Author Topic: Why ACA if in California, vs Self-Insuring/High Deductible?  (Read 2033 times)

bimmerjeff

  • Newbie
  • *
  • Posts: 3
    • View Profile
Why ACA if in California, vs Self-Insuring/High Deductible?
« on: February 20, 2019, 09:33:45 AM »
Hey Jeremy,

I read several comments you made in recent posts about worrying if you qualify for the lowest ACA teirs in Covered CA, should you move back here.  We are about to move to Taipei from CA, but plan to move back within a few years at most.  When I come back I figured if we don't qualify for the cheapest ACA teir due to income levels, I would buy a high deductible insurance plan that doesn't start coverage until a $10k cap per year, and just pay out of pocket for any care we need.  The premiums are very low per month, as the insurer rarely pays out.  Even with an occasional big bill this should be less than paying over $1000 a month forever for an ACA family plan, at least most years, as we are all healthy and rarely see a doctor.  In a big emergency, the plans cover everything beyond $10k.  Yes, it would suck to write a $10k check on a bad year but that's my max out of pocket, and would have paid more in the year in premiums anyhow.  You have talked about self-insuring before in your blog, why the switch to ACA now? 

gocurrycracker

  • Administrator
  • Sr. Member
  • *****
  • Posts: 272
  • I live here.
    • View Profile
    • Retire Early. Travel the World.
Re: Why ACA if in California, vs Self-Insuring/High Deductible?
« Reply #1 on: February 20, 2019, 11:52:17 PM »
Hi Jeff

Can you point me to a high deductible health plan that works as you describe?

bimmerjeff

  • Newbie
  • *
  • Posts: 3
    • View Profile
Re: Why ACA if in California, vs Self-Insuring/High Deductible?
« Reply #2 on: February 21, 2019, 10:47:30 AM »
After further research it seems only my daughter would qualify for the super high deductible plan with Kaiser.  I did see health share Catastrophic Coverage plans like this:

https://www.alierahealthcare.com/individual-family/catastrophic-plans/

I'm sure they have drawbacks too and require additional research, but the premium is $150-$200/mo for Family coverage.

I also see what you mean about the limits, under $56k income gets a huge subsidy on ACA plans that makes it < $300/mo for Family.  If I can make my investment returns fall under that threashold after the $24k standard deduction that would be ideal.

gocurrycracker

  • Administrator
  • Sr. Member
  • *****
  • Posts: 272
  • I live here.
    • View Profile
    • Retire Early. Travel the World.
Re: Why ACA if in California, vs Self-Insuring/High Deductible?
« Reply #3 on: February 21, 2019, 07:07:28 PM »
Thanks Jeff, that more matches my understanding.

the health sharing ministries are an option, although financially they seem too close to a Ponzi scheme so do some due diligence. Plus, I don't qualify because of my wicked sinful ways

self insuring is a viable option in places / countries where there is price transparency and prices are low/reasonable. Taiwan, for example, although we are legally required to buy insurance. It's good value in any case.

The standard deduction doesn't offset income for purposes of calculating ACA subsidies. So you would need to aim for <400% FPL for total income.

Cheers

Jeremy