[USCFCAT1]

Originally Posted by bagboy

The OP has a very real dilemma. They will both need to purchase health insurance. Other than aquiring insurance with Florida Blue, through the ACA Marketplace, what do you or your wife suggest they do?

Simplest solution - decide if the "fine" is lower than the cost of coverage. If you need a major medical policy so be it.

From there, keep an address in the home state if there is coverage there...and keep it.

Anyone who is so hoodwinked to think that ACA is a good thing needs to really catch up with reality. Just because you have a card that says BCBS or United does not mean that any provider needs to accept it.

Remember, with ACA if you cut your thumb at home...that is NOT a health insurance claim, that is a Home Owners claim.


If you cut your thumb at your neighbors, that is a claim on THEIR home owners/renters policy.

If you hurt your thumb at work...that is a Comp injury.

If you hurt your thumb in the car...Auto claim.

COBRA is never ever not even slightly a good idea for 99% of the population.

[bagboy]

Originally Posted by USCFCAT1

Simplest solution - decide if the "fine" is lower than the cost of coverage. If you need a major medical policy so be it.

From there, keep an address in the home state if there is coverage there...and keep it.

Anyone who is so hoodwinked to think that ACA is a good thing needs to really catch up with reality. Just because you have a card that says BCBS or United does not mean that any provider needs to accept it.

Remember, with ACA if you cut your thumb at home...that is NOT a health insurance claim, that is a Home Owners claim.


If you cut your thumb at your neighbors, that is a claim on THEIR home owners/renters policy.

If you hurt your thumb at work...that is a Comp injury.

If you hurt your thumb in the car...Auto claim.

COBRA is never ever not even slightly a good idea for 99% of the population.

I hope you are not under the impression that I support the ACA. I'm simply replying to the OP who as I see it will not have the opportunity to keep their current health plan. To my knowledge in the state of Florida, there isnt an open market for the OP to shop for health insurance. There is one company, Florida Blue, and one way to purchase coverage, through the ACA Marketplace. To not have some type of coverage to cover unexpected catastrophic events would really be a huge risk.
The OP should contact a local, experienced agent and get the facts of coverage availability, and get guidance on proceeding.

[USCFCAT1]

Originally Posted by valuemkt

And reductions in Medicare reimbursements to doctors and hospitals only end up having them charge more to the non-Medicare people. Have you ever seen a doctor or hospital take a pay-cut?

Huh? Lets start with "Fee Schedules". Medicare will pay $X for Procedure "Y". From there, ALL providers create a fee schedule from the known minimum (medicare). This fee is typically Medicare + Z%. So, "cash pay" would essentially be "Medicare+X%". Insurance companies who are contracted to providers will pay "Medicare+Q%" on certain procedures.

So - if your sympathetic joint effusion has a reimbursement of $1.00 from Medicare....

$1.00 (what Medicare pays)
$0.15 (what Medicaid pays - when they get around to it)
$1.30 (what BCBS will pay to an in-network provider)
$2.00 (cash pay fee schedule for WorkComp/PI - knowing it will take years to get paid)

To claim that providers are jacking their price to "cover" Medicare is foolish...they only "cover" Medicaid...and most simply do not accept Medicaid as it never pays a bill let alone a steeply discounted bill.

Have I seen providers take a pay cut? LOL, you have GOT to be kidding. Medicare no longer pays for MANY high level hospital consults. They dont pay for many diagnostic visits nor much of the DME/Supplies used.

[USCFCAT1]

Originally Posted by bagboy

I hope you are not under the impression that I support the ACA.

Not all all.

It is just funny to see people show shock when they get the questionnaire in the mail asking "what, where, how, when" for many issues. Then they fill it out - get a denial and blame the provider. In actuality it is simply underwriting deferring PX billing responsibility to ANYONE other than their own policy.

[USCFCAT1]

Originally Posted by bagboy

The OP has a very real dilemma. They will both need to purchase health insurance. Other than aquiring insurance with Florida Blue, through the ACA Marketplace, what do you or your wife suggest they do?

Christian Healthcare Ministries: Home

[biker1]

Getting a subsidy from the Obamacare exchange is all about your adjusted gross income. If you can structure your finances so as to show a low adjusted gross income then you can get a subsidy. In other words, your net worth is not part of the equation - only what you show as adjusted gross income on your tax return.

Originally Posted by Kahuna32162

OK, pretty much same boat, moved here at 59 and had to purchase our own health care insurance. Unless you want the absolute bare bones, it's expensive, to the tune of about $1,400/month for 2. We started with Florida Blue, but changed to United Health care for last year (they seem to be the preferred provider in The Villages). as of Jan 1, 2017, UHC will no longer be issuing individual policies in the State of Florida. So, for us, it's back to Florida Blue at about the same rate with a higher deductible than last year.

You can try going through the exchange, while it still lasts, but if you don't qualify for a subsidy, it's really not worth it. BTW, we used Mid Florida Agencies in the Palm Ridge Plaza and Renata Cockburn 352 259-0666. Good Luck!

[bagboy]

Maybe the Florida Blue rep can respond and confirm ,it's gross income that is used, not adjusted gross income.

[biker1]

It is actually modified adjusted gross income.

Originally Posted by bagboy

Maybe the Florida Blue rep can respond and confirm ,it's gross income that is used, not adjusted gross income.

[Chi-Town]

Originally Posted by biker1

It is actually modified adjusted gross income.

That is correct. From HealthCare.gov

Your MAGI is the total of the following for each member of your household who’s required to file a tax return:

Your adjusted gross income (AGI) on your federal tax return
Excluded foreign income
Nontaxable Social Security benefits (including tier 1 railroad retirement benefits)
Tax-exempt interest
MAGI does not include Supplemental Security Income (SSI)

Sent from my SM-N910V using Tapatalk

[rexxfan]

Originally Posted by villagetinker

If I understand it correctly, VHS will accept your insurance (please call them to confirm), until you are 65, then you MUST convert to one of the accepted MEDICARE ADVANTAGE plans, or leave your Primary care doctor in VHS.

To my knowledge, VHS stopped taking on new patients with one of their accepted non-Medicare insurances (e.g. Cigna) in mid-October, 2015. I made my initial appointment with VHS before the cutoff and I was allowed in. My wife wanted to wait until after we got here (which was after the cutoff) to learn more about it before deciding and she got frozen out. I'm not aware of any reversal of that policy. We're both in our early 60's so aren't yet eligible for Medicare.
--
Bob C