The self-pay patient

This is an incredibly useful article about strategies for dealing with Obamacare without exposing your household to financial ruin.  I look forward to reading the guy's book when it comes out.  There is information about price transparency, cash discounts, exempt healthcare cost-sharing ministries (including for non-evangelicals), exceptions to tax penalties, affordable telemedicine for simple illnesses, and exempt short-term or limited-scope insurance policies.  This is exactly the sort of information I've been looking for from licensed health insurance brokers, two of whom have proved to know very little about the subject.


Grim said...

That is helpful. Even those who survived Round One of grandfathering can't expect that to continue forever. Sooner or later they will destroy all the old policies -- though the politically-well-connected will be last.

raven said...

Thank you, I will review the info.

Texan99 said...

Re avoiding the penalty if you pursue one of these alternatives:

Households with incomes above 400% of the federal poverty level (i.e., those that don't qualify for subsidies) will be exempt from paying tax penalties if insurance in their area costs more than 8% of their taxable income, after taking into account employer contributions or tax credits. At the $830/month quoted for a Bronze plan in my area, our household income would have to exceed $124,500 before we'd suffer a penalty. Oddly enough, since the cash we have available to cover living expenses has very little to do with our taxable income, I'm not sure we qualify for this exemption; it wouldn't be uncommon for us to fall below 400% of the FPL as the IRS sees things. Sounds almost as though we would be penalized for not taking the subsidy! Such a weird law.

In addition, people will be able to apply for exemptions to the tax penalty if:

- they have financial hardships,
- they have religious objections,
- they’re an American Indian,
- they’re uninsured for less than three months,
- they’re an undocumented immigrant,
- they’re incarcerated.

I believe the religious objection applies to those of us who sign up instead for healthcare ministries, but I'm not sure what it takes to establish the exemption. Who knows what a "financial hardship" is per this standard.

raven said...

Be sure to check out the reputations of the insurers- my wife did a bit of research into some of the short term insurance offerings and found some with questionable results.
This looks interesting

Texan99 said...

I've been talking to Assurant Health today, which has a long and respectable history, I think. They also boast a network that, unlike Blue Cross, includes virtually every fine hospital in the country, including the Mayo Clinic. Not cheap, though, by any means.