Monday, May 16, 2022

Hi diddley dee, it's HDHP for me

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Welp, after 25 years of employer-sponsored health coverage provided by a hospital, my wife and I are enrolled in ACA marketplace coverage, effective June 1.

I have a post pending  up at outlining how, as an older couple with enough savings to cover the annual out-of-pocket maximum, we were pushed relentlessly by the marketplace benefit structure (and the U.S. tax code) to enroll in a high deductible bronze plan linked to an HSA. 

Factors include: 1) the large spread between premiums for benchmark silver and the cheapest bronze plans that generally obtain for older enrollees, as premiums, and therefore subsidies, increase with age; 2) the high out-of-pocket maximums that are the norm for silver as well as bronze plans (for those who don't qualify for CSR); 3) the lower statutory OOP maxes attached to HSA plans; the above-the-line deductibility of HSA savings, which increases premium subsidies; and 4) the possibility of a medical costs tax deduction if we both turn out to need a lot of medical care. I don't like being in a plan with a $6,000 individual deductible, but the odds that an available silver or even non-HSA bronze plan would end up saving us money are vanishingly small.

P.S. a warning to those who transition from employer-sponsored insurance to the marketplace: I, a well informed and neurotically attentive applicant, screwed up on the application for a Special Enrollment Period. The form asks when you will lose coverage, and I put down the first day we would be without coverage, June 1. The correct answer is May 31 -- and the GetCoveredNJ form does not specify whether to put down the last day you're covered or the first day you're not, or warn of the consequences of getting this wrong. Accordingly, when I selected a plan, the effective date came up as July 1 -- a month late. 

A very professional assister on the GetCoveredNJ help line got this problem fixed quickly and told me it's a frequently-needed fix for people transitioning from other coverage. Hopefully it will be fixed in time for OEP 2023 -- generally, they can't change text before the annual retool. Transitioner beware!

Once more: the full post is here.

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