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Thread: "Can I still pay cash for medical treatment in 2014" ?

  1. #26
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    Default Re: "Can I still pay cash for medical treatment in 2014" ?

    Quote Originally Posted by SarahTime View Post
    Question about deductibles...

    If you find a plan with a co-pay, how does this factor into the usefulness of the plan?

    For example, before my families private insurance was cancelled (we opted to cancel instead of taking the HUUUUGE rate hike), when one of us went to visit the doctor, we paid a $25 co-pay and that was it. We never got a bill from the doctors office, and we only had to pay our co-insurance amount of 30% of a bill when we had to have lab work done or something similar - and it was only that 30% and we never came close to reaching the deductible yet we still only paid our co-payments and 30% co-insurance and nothing more.

    So while looking at these Obamacare plans, if I choose one that has a stupidly high deductible, but also has a co-pay for doctors visits (some do not have co pays, some do), should I expect the same thing as was happening for us on the private insurance plan?

    I am expecting to pay cash for medical treatment and eat the fine hoping and praying this all gets ummmm... worked out... perhaps. If I can get a reasonable price similar to what we were paying with private insurance and be able to count on the co-pay covering the visit and not having to meet the enormous deductible first, I might change my mind..... might.
    since you're in texas you don't have to pay a fine. your state opted out of rhe ACA.

  2. #27
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    Default Re: "Can I still pay cash for medical treatment in 2014" ?

    since you're in texas you don't have to pay a fine. your state opted out of rhe ACA.

    ^^^ actually, no state was allowed to 'opt out' of the federal Affordable Care Act. What some states WERE allowed to do by the US Supreme Court is to decide they would not commit the state funds necessary to implement Expanded Medicaid, and to decide that they would not commit the state funds necessary to implement a state-run public health insurance exchange ( which forced the public health exchanges established in those states to be federally run not state run ).

    Since the new IRS penalty tax is federal, Americans living in ANY state must pay that new IRS penalty if they choose not to purchase 'qualified' health insurance coverage for themselves ... if such coverage was available at an 'affordable' price. The ACA supposedly establishes 'affordable' to be insurance premiums which ( net of taxpayer subsidies ) do not cost more than 8% of the person's gross income. Thus even Americans who are living in states which did not commit state funding to state run exchanges and/or to Expanded Medicaid will still have to pay the new IRS penalty ... unless their gross incomes are small enough to fall below 133% of the Federal poverty level thus making them ineligible to purchase public health exchange insurance. For a single person without children 133% of FPL is somewhere around $14,000 per year.

    I will add that, for Americans residing in states which chose not to offer Expanded Medicaid and who 'forced' the federal gov't to set up the public health insurance exchange in their states, there is a lawsuit on the federal court docket which could potentially change this situation greatly. That lawsuit contends that the specific wording of the ACA law does not authorize the IRS to pay out taxpayer funded subsidies for public health exchange based health insurance policies. If this lawsuit is successful, then in states which chose not to offer Expanded Medicaid and who 'forced' the federal gov't to set up the public health exchange, state residents earning $150,000 per year or $40,000 per year or $15,000 per year would all wind up having to pay the same unsubsidized monthly premium cost ( which is likely to be in the $200 per month ballpark at minimum in the absence of taxpayer subsidies ).

    If that turns out to be the case after a future court ruling, then some state residents would fall under the 8% 'affordable' insurance exception ... thus would not be required to pay the new IRS penalty tax if, and only if, 12*$200 per month ( i.e. lowest available ) unsubsidized insurance premium cost exceeds 8% of their gross income. So depending on this future court ruling, as well as on the lowest available ( unsubsidized ) public health exchange health insurance premium cost, this may wind up allowing residents of these states who earn less than ~$30k per year to avoid having to pay the new IRS penalty tax based on the 8% 'affordability' exception. But those residents of these states whose incomes will exceed that 8% calculation ( ballpark $30k per year ) will STILL have to pay the new IRS penalty tax if they choose not to purchase health insurance, regardless of how the future court decision actually comes down. And, obviously, future executive action or 'repair' legislation could cause this lawsuit to 'disappear' by confirming IRS authority to pay out taxpayer funded insurance premium subsidy money to ALL Americans earning less than 400% of the FPL ( = about $46,000 per year for a single person with no children ).

    Thus, regardless of what state you live in, unless your earnings level is below the 133% of FPL = $14,000 per year eligibility level for public health exchange insurance purchases, you'd better plan on paying 1%, 2% and 2.5% of your gross income for this new IRS penalty tax in 2014, 2015, and 2016+ respectively, if you don't purchase 'qualified' health insurance coverage and opt to pay 'cash' for medical treatments .
    Last edited by Melonie; 01-12-2014 at 06:10 AM. Reason: n

  3. #28
    God/dess SarahTime's Avatar
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    Default Re: "Can I still pay cash for medical treatment in 2014" ?

    Quote Originally Posted by charlotte. View Post
    since you're in texas you don't have to pay a fine. your state opted out of rhe ACA.
    I wish! Lol
    xoxo ~ Sarah




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