The application for healthcare exchange

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Re: The application for healthcare exchange

Postby zed » Thu May 02, 2013 10:04 pm

Jack wrote:
zed wrote:Ok I think I get it.

The calculators dont tell you what you WILL have to pay.

The calculators tell you the maximum you MIGHT have to pay. The actual premium will be dependant on the plan selected and conditions submitted at time of application. So in short your premium will be somewhere between zero and the maximum.

Close, but not exactly. You could end up spending more than the calculator maximum. That is because your spending is calculated based on a silver plan. If you chose a gold or platinum plan, you could end up spending more than the maximum because the cost of premiums above the silver plan aren't counted towards your maximum.


Ah yes so then whatever the calculator spits out is crapola.

The calculators dont collect enough data really to make even a ballpark determination. You wont known what your premium will be until the exchanges actually open and you apply.

This thread has gone full circle. Nobody knows.

Zed

PS

re-reading my post. Jack, no dis intended toward you personally. Like others perhaps am frustrated by the unknowns of ACA. Thank you for your efforts to bring some clarity to the subject
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Re: The application for healthcare exchange

Postby gerrym51 » Thu May 02, 2013 10:18 pm

zed wrote:
Jack wrote:
zed wrote:Ok I think I get it.

The calculators dont tell you what you WILL have to pay.

The calculators tell you the maximum you MIGHT have to pay. The actual premium will be dependant on the plan selected and conditions submitted at time of application. So in short your premium will be somewhere between zero and the maximum.

Close, but not exactly. You could end up spending more than the calculator maximum. That is because your spending is calculated based on a silver plan. If you chose a gold or platinum plan, you could end up spending more than the maximum because the cost of premiums above the silver plan aren't counted towards your maximum.


Ah yes so then whatever the calculator spits out is crapola.

The calculators dont collect enough data really to make even a ballpark determination. You wont known what your premium will be until the exchanges actually open and you apply.

This thread has gone full circle. Nobody knows.

Zed

PS

re-reading my post. Jack, no dis intended toward you personally. Like others perhaps am frustrated by the unknowns of ACA. Thank you for your efforts to bring some clarity to the subject



thats what i said on the post earlier.conflicting calculators giving conflicting info. ain't life grand
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Re: The application for healthcare exchange

Postby zed » Thu May 02, 2013 10:26 pm

gerrym51 wrote:
zed wrote:
Jack wrote:
zed wrote:Ok I think I get it.

The calculators dont tell you what you WILL have to pay.

The calculators tell you the maximum you MIGHT have to pay. The actual premium will be dependant on the plan selected and conditions submitted at time of application. So in short your premium will be somewhere between zero and the maximum.

Close, but not exactly. You could end up spending more than the calculator maximum. That is because your spending is calculated based on a silver plan. If you chose a gold or platinum plan, you could end up spending more than the maximum because the cost of premiums above the silver plan aren't counted towards your maximum.


Ah yes so then whatever the calculator spits out is crapola.

The calculators dont collect enough data really to make even a ballpark determination. You wont known what your premium will be until the exchanges actually open and you apply.

This thread has gone full circle. Nobody knows.

Zed

PS

re-reading my post. Jack, no dis intended toward you personally. Like others perhaps am frustrated by the unknowns of ACA. Thank you for your efforts to bring some clarity to the subject



thats what i said on the post earlier.conflicting calculators giving conflicting info. ain't life grand


Well now that you ask and we can talk about things that really matter. Life is grand. In fact the fishing is pretty good here in the Bitterroot. :)

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Re: The application for healthcare exchange

Postby Jack » Thu May 02, 2013 11:15 pm

zed wrote:Life is grand. In fact the fishing is pretty good here in the Bitterroot. :)

Just wait a couple of weeks. The snow will melt and it will all turn to mud for a while.
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Re: The application for healthcare exchange

Postby Sponger » Fri May 03, 2013 10:23 am

http://www.washingtonpost.com/wp-srv/sp ... -for-you/#


Here is a link to another calculator. This one asks for your adjusted gross income, and allows you to select how many people in your household.
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Re: The application for healthcare exchange

Postby gerrym51 » Fri May 03, 2013 10:26 am

Sponger wrote:http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/#


Here is a link to another calculator. This one asks for your adjusted gross income, and allows you to select how many people in your household.



i looked at it . it does not let you say 2 people in household but only 1 needs insurance. if you put 2 people in household it assumes both need insurance.
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Re: The application for healthcare exchange

Postby Jack » Fri May 03, 2013 12:01 pm

gerrym51 wrote:
Sponger wrote:http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/#
Here is a link to another calculator. This one asks for your adjusted gross income, and allows you to select how many people in your household.

i looked at it . it does not let you say 2 people in household but only 1 needs insurance. if you put 2 people in household it assumes both need insurance.

No, it does not assume both need insurance because it doesn't matter in the calculation. The maximum amount you have to spend is based only on your income and family size. It doesn't matter how many do or do not need insurance. If only one of you needs insurance, you might not reach the maximum out of pocket and get no subsidy. If you have two or more who need insurance, you may reach the maximum out of pocket and get a subsidy.

The calculations do not require knowing how many need insurance. The calculations only tell you the maximum your family might pay in the worst case based on the law. You won't know your actual costs until the insurance companies post their plan costs later this year, but it will be no more than the calculated number. It could be less.
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Re: The application for healthcare exchange

Postby gerrym51 » Fri May 03, 2013 12:40 pm

Jack wrote:
gerrym51 wrote:
Sponger wrote:http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/#
Here is a link to another calculator. This one asks for your adjusted gross income, and allows you to select how many people in your household.

i looked at it . it does not let you say 2 people in household but only 1 needs insurance. if you put 2 people in household it assumes both need insurance.

No, it does not assume both need insurance because it doesn't matter in the calculation. The maximum amount you have to spend is based only on your income and family size. It doesn't matter how many do or do not need insurance. If only one of you needs insurance, you might not reach the maximum out of pocket and get no subsidy. If you have two or more who need insurance, you may reach the maximum out of pocket and get a subsidy.

The calculations do not require knowing how many need insurance. The calculations only tell you the maximum your family might pay in the worst case based on the law. You won't know your actual costs until the insurance companies post their plan costs later this year, but it will be no more than the calculated number. It could be less.


this calculator disagrees with your premise. it has family income than asks how many in family need insurance then defaults to single parameters. i am not saying you are , n wrong-because i don't know for sure-but i cannot find verification anywhere that this is the case. i have asked my own provider, other people on other boards have asked their providers-we all get not sure. i will accept your opinion but would like you to get a link to somewhere in print that IF you have a household of 2 but only one needs insurance(my wifes on medicare) this is what happens.that is what i want verified

http://www.accesshealthct.com/how-to-save/
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Re: The application for healthcare exchange

Postby Jack » Fri May 03, 2013 2:01 pm

All I can say is that the Connecticut calculator is misleading at best and flat wrong at worst (It does say this is only a preliminary estimate). When you enter the number needing insurance, they are assuming this is the same as the size of your family and that is just wrong.

In order to calculate the subsidy, you must know the size of the family, separately from the number needing insurance, because Federal Poverty Level is based on family size, by law, not number of insured.

You can read the most current regulations directly from the HHS here:

http://www.gpo.gov/fdsys/pkg/FR-2011-08 ... -20728.pdf

On page three of the PDF you will see Credit Computation. It is determined by Federal Poverty Level (FPL) which is determined by the modified adjusted gross income (MAGI) and by family size. It does not depend on number of insured. The subsidy is defined as the excess premium cost above the percentage of family income determined by FPL calculation. If you have more family members needing insurance, you get a bigger subsidy, but the amount that you pay can never exceed the value calculated by family size.
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Re: The application for healthcare exchange

Postby Jack » Fri May 03, 2013 2:24 pm

One of the best calculators I have seen is from UC Berkeley Labor Center because it shows step by step calculations.

"http://laborcenter.berkeley.edu/healthpolicy/calculator/"

For a good example, enter 3 for number in household and $60,000 for income, and enter 50 for age of first adult. Leave everything else blank, that is, only one insured in the family.

From the FPL ("http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Downloads/2013-Federal-Poverty-level-charts.pdf") you can see that the FPL is 307% based on family size (not number of insured), exactly as the calculator shows. ($60,000/19,530 = 3.07)

From this table "http://101.communitycatalyst.org/aca_provisions/subsidies" you can see that this puts you at the 9.5% of income level. That is the maximum amount of your income you will pay.

Look at the bottom of the calculator and it says that you will pay $475 a month. Multiply by 12 and you see that is exactly 9.5% of $60,000, just as expected.

Now change the parameters by entering a spouse and/or children. You will see that the amount that you pay $475 does not change at all. The only thing that changes is the amount that the actual policy costs and the amount that the government pays. The only reason for knowing the ages and number of insured is to determine how much the government pays, not how much you pay (although you may pay more if you select a gold or platinum plan).
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Re: The application for healthcare exchange

Postby gerrym51 » Fri May 03, 2013 3:08 pm

Jack-yes -but the ct calculator disagrees. we go over and over this. No more calculators. i want to see a printed statement. if you have 2 in a family and only one needs insurance- does it default to 45,700 income of 1 or 60,000 income of 2 split in half. thats what i need to see.

or i need another calculator-not ct-

that enters income as family then says how many people in family need insurance not another of the many calculators that just say family income age of oldest insured age of spouse
if you produce one that does this-not the ct. one-and it agrees with the other calculators-i will agree with you.
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Re: The application for healthcare exchange

Postby floydtime » Fri May 03, 2013 3:34 pm

The CT one is wrong because as Jack said earlier, "When you enter the number needing insurance, they are assuming this is the same as the size of your family and that is just wrong."

The berkely one handles this correctly, according what's written in the law. Saying it disagrees with the CT one on this point is a compliment to it. :)
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Re: The application for healthcare exchange

Postby gerrym51 » Fri May 03, 2013 3:57 pm

floydtime wrote:The CT one is wrong because as Jack said earlier, "When you enter the number needing insurance, they are assuming this is the same as the size of your family and that is just wrong."

The berkely one handles this correctly, according what's written in the law. Saying it disagrees with the CT one on this point is a compliment to it. :)



the other calculators always assume family is "MORE THAN ONE". you actually never can get an answer if family of 2 for 1 insured. for all you know if it was allowed to be entered this way the other calculator it would also defaul to one
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Re: The application for healthcare exchange

Postby Jack » Fri May 03, 2013 4:18 pm

gerrym51 wrote:Jack-yes -but the ct calculator disagrees. we go over and over this. No more calculators. i want to see a printed statement. if you have 2 in a family and only one needs insurance- does it default to 45,700 income of 1 or 60,000 income of 2 split in half. thats what i need to see

I provided you with the printed regulations directly from the HHS (U.S. Dept. of Health and Human Services) above. You can read it yourself. FPL (Federal Poverty Level) has a legal definition -- it is total family income. There is no splitting of incomes.

or i need another calculator-not ct-

that enters income as family then says how many people in family need insurance not another of the many calculators that just say family income age of oldest insured age of spouse
if you produce one that does this-not the ct. one-and it agrees with the other calculators-i will agree with you.

I provided you with the Berkeley calculator that does exactly what you asked for and an example that proves exactly what you ask for, with various numbers of family member needing insurance. There's nothing more I can do for you. You are just going to have to wait until later this year when the real exchanges go on line with real insurance policies.

The Connecticut calculator is just preliminary and misleading. Forget about it. They will correct things when the exchange goes live.
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Re: The application for healthcare exchange

Postby gerrym51 » Fri May 03, 2013 4:29 pm

Jack wrote:
gerrym51 wrote:Jack-yes -but the ct calculator disagrees. we go over and over this. No more calculators. i want to see a printed statement. if you have 2 in a family and only one needs insurance- does it default to 45,700 income of 1 or 60,000 income of 2 split in half. thats what i need to see

I provided you with the printed regulations directly from the HHS (U.S. Dept. of Health and Human Services) above. You can read it yourself. FPL (Federal Poverty Level) has a legal definition -- it is total family income. There is no splitting of incomes.

or i need another calculator-not ct-

that enters income as family then says how many people in family need insurance not another of the many calculators that just say family income age of oldest insured age of spouse
if you produce one that does this-not the ct. one-and it agrees with the other calculators-i will agree with you.

I provided you with the Berkeley calculator that does exactly what you asked for and an example that proves exactly what you ask for, with various numbers of family member needing insurance. There's nothing more I can do for you. You are just going to have to wait until later this year when the real exchanges go on line with real insurance policies.

The Connecticut calculator is just preliminary and misleading. Forget about it. They will correct things when the exchange goes live.



jack i looked at the berkley calculator-it does not-you can put any age into the spouse and it give you a 2 person figure-it reads 0 as an age-i tried spouse of 0-2-4-6.
it reads any number as an acceptable spouse age. 0 is an age to the calculator
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Re: The application for healthcare exchange

Postby teacher » Fri May 03, 2013 5:07 pm

I intend to get an answer to my question through this contact:

For general information or inquiries please contact the California Health Benefit Exchange at (916) 323-3502 or info@hbex.ca.gov.

Most likely there is a contact for inquiries in other participating states.
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Re: The application for healthcare exchange

Postby floydtime » Fri May 03, 2013 6:01 pm

gerrym51 wrote:
Jack wrote:
gerrym51 wrote:Jack-yes -but the ct calculator disagrees. we go over and over this. No more calculators. i want to see a printed statement. if you have 2 in a family and only one needs insurance- does it default to 45,700 income of 1 or 60,000 income of 2 split in half. thats what i need to see

I provided you with the printed regulations directly from the HHS (U.S. Dept. of Health and Human Services) above. You can read it yourself. FPL (Federal Poverty Level) has a legal definition -- it is total family income. There is no splitting of incomes.

or i need another calculator-not ct-

that enters income as family then says how many people in family need insurance not another of the many calculators that just say family income age of oldest insured age of spouse
if you produce one that does this-not the ct. one-and it agrees with the other calculators-i will agree with you.

I provided you with the Berkeley calculator that does exactly what you asked for and an example that proves exactly what you ask for, with various numbers of family member needing insurance. There's nothing more I can do for you. You are just going to have to wait until later this year when the real exchanges go on line with real insurance policies.

The Connecticut calculator is just preliminary and misleading. Forget about it. They will correct things when the exchange goes live.



jack i looked at the berkley calculator-it does not-you can put any age into the spouse and it give you a 2 person figure-it reads 0 as an age-i tried spouse of 0-2-4-6.
it reads any number as an acceptable spouse age. 0 is an age to the calculator

It's perfectly clear to me and I don't understand the difficulty. You yourself said earlier "no more calculators". Okay, read the regulations that Jack provided a link for. That's as exact as you can get and it's not clear what more you're looking for.

That being said, this berkely calculator seems to me to follow what's in the regulations perfectly. If I enter zero, it means there is not a person. Zero is obviously not an age, as can be seen by just running a few numbers. It says this very clearly as well...
Only enter members of your household who would enroll in Exchange coverage

Zero means nobody (just like blank). Now if I enter 1 (years old), the premium jumps, because now there *is* another person enrolled. If I enter 2 (years old), no change from 1 (years old) - taking into account the lack of infant race car drivers no doubt. There is no increase in premium for this enrolled person until I get to 21 (years old). This is about what I would expect.

Again, Zero is not an age, it means exactly what it says above - nothing entered, person not enrolled.
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Re: The application for healthcare exchange

Postby gerrym51 » Fri May 03, 2013 10:47 pm

floyd i looked at it again and you are correcto mundo.

the only problem is the subsidized coverage is still requiring me to pay 500 a month. still 6000 out of pocket-this is because i have to use all family income
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Re: The application for healthcare exchange

Postby Cut-Throat » Sat May 04, 2013 9:07 am

gerrym51 wrote:floyd i looked at it again and you are correcto mundo.

the only problem is the subsidized coverage is still requiring me to pay 500 a month. still 6000 out of pocket-this is because i have to use all family income

And Without the ACA you'd be paying about 1,200 out of pocket. I don't see the problem.
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Re: The application for healthcare exchange

Postby gerrym51 » Sat May 04, 2013 10:10 am

Cut-Throat wrote:
gerrym51 wrote:floyd i looked at it again and you are correcto mundo.

the only problem is the subsidized coverage is still requiring me to pay 500 a month. still 6000 out of pocket-this is because i have to use all family income

And Without the ACA you'd be paying about 1,200 out of pocket. I don't see the problem.



cut-throat-

i am on the health care exchange already in massachusettes-the only one in the country that already exists-i pay full price for an idividual policy-my premium is 570 a month.

my income was too high to qualify for mass subsidized as they currently only go to 300 percent of poverty.

massachusettes on which the ACAPA is modeled however has some differences and i do not know if it will change. there are only certain plans that are subsidized. i will not catagorize them because then it sounds like i'm being politcal/critical. i will only apply for a subsidy if i can keep the current plan i buy


you can go here and browse how an actual exchange works. even though open enrollment is july 1-august 15 in massachusettes if you want to read about the plans read the links and it will tell you what to do. if you want to see the many plans and prices use any massachusettes zip code

https://www.mahealthconnector.org/portal/site/connector


i will answer any question you have.
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Re: The application for healthcare exchange

Postby Cut-Throat » Sat May 04, 2013 11:07 am

I don't think you will be able to calculate your actual costs until these plans get fully implemented. At any rate your premium was bound to increase anyway. All health care insurance premiums are going to go up substantially. The only eventual solution will be to on a single payer health plan.
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Re: The application for healthcare exchange

Postby Jack » Sat May 04, 2013 11:54 am

Cut-Throat wrote:The only eventual solution will be to on a single payer health plan.

Eventually most do when they turn 65.
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Re: The application for healthcare exchange

Postby gerrym51 » Sat May 04, 2013 12:19 pm

oh by the way jack and cutthroat-although i had to concede that the calculator you showed me did allow all info-i also tried putting 66 into the questions. it still gave me an answer and did not say uh uh your on medicare like some of the calculators do.

i actually think :mrgreen: the CT. calculator is the correct one
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Re: The application for healthcare exchange

Postby floydtime » Sat May 04, 2013 6:37 pm

Deleted - I blame the :beer
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Re: The application for healthcare exchange

Postby gerrym51 » Sat May 04, 2013 6:58 pm

floydtime wrote:Deleted - I blame the :beer



i actually have found myself doing this same thing. my wife says i can be exasperating. No problem. perfectly understandable :sharebeer
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