State sponsored insurance and obamacare... (non political)

[TMG51]

I just had a frank phone conversation with my state-sponsored insurance carrier, in which I informed them their system is the most horrible piece of crap I've dealt with in my life and that for 2016 I'll opt to go without insurance and pay any fines I incur, as I would rather pound rusty nails through my sensitive bits than deal with them for another year.

Anyone else familiar with Vermont Health Connect? Surely other states have similar programs? Are they all as bad?

I'm young, healthy, employed. Previously, I had health insurance through my employer. Coincidentally, right when all this Obamacare mandated insurance stuff started, I changed employers and went to a higher paying position that did not offer health insurance. That meant I had to buy insurance from the state in order not to be penalized for not having it (penalty is based on income). Every single month they got my billing wrong, every month I would call to complain, they said they would fix it, they never did, they cancelled me due to their own inaccurate billing, had to fight to get reinstated, their online system doesn't work, can't make electronic payments, have to mail a check and reference a payment code each month... most of the time I can't even log in to their system to see my (inaccurate) statements. I can't even get my tax info right now.

Maybe this is a reason in and of itself to change my residency state? Can anyone in a similar situation (not on medicare, etc) offer any input as to which states might have better insurance programs? I don't even know what I will be fined but this VHC frustration is just not worth it. Surely there must be another option.

Remember, no politics, just logistics.

 

[WriterMs]

I have health insurance again via South Dakota, but I did not last year because the state didn't participate, etc. etc.

I had insurance the first year of Obamacare through SD (because the state used the federal marketplace).

I cannot say anything about care received because I have not actually used any of the services at all (not in 2014 nor this year). But, the insurance company itself (Avera) seems to be on the ball just fine. No billing weirdness or such. I am going to be talking with them to learn if a part of cataract surgery would be covered, so I may know a lot more within the month.

You do know, I"m sure, that you can go directly to an insurance company to get a quote for your individual insurance. You can use a state's online marketplace to compare and such, but as far as I know from general news information, you can get your insurance from any company that will write you.

Oh, and there were posts in another thread (I think on state residency) about what the penalty fines are -- they go up each year in percentage of your income.

 

[TMG51]

I do know that the insurance can be bought through any private provider. But, at least when I last looked, I didn't find anything nearly as affordable as the state run plans. I also don't use my insurance - it's not health insurance, really; it's tax penalty insurance.

I suppose I could just buy one of those truly useless "catastrophic only" plans through a private carrier, if I'm committing to not using my coverage.

 

[Canine]

Montana is a mess, too, but haven't seen what you've experienced. I don't have first hand experience with insurance, though, as the cost is way out of my reach. The fine is very close to 15% of your gross income. The more you make, the bigger the fine.

 

[gcal]

I just had a frank phone conversation with my state-sponsored insurance carrier, in which I informed them their system is the most horrible piece of crap I've dealt with in my life and that for 2016 I'll opt to go without insurance and pay any fines I incur, as I would rather pound rusty nails through my sensitive bits than deal with them for another year.

Anyone else familiar with Vermont Health Connect? Surely other states have similar programs? Are they all as bad?

I'm young, healthy, employed. Previously, I had health insurance through my employer. Coincidentally, right when all this Obamacare mandated insurance stuff started, I changed employers and went to a higher paying position that did not offer health insurance. That meant I had to buy insurance from the state in order not to be penalized for not having it (penalty is based on income). Every single month they got my billing wrong, every month I would call to complain, they said they would fix it, they never did, they cancelled me due to their own inaccurate billing, had to fight to get reinstated, their online system doesn't work, can't make electronic payments, have to mail a check and reference a payment code each month... most of the time I can't even log in to their system to see my (inaccurate) statements. I can't even get my tax info right now.

Maybe this is a reason in and of itself to change my residency state? Can anyone in a similar situation (not on medicare, etc) offer any input as to which states might have better insurance programs? I don't even know what I will be fined but this VHC frustration is just not worth it. Surely there must be another option.

Remember, no politics, just logistics.

I have read about a lot of problems with state run programs. Some of them just do not seem to be able to do it. The smart ones who realize they are over their heads turn it over to the Feds to run. Bigger system and more money to pay computer experts. Moving out of state is pretty drastic, but Vermont winters are really cold and a person can only stand so much frustration.

 

[johnny b]

I paid $427 penalty for not having insurance for 2014. I bought a short term (6 month) private 'catastrophic' policy for $200/mo so I'd have coverage in case of injury (for racing season). That policy was not ACA 'compliant' therefore had to pay the penalty as well. Haven't done my taxes yet this year but I think my penalty will be about double that.
In Virginia we have no state program, just the Fed--Healthcare.gov
I attempted to get ins. for 2015 but could not get the website to work--had a profile set up but once logged in, got to a certain point and could never finish the application process. So I figured to get the short term private insurance again so I could race, but received a 'denial' due to "age & weight"--I had turned 60 in 2015, weight was the same---by the time I got the denial notice, the application 'window' for ACA was closed. So even though I wanted to buy insurance, I couldn't. And NO you CANNOT buy private ACA compliant insurance outside of the Federal 'Open Enrollment window' which closed this year on Jan. 31. (There are exceptions--check the website)
Did not race at all in 2015.
For 2016, I bit the bullet and called 1800-318-2596, and after about 4 attempts finally got my web profile 'fixed' and bought a bronze plan for $18/mo with subsidy. (depending on how close my actual income this year matches my estimate on the application, I may get more subsidy or I may have to pay some back---helluva system, eh?)
The penalty is based on household income (over a minimum) and can go up to a maximum equivalent to the yearly price of the cheapest bronze plan.
But I think what sums up the ACA the best is the phone number--1800-318-2596. Check your phone, it spells 1800- ? ?????
Digit '1' has no letters and if you dial an extra digit at the end it don't matter.
BTW--I was in the phone biz for 20 years, I know how 800 numbers are ordered---'somebody' wanted this number--couldn't be 'coincidence'!  

 

[TMG51]

But I think what sums up the ACA the best is the phone number--1800-318-2596. Check your phone, it spells 1800- ? ?????
Digit '1' has no letters and if you dial an extra digit at the end it don't matter.
BTW--I was in the phone biz for 20 years, I know how 800 numbers are ordered---'somebody' wanted this number--couldn't be 'coincidence'!  

Hmm, yes, I see what you mean. It spells "informed consumer."

 

[Canine]

Does anyone know of an actuary type of person that can calculate the odds of that phone number spelling out that naughty word? My curiosity is piqued.

 

[ramblingvanman]

I think it was someone's way of telling us exactly what they were doing to us.

 

[anewbiewannabe]

Years ago I had insurance for one through anthem because to get the same coverage I previously had would have cost $332/month with COBRA and higher copays. Even with a $2500 deductible when I needed it it paid for itself in one day---my monthly payments were $75 and copays for doctor visits were $25, but that was many years ago as I said. A few months later my policy was cancelled. Insurance like that might be an option for someone else though.

I really appreciate all the information in this thread. I knew they were penalizing the uninsured, but I haven't delved deeply into it yet because I'm dealing with other things that make my head spin. It's doubtful my income will make it out of the subsistence level so I wonder how high the cap is for fully subsidized insurance once I spend back down when the time comes. Research for another time. For now I'm having enough trouble finding specialists in a 100 mile radius that take medicaid.

It would be nice if they presented just the facts to go through on medicaid/medicare or insurance through the state instead of having a bunch of insurance companies using marketing tactics to get the business through the gooberment. I guess a simple side by side comparison is too much to ask.

I miss the old days when health care was run more by doctors and less by insurance companies and big pharma.

That phone number is funny, not haha funny, but funny.

 

[BradKW]

As with everything tax-related, there’s no simple answer to “How much is the Obamacare penalty tax?” But here are some key points, from FactCheck.org:
The penalty/tax will be phased in from 2014 to 2016.
The minimum penalty/tax in 2016 will be $695 per person and up to 3-times that per family. After 2016, these amounts will increase at the rate of inflation.
The minimum penalty/tax per person will start at $95 in 2014 (and then increase through 2016)
No family will ever pay more than 3X the per-person penalty, regardless of how many people are in the family.
The $695 per-person penalty is only for those who make between $9,500 and ~$37,000 per year. If you make less than ~$9.500, you’re exempt. If you make more than ~$37,000, your penalty is calculated by the following formula…
The penalty is 2.5% of any household income above the level at which you are required to file a tax return. That level is currently $9,500 per person and $19,000 per couple. The penalty on any income above that is 2.5%. So the penalty can get expensive quickly if you make a lot of money.
However, the penalty can never be more than the cost of a “Bronze” heath insurance plan purchased through one of the state “exchanges” that will be created as part of Obamacare. The CBO estimates that these policies will cost $4,500-$5,000 per person and $12,000-$12,500 per family in 2016, with the costs rising thereafter.
So, basically, you’re looking at penalties of approximately the following at the following income levels:
Less than $9,500 income = $0
$9,500 – $37,000 income = $695
$50,000 income = $1,000
$75,000 income = $1,600
$100,000 income = $2,250
$125,000 income = $2,900
$150,000 income = $3,500
$175,000 income = $4,100
$200,000 income = $4,700

 

[WriterMs]

Montana is a mess, too, but haven't seen what you've experienced. I don't have first hand experience with insurance, though, as the cost is way out of my reach. The fine is very close to 15% of your gross income. The more you make, the bigger the fine.

Canine -- you really should call the 800 number or go online with healthcare.gov -- I don't know when the next enrollment period is, but if you have low income your premium might be zero or close to that. Then you could save having to pay the penalty AND have health coverage of some sort.

I am also quite sure by the way the tax form is set up that, if you buy (or get free) insurance at some point during the year, the penalty only applies to your months without insurance.

 

[NickTheoBennett]

My experience in Oregon has been overwhelmingly positive. I've been living off of student loans, so I essentially have no reported income. Because of that, I qualified for free entry into Oregon Health Plan.

I've never had to pay a dime for anything. The coverage is still a PITA sometimes (trying to see a specialist is like pulling teeth). The coverage is also fairly limited. If it's not "medically necessary", they probably aren't going to pay for it.

The dental is less spectacular, but I still don't pay anything ever. They don't cover anything more expensive than a root canal, and even those they will only pay for in a front tooth.

 

[Every Road Leads Home]

I have the state plan through Massachusetts. For starters, I hate Massachusetts, the amount of government in your life in this state is so overwhelming, I can't believe we haven't had a mini revolution. However, all that BS aside, I am able to give credit where credit is due and I think the state health insurance is excellent. There are various options and plans you can chose from. It's very affordable if you are low income. If you make under 20 grand a year its anywhere from free to $60 a month. 20-30k and i think it's about 120-180 a month. It has cheap prescriptions and low office visit co pays. I have been disabled the last four years starting at age 31 and for the first three had a mystery illness (ended up being Lyme) During those three years I had about 15 different Dr's do lab work, two MRI's one CatScan, ultrasound, Xrays, and spent 9 days in a Boston Hospital where I had more scans and lab work done and out of pocket those three years besides my $50 monthly premium I think I may have spent $300-$400. But as much as I like the affordable health insurance here, I'm very much looking forward to relocating soon. Have a home in Plymouth Ma to sell and a home in Sanford, Me and then it's good bye East Coast for this guy. Still have some effects from the Lyme but am already in good enough shape to travel and hopefully by the time i'm on the road I can begin hiking, snowboarding, and rock climbing again.

-Matt-

 

[Stephen]

I'm new here and this thread is one of the things I am thinking seriously about. 

I am retired and have Medicare. My wife is still working. She plans to retire in the next six months or so. We will be leaving NY and moving to Michigan. My wife will only be 62 so for three years we have to come up with some sort of medical insurance. I hear all sides of the argument. The Affordable Care Act is crap, the ACA is wonderful.

We have some friends who just did this whole retiring thing and the woman pays over $600/mo. That's a bit out of my ballpark if we are to do any traveling. Before I retired, the place where I worked couldn't afford to pay benefits so I had to get my own. At the time, the state of NY had a plan, but you had to make under $21000 (I think) and the payments were $615 per month. I don't know what idiot politician thought that a person making less that $21000 could afford $615/mo, but they were wrong.

I wish we were smart enough to have some sort of Universal Health system like all the other industrialized nations, but I don't see that happening in the near future.

If anyone has suggestions, I would be glad to hear them. If anyone is from MI, I would really like to hear what you have to say about their system.

 

[jimindenver]

Insurance as it is is nothing more than paying extra to go broke if you get sick.

 

[ccbreder]

Oh great. another conspiracy theory. If I ordered a number, why not all the letters? Just another searched-out coincidence.

 

[akrvbob]

I make 24,000 a year and Obamacare is covering $350 of my $400 a month high-deductible policy.
Bob

 

[Stephen]

I make 24,000 a year and Obamacare is covering $350 of my $400 a month high-deductible policy.  
Bob

Thanks, Bob. I appreciate your transparency and information. I think we could manage that.   :blush:

 

[Canine]

Not trying to turn this into a political thing but If we want universal health care,we need to vote for the politicians who will push for it.Regardless of their party affiliation.