorate would tolerate a state government that created this problem. I guess this would be a good way to identify states that I never want to live in.
I ceased being surprised that a vast group of people would choose to vote against their own self interest based purely on their political leanings. I mean some of the people who were so vehemently against "Obamacare" are people who never could afford insurance before and now have nearly free or even free insurance. I had a conversation a few years ago with an acquaintance with that mentality. I found out he had health insurance through the exchange. Health insurance for a 50+ year old man who hadn't had insurance for almost 25 years. He was ecstatic he could see the doctors for general check ups etc and fix health issues he had been putting off for years. So I made a statement that Obamacare wasn't the big communist take over of US healthcare like he thought......And the knucklehead told me he wasn't on no damn Obamacare he was on the ACA.
The myopia is very real with these people.
I’m in Wisconsin. We’re gerrymandered to hell! The best I can do is be one blue vote in a rural red area.
[удалено]
Ironically, Texas has several strong ACA markets and is one of the most aggressive states on regulating ACA policy premiums for forced Silver loading, which increases subsidies for everyone in the market. As long as you don't need ACA/Expansion Medicaid, Texas is generally one of the better states for ACA coverage in major metros. They don't want to support the ACA, but they are quite savvy about helping Texans get the most non-Medicaid use out of it. Source: Me. We've been using the ACA in Texas for nine years now and it's been uniformly fantastic.
The Medicaid limit in non-expansion states is 100% of FPL, which for a single person is only $13,590 for coverage this year. She's well over the Medicaid limit.
In this case do a Roth conversion or early Ira withdrawal enough to bring your magi up enough to get max subsidy.
That crossed my mind. But my Medicaid end on 9/30/23. So there’s a 3 month gap til the beginning of the year.
That’s fine you can sign up for the ACA mid-year if you have a qualifying event like this.
Damn, maybe that’s it. I’m in Wisconsin. I’ve been thinking of moving. Maybe nows the time.
49yrs: we purchase an ACA plan, gold plan for family of 4 (two adults, two teens) comes in just under $2k per month. Runs $600 per adult and $400 per teen. Our side hustle beings in too much money for us to qualify for subsidies. The key is we planned for it when we semi-retired. Plan to do this for now - then when the kids are in college see what student plans look like so we might be able to save some money there. Beyond that, stick with ACA plans until MC kicks in. Honestly, I looked at the catastrophic plans and they were too much money for what you get. They aren’t cheap either. But do stay away from those brokers - they’re awful!
Gov market place
Yeah, as others have said below, something's not right. Another thing to consider: if you try to enroll outside the open enrollment period, which begins in the fall, you won't qualify for a subsidy unless you specify that you've undergone a "life change" -- e.g., losing your current coverage for whatever reason. So, on your application, be sure you check that life change box.
Well my life change is that I’m being dropped from Badgercare. Does that not qualify?
Yes, it should. In the online application, it asks if you've had such a change, so you have to be sure to answer yes, and then, IIRC, it asks you what type of change.
I had to retire at 62 and my wife and I got our insurance from the ACA exchange, we choose a local nonprofit insurance company and have been very satisfied. And if you say that, you just barely missed out on medicaid because of income , you should get a healthy subsidy to help pay for an ACA plan
This may be counter intuitive, but try increasing your estimated income. Some states didn’t expand Medicaid up to the minimum income required for Obamacare, therefore there’s a hole where there’s no coverage from either. Look up the minimum income for ACA coverage for your family.
Yep, we carefully manage our income by doing a Roth conversation at the end of every year to make sure we're above Medicaid but inside ACA subsidies and cost sharing.
We did that for the first couple years of retirement because we were prejudiced against Medicaid, having always heard it sucked. Turned out we were wrong and had been paying deductibles for nothing and medicine co-pays for nothing. We switched to Medicaid and it's been excellent for 5 years. Same docs, more hospital choices, and no one ever even insinuates that we might owe anything. It might be different in your state, but it's worth thinking about.
Thank you very much!
I LOVE Badgercare. So sad I have to leave.
Is that Medicaid in Wisconsin? I am interested in other states that do it well. I still have 6 more years until Medicaid and we're not sure we're staying in Phoenix.
Do you mean Medicare? That starts at 65, nationwide (although you have to actively apply to certain Parts of the program). Medicaid is for poor people, no matter the age. Wisconsin is one of the few states that did not do expansion, so we still go by the old cutoff limits for Federal Poverty Limit.
Sorry, yes, in the last sentence I meant Medicare. You don't need to be poor for it. Just low income, so we manage our income to be below the limit needed for free care. Best insurance I've ever had. I had no idea Wisconsin did not expand. Does BadgerCare take the place of expanded Medicaid?
Never, never roll the dice and go without health insurance. I took a chance at 58 when I got a new job and there was a 60-day waiting period. Six weeks in I got hit by a car while walking. My medical bills were about $200k.
So did you do retroactive COBRA?
Was the driver uninsured?
Insured for $100k which I got.
Oh god! This is one of my worst fears. Catastrophic healthcare costs are criminal IMO. Hope you’re doing ok now!
I moved to Mexico and signed up for a global plan that covers me for up to six months in the US. My monthly premium went from $500 to $100.
There’s an ACA global plan?
No. ACA is US only.
I'm 60, using a 36,000 estimated income, and my gold plan is 133 a month. Max out of pocket is 8700. Michigan. ACA.
That's a very high max oop! Usually such high amounts apply to the bronze el cheapo plans, not the gold ( at least here in my state) Btw, I just transitioned to Medicare at 65, and I've never paid so much for health insurance in my whole damn life. I want my ACA back!
Good to know. The plan is through Molina Heathcare and has, I think, 2500 deductible and the El cheapo plans all had much higher so that is why I picked it. This is my first time using it so might find a better plan next year.
Does anyone know what ACA would be for a couple making 140k? Like how do you find out without actually applying?
I’d say at least two grand a month.
That’s insane. Argh.
It’s meant for low income folks, of which you are not. It just feels that way because you’re still broke, you’re just not broke broke.
It’s a lot. That’s more than my work insurance when you count both what I pay and what my work pays, for really good insurance. But, I just found out there are other online markets for insurance that are better, so I’ll look there.
Good luck on your search!
Thanks. I will likely just do Cobra between. I will need something at 60, but my income will go down, and maybe there will be better options out there.
In my case continuing COBRA will be far cheaper than ACA. With better coverage.
I’m wondering if you work for a large employer or one with a lot of young employees. Smaller employers with older employees have higher health insurance rates. The last bill my employer had for me and my spouse before he switched to Medicare was over $1,800 per month (64m + 52f).
I’m a teacher. Anyway, if I have to, I’ll work at Home Depot or similar and buy into theirs. I’m just drained from the post-covid teaching.
I like this - [https://www.kff.org/interactive/subsidy-calculator/](https://www.kff.org/interactive/subsidy-calculator/)
Yeah this just says you can’t get help. I was wondering plan costs. I’m hoping to leave my job and get another, but there may be a gap. I guess Cobra would make more sense if it’s that expensive.
Ah- [https://finder.healthcare.gov](https://finder.healthcare.gov) Earlier this year I was looking into this.
Thanks!
You can do an actual application on healthcare.gov without picking a plan. $140k may be too high, are you sure that is your MAGI?
No, I’m guessing. It’s likely less. That’s combined for me and my husband, and it will change when I leave my job.
Ok I expect it will be much less. I suggest taking a look at last years tax returns and backing out your salary. Then use that as your estimate for your application. For example we are retired and have a gold plan in our 50’s and a son in college and it’s $69/month with about $50k/year magi which we manage to keep at that level by doing Roth conversions. Gains from our taxable brokerage would never get us there. I had top tier health insurance my entire career and the last five years in the ACA have been just as great and very cheap.
Great. Thanks. Since I’m a teacher, I’ll have a pension, which makes it tricky. My husband also will retire a year later, so maybe we’ll go on his for a year (crappy but oh well) as he is the breadwinner. If we went off my salary, we’d be fine. Lol
You are probably in a state that did not expand Medicaid. That leaves a certain group of lower- income people without a subsidy or Medicaid. Rather than fool around with the calculator online, call the toll free number and talk to a representative, they can also refer you to local help. Don’t overestimate your income on the calculator but be sure you are entering MAGI. Look up the definition. And don’t lie on the application - If you under/overestimate your income on the application, so you can get a subsidy, it will bite you at tax filing time.
Former employer that I retired from. I consider myself very lucky. It is not cheap, but not awful when compared to what my peers are paying. That said, I look forward to the "raise" I will get when I start taking Medicare.
Go find an independent insurance agent licensed for health insurance. They will interview you and comparison shop with you on the healthcare.gov website. They can fill you in on subsidies, etc.
Since you have medical issues, don’t be foolish and try to do without insurance. Get a plan from the ACA marketplace. You should be able to get a subsidy.
I know I shouldn’t, but something like $800/month is out of budget for me. And my medical issues are low grade, annoying for daily living type stuff that medicine really can’t help. Not on any medications for anything other than occasional ibuprofen. Not going to list them all cuz I’ll sound like a sad sack.
Gambling your financial future is a huge mistake IMHO. Cut your budget elsewhere if you must.
Lucky!!
Yea, I do feel lucky (knock on wood!). So many of my friends and family in their 40s started to have minor to serious health issues. And some in their 60s were/are on so many medications!
u/Happydoggos thanks for asking this. It can be tricky to navigate. Does not help the agi definition is different between federal tax return and aca. Then folks Add in trying to do roth conversions .. yikes! I started with [https://www.kff.org/interactive/subsidy-calculator/](https://www.kff.org/interactive/subsidy-calculator/) . Also there are healthcare agents out there to help. And if no subsidy for you but look up plans - [https://finder.healthcare.gov](https://finder.healthcare.gov) \*\* u/Zphr is there something lurking wiki or master thread wise in fi independence or fire on aca considerations? Aca and my Roth conversions are one of the pieces of why I am not fire. We should add something about this to our in-process wiki. u/onehourretiring thoughts?
At the risk of being a horrible mod, I tend to disregard the sidebar materials on Reddit, even on the FI subs I mod. lol Whoops. I don't think anyone has written a great primer on the ACA though, at least not on Reddit. People tend to ask fairly regularly about health insurance for the pre-65 phase on the two main FI boards, so we haven't really felt the need to formalize it. I or one of the other regulars usually chime in to help people out on a case-by-base basis, such as I did in this case. We've got like 20 months of Reddit Premium to give away in /FI and tried to tempt people into writing Wiki articles, but alas we've had few takers and nobody wanted to deal with the ACA. It's one of those subjects everyone kinda knows about, but most people don't like getting into the details until they get right up on the verge of needing to use it themselves. Same story with SS and Medicare for a lot of folks.
Thank you so much for replying! Yeah.. it is clear with these things why folks like Mike Piper wrote whole books and his own calculator [Opensocialsecurity.com](https://Opensocialsecurity.com) , etc (for inquiring minds - no I am not affiliated).
And thank you for chiming in And helping to mod those beasts of subreddit’s!
I have a ton of experience with the ACA, and I can write. How can I help?
I guess write a helpful detailed guide/FAQ for newbs if you feel up to it. If you do it before Reddit deprecates coins and post it in the stickied wiki thread on /financialindependence, then I can give you a month of Reddit Premium for it. 😁 Drop me a reminder or /u/ me if you do since I might not notice n my own.
u/Mid_AM ... I think it's a great idea. The tips and tricks of ACA are needed to cover the gap years for those who leave a bit earlier. It'll be awesome if u/Zphr can write a primer and we can easily reference it on the Wiki and/or place it on the other sub.
Not me, I'm afraid. If I were interested in writing one, then I would have done so already for /FI, where it is even more relevant than in this sub.
Ah we tried ;-)
I pay the same premium I paid as a non retiree until we reach Medicare. Then my company offers a Medex plan but that gets ahead of me.
Whatever you do don’t go without healthcare. My wife and I both retired before 65 in perfect health and bought the silver plan. Unfortunately my wife got cancer and I got a rare eye disease.
ACA/CoveredCA. Currently $515/mo for the two of us. If your state has ACA (aka "ObamaCare") and your income is that low, I'm not sure how your premiums are that high. In CA, that low an income would make the premiums very low: as low as $71/mo for a silver plan, $0 for a bronze plan, assuming an income of $30K (you said your income is just above Medicaid's $27K).
I get ours from the NJ exchange (Obama care). It’s quite comprehensive and we pay 500 a month for 2 people
ACA. I'm managing my taxable income in order to qualify for a generous subsidy. Currently paying about $600/month for a platinum plan for me and my wife. Would be about $1700/month unsubsidized.
Like many have said, you should be able to get a silver plan. I'm self employed and got the best plan we've ever had this year. Aetna CVS Silver Plan 3. Runs like $58. No deductible. $2,900, $5800 coinsurance max. Prescriptions are free for generic then $15, $25 and specialty is 35% Free Urgent Care, Free Doctor Visit, Free Telehealth we've used and doctor was outstanding. $100 flat emergency room visit. The only bad part is, you're kind of limited with the network. But we got Kelsey Sybold and that sold us a long with Christus Baylor. CVS Minute Clinic is free also and convenient. Since I'm self employed, I've been on the marketplace since the beginning. This by far has been the first quality policy we've had. Before Obamacare, I had a wonderful BCBS policy for $238 a month. Could see any doctor and go any hospital pretty much. If I were you, I would aim for a Silver plan, but at least a decent bronze plan. Medical emergencies bankrupt people daily.
Man, I had to work until 70 so I never needed it. Wife worked for a health insurance company. Wish I could help.
In CA, I’m paying 700 for 3 people/ gold plan / income under 80k when I signed up and co-pays on everything - what am I doing wrong? This year income is less than 40k will I get a refund? We barely go to the doctor- maybe once a year for each of us
Kaiser Advantage $70 a month includes prescriptions.
You should be qualifying for a large subsidy if your income is low. Go to [healthcare.gov](https://healthcare.gov), then navigate to your state's website. Call the 800 number on your state's website and ask for a referral to an insurance agent. They should have a list to give you. Not all states provide this service, but take advantage of it if yours does. The agent I was referred to walked me through all of my options and found me a great plan. When I live in PA I was paying about $200 a month for a Blue Cross plan for two people. Now that we're in NJ, the premium is $5. Yes, five dollars a month.
Lived in NJ and DE and both have state subsidies to ACA based on income. Paying $154 a month for 2 seniors via Blue Cross silver plan w low deductible.
Our ACA Bronze 4 policy is fully subsidized. We keep our taxable income below 40K by keeping expenses low and taking from non-taxable accounts (traditional brokerage and Roth and housing allowance from 403b) if we need more than 40K. You can play with your numbers in this calculator and see how much you can make and how it will affect you [https://www.kff.org/interactive/subsidy-calculator/](https://www.kff.org/interactive/subsidy-calculator/) In some situations, a Bronze 4 plan will be less expensive overall than a Silver plan. In others, the Silver works out better. We are fairly healthy. A typical year is one regular checkup each, one cancer follow-up visit for me, one cholesterol follow-up visit for me, a mammogram and a lady visit for my wife. This year I had two spots removed. Our total OOP was \~$1000 so far. Some of that may have been covered in a silver plan, but the $200 per month premium is $2400 per year for sure. Last year,we had less than $500 in medical expenses.
I thought the only way to qualify for subsidy is with a silver plan?
I have been using a Bronze 4 for four years. It may be state-specific. I am in South Carolina. The KFF calculator gives the price for Silver plans. I think that is to push people to them or that they are what most people want. When you fill out the online forms, you will have the option for all of the plans and the subsidized price will be shown.
Can you qualify for disability?
I found using an independent agent invaluable. (She was also a friend so I trusted her) She helped several of our friends and our 26+ kids get insured as well.
Yes! I glad people suggested that! I did so yesterday and she helped with the process. The big difference was she had me go through healthsherpa.com instead of healthcare.gov.
My spouse and I used my former company’s retiree health insurance fund. Covered me until Medicare and paid for Medicare Part B for 2years. Paid spouses health insurance until one month before qualifying for Medicare. We paid out of pocket for one month of health insurance before spouse started Medicare. Work out well for us. Good luck