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Affordable Care Act -- NOT Affordable


yinne
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Just received my info from Blue Cross Blue Shield my premium is jumping from $578 a month to $1,092 a month and going from a $7,000 deductible to a $8,000 deductible.   We are a self employed (small) farming family -- where in the world am I suppose to find an additional 500 a month to pay the premium -- and no, the insurance agent doesn't think we will qualify for any assistance.   

 

This is crazy -- do you realize that if you don't get insurance by March 31, 2014 you are out of luck until enrollment opens again on October 15, 2014 for the new year 2015.   The only way you can change your plan is if there is a marriage, divorce, birth, or adoption.   So if you get stuck with a rotten insurance company you are stuck for the year -- no changes.

 

I am sorry -- I am so frustrated right now -- I don't know what to do.    We don't do cable, satellite, netflix, data plan cell phones (much to the kids dismay, they would love I-phones), vacations, etc., because we try and be responsible with our money and our choices and we can't afford most of those things -- I can't afford the new and approved health care system -- where can I check out??

 

Yvonne in NE

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Just received my info from Blue Cross Blue Shield my premium is jumping from $578 a month to $1,092 a month and going from a $7,000 deductible to a $8,000 deductible. We are a self employed (small) farming family -- where in the world am I suppose to find an additional 500 a month to pay the premium -- and no, the insurance agent doesn't think we will qualify for any assistance.

 

This is crazy -- do you realize that if you don't get insurance by March 31, 2014 you are out of luck until enrollment opens again on October 15, 2014 for the new year 2015. The only way you can change your plan is if there is a marriage, divorce, birth, or adoption. So if you get stuck with a rotten insurance company you are stuck for the year -- no changes.

First off, I'm sorry that you're frustrated. Health insurance is always frustrating for me. What state do you live in? Has your state elected to set up their own exchanges or will you have to go through the federal exchange?

 

Secondly, and I don't mean to be harsh, but for those under employer based coverage this rule is already in effect. For employers who offer choices, you are locked into the plan until the next year or if you have a qualifying wvent. It stinks, but unfortunately, this is what happens when we work within the existing system.

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http://www.whitehouse.gov/health-care-meeting/proposal/titlei/hardship

 

I found this recently.  We don't qualify for subsidy, but the premiums are more than 8% of our income, which qualifies us for this.  I hadn't heard anything about it though, which surprised me, and I'm wondering how many people will fall into this category.

 

"Hardship" Waiver

Individuals and families are eligible for a waiver from the requirement to purchase health insurance if coverage is unaffordable – if premiums exceed 8 percent of income.

 

Americans under the age of 30 and other Americans who are exempt from the requirement to purchase insurance are eligible for a low-cost catastrophic plan that covers serious illness and injury.

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There is so much confusion about the ACA and it starts in less than two weeks! Perhaps you will have to buy your insurance from the federal (state?) exchange instead of your insurance agent? When do your rates go up? Maybe you can get a plan under the exchange before you need to renew? Hopefully, it will be cheaper.

 

I don't know, I'm just throwing out some ideas. I wish I knew more....

 

hugs,

 

K

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If Christian, look into health sharing ministries. We are part of Samaritans Ministries and have had absolutely no problems with it (3 claims so far, soon to be a 4th). Membership exempts folks from needing health insurance. These groups aren't insurance - they are more like co-ops, but again, we've found nothing but positive in our experience going back at least a decade (maybe more). Our monthly share is $370 and it covers everyone in the family. Regular check ups and anything under $300 isn't share-able, but anything (covered) over it is at 100%. Some things are not covered (mental health, vision, abortions, anything alcohol related, etc) so check into it carefully.

 

And again, it's only open to Christians...

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If Christian, look into health sharing ministries. We are part of Samaritans Ministries and have had absolutely no problems with it (3 claims so far, soon to be a 4th). Membership exempts folks from needing health insurance. These groups aren't insurance - they are more like co-ops, but again, we've found nothing but positive in our experience going back at least a decade (maybe more). Our monthly share is $370 and it covers everyone in the family. Regular check ups and anything under $300 isn't share-able, but anything (covered) over it is at 100%. Some things are not covered (mental health, vision, abortions, anything alcohol related, etc) so check into it carefully.

 

And again, it's only open to Christians...

 

I just printed out their application and will be looking very closely at this.  

 

My brother just found an article that quoted the Nebraska Insurance Commissioner as saying that rates in Nebraska are going up anywhere from 21% to 143%.   The rates from BCBS are pretty much in line with what other insurance companies have proposed based on the rates that the state department of insurance is providing.  

 

Yvonne in NE

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We are self employed as well. Check out United Healthcare. We are guaranteed no rate increases thru 2014. Our premiums for 4 of us (all adults) are about half of your higher rate and our deductible goes down each year we don't make a claim. We haven't made claims because it is high deductible ($5,000, but now $4,000).

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Ssssshhhhhhh...I am trying to ignore the price increase until the open enrollment meeting next month at dh's work. We are used to a short window to get new insurance, but the price and coverage have remained basically the same for 6 years, so I am scared to hear the new numbers. We cannot cut anything else out either, and I do not want to go to work just to pay for insurance, sigh. Ok, head back in the sand until next month.

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Two local hospitals are starting major layoffs in anticipation of ACA.  Several business owners *and* our county government are cutting employee hours so they aren't required to provide insurance.  We don't have insurance at all right now, so I guess we're going to be fined.  I'm so thrilled with this legislation (sarcasm). :glare:

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We are self employed as well. Check out United Healthcare. We are guaranteed no rate increases thru 2014. Our premiums for 4 of us (all adults) are about half of your higher rate and our deductible goes down each year we don't make a claim. We haven't made claims because it is high deductible ($5,000, but now $4,000).

We just went this route this week but with the 10,000 declining deductible. For two people we are only paying a little less than $300. The deductible is outrageous, but with 100% coverage after that and all preventative care included, it was not a bad deal. The price for the $5,000 deductible was only $130 more, so still manageable. We have absolutely no health issues, though, so that may factor in. From what I hear, this policy won't be available at all after the first of the year.

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There is so much confusion about the ACA and it starts in less than two weeks! Perhaps you will have to buy your insurance from the federal (state?) exchange instead of your insurance agent? When do your rates go up? Maybe you can get a plan under the exchange before you need to renew? Hopefully, it will be cheaper.

 

I don't know, I'm just throwing out some ideas. I wish I knew more....

 

hugs,

 

K

 

Yes, this.... look at the state or federal exchange when they start on October 1st. Although the exchanges will be offering private policies, you must get it through them for the exchange pricing, rather than directly through the agent.

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It's all so dependent upon how big a mess your state has made of it. Michigan is really struggling. The governor finally signed the Medicaid expansion this week but it was too late for the October deadline.

 

We purchase our own health isnurance through United Healthcare and I've gotten multiple letters from them cajoling us not to look at the exchanges. We'll see. :)

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 -- I can't afford the new and approved health care system -- where can I check out??

 

Yvonne in NE

You can check out at tax time and pay the penalty.  Here are the penalties by year..

 

 

Your tax penalty for not having insurance is paid on your taxes at the end of the year. If your taxable income is below 133% of the FPL you are exempt from this tax.

2014 = $95 per person per year or 1% of your Income

2015 = $325 per person per year or 2% of your Income

2016 = $695 per person per year or 2.5% of your Income

2017 = Tax Penalty will increase by the rate of inflation going forward, or 2.5% of your Income

 

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I am still trying to figure out how this is going to "help" people who can't afford insurance.  What, they want to give tax rebates?  We don't have the money to spend to get it back at tax time!

 

I'm pretty sure these credits work differently than normal tax credits. As in, applied at time of payment of premiums, not at tax time. Trying to find confirmed info on that but that's how it was explained at a class I attended.

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Yes, this.... look at the state or federal exchange when they start on October 1st. Although the exchanges will be offering private policies, you must get it through them for the exchange pricing, rather than directly through the agent.

 

Hmmm, that is interesting because the agent, who we have known for years, told me today that it makes no difference if I go through the exchange or him the pricing is the same.    He also said that the whole thing is one big mess :(

 

Yvonne

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I'm pretty sure these credits work differently than normal tax credits. As in, applied at time of payment of premiums, not at tax time. Trying to find confirmed info on that but that's how it was explained at a class I attended.

 

It was explained to me today that you will be able to choose to have the subsidy sent directly to your insurance company or receive a tax rebate at the end of the year.

 

Yvonne

 

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I hear you. Same boat here. Self-employed. Blue Cross Blue Shield. Even in a different state (Oregon), rate increase is very similar. The plan they're offering us to replace our current high-deductible policy, that will be discontinued with ACA, more than doubles the premium while raising the deductible even higher. With the pediatric dental coverage (required by federal law for all children up to age 19—did you know that?) lumped on top of it, deductibles would be more than 15% of our gross income.

 

I called our local health insurance agent (not Blue Cross Blue Shield) to talk me down off the ledge when the letter arrived this week. She said it appears BCBS is trying to purge their rolls with this insane increase and recommended we look elsewhere. She ran some quick numbers on some of the plans, including those on our state's exchange. The numbers were much more reasonable. We'll likely qualify for a gov't subsidy, but the subsidized plans won't allow us to contribute to an HSA, which we've been doing for ~8 years. So I can't keep my plan and can't continue my HSA. Thank you very much.

 

Hugs and best wishes as you navigate your choices.

 

Erica in OR

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I hear you. Same boat here. Self-employed. Blue Cross Blue Shield. Even in a different state (Oregon), rate increase is very similar. The plan they're offering us to replace our current high-deductible policy, that will be discontinued with ACA, more than doubles the premium while raising the deductible even higher. With the pediatric dental coverage (required by federal law for all children up to age 19—did you know that?) lumped on top of it, deductibles would be more than 15% of our gross income.

 

I called our local health insurance agent (not Blue Cross Blue Shield) to talk me down off the ledge when the letter arrived this week. She said it appears BCBS is trying to purge their rolls with this insane increase and recommended we look elsewhere. She ran some quick numbers on some of the plans, including those on our state's exchange. The numbers were much more reasonable. We'll likely qualify for a gov't subsidy, but the subsidized plans won't allow us to contribute to an HSA, which we've been doing for ~8 years. So I can't keep my plan and can't continue my HSA. Thank you very much.

 

Hugs and best wishes as you navigate your choices.

 

Erica in OR

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Thank you.

 

This is what bothers me:

 

For the poorest Americans, the ACA greatly expanded access to Medicaid. However, the Supreme Court's ruling said states did not have to accept this provision of the law, and many states have said they oppose the expansion. In states that do decide not to expand their Medicaid rolls, it's not expected that many affected people will be able to afford health insurance through their state exchange.

 

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Our insurance changed drastically this year. We have an $8400 deductible and after the deductible we are responsible for a percentage. My dh has had medical issues the past few weeks that are putting us in serious debt. I really don't know how we can get out of it. I also have two dds with airway/asthma issues and am really worried about being able to keep their appointments (meaning pay for them). Our insurance for the past 13 years has been great.  We have had bills but nothing like this year that threaten to hurt us so horribly.

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Erica in OR:

 

I did call BCBS and they recommended that as soon as the Marketplace opens Oct 1 that I check other companies other than BCBS, but did tell me that I would find that the BCBS rates were some of the lowest in Nebraska.     The prelimnary numbers that the state department of insurance posted didn't really have BCBS rates any higher than the other 3 companies they were quoting.   We also contribute to an HSA, not sure what will happen with that. -- Ugh, I hate, hate, hate this!!!

 

So much for "If you like your plan, you won't have to change!"

 

Yvonne in NE

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Our insurance changed drastically this year. We have an $8400 deductible and after the deductible we are responsible for a percentage. My dh has had medical issues the past few weeks that are putting us in serious debt. I really don't know how we can get out of it. I also have two dds with airway/asthma issues and am really worried about being able to keep their appointments (meaning pay for them). Our insurance for the past 13 years has been great.  We have had bills but nothing like this year that threaten to hurt us so horribly.

:grouphug:

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Hmmm, that is interesting because the agent, who we have known for years, told me today that it makes no difference if I go through the exchange or him the pricing is the same.    He also said that the whole thing is one big mess :(

 

Yvonne

 

You cannot get subsidies if you go through the agent.

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We just went this route this week but with the 10,000 declining deductible. For two people we are only paying a little less than $300. The deductible is outrageous, but with 100% coverage after that and all preventative care included, it was not a bad deal. The price for the $5,000 deductible was only $130 more, so still manageable. We have absolutely no health issues, though, so that may factor in. From what I hear, this policy won't be available at all after the first of the year.

 

I just emailed our agent. After reading Pamela's thread, I want to know that the policy will be good, and not go rummaging back in our past to try to deny claims, even though there is no reason. We have been through that (and won) but it was a hassle to say the least. I see that those with pre-existing conditions can get insurance. But what about policies still in force? The marketplaces only sell Oct. - Dec. so we will have to keep our plans all of 2014.

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If Christian, look into health sharing ministries. We are part of Samaritans Ministries and have had absolutely no problems with it (3 claims so far, soon to be a 4th). Membership exempts folks from needing health insurance. These groups aren't insurance - they are more like co-ops, but again, we've found nothing but positive in our experience going back at least a decade (maybe more). Our monthly share is $370 and it covers everyone in the family. Regular check ups and anything under $300 isn't share-able, but anything (covered) over it is at 100%. Some things are not covered (mental health, vision, abortions, anything alcohol related, etc) so check into it carefully.

 

And again, it's only open to Christians...

Are there any others besides Samaritans Ministries??

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We just went this route this week but with the 10,000 declining deductible. For two people we are only paying a little less than $300. The deductible is outrageous, but with 100% coverage after that and all preventative care included, it was not a bad deal. The price for the $5,000 deductible was only $130 more, so still manageable. We have absolutely no health issues, though, so that may factor in. From what I hear, this policy won't be available at all after the first of the year.

 

I am not covered (lost benefits in a job change. Chose to see my children occasionally instead).

 

I got notice recently that 1) the state will not cover my kids through CHIPS anymore and 2) I lost the appeal.

 

I am *seriously* considering filing for disability for my dd - something I'd rather not do and haven't done in the nearly 8 years she's been diagnosed.

 

My xh was informed that the kids are not covered and is coming unglued. He's telling me to "get coverage" and "call my insurance company." When I informed him that a $345 a month policy would come with a $10k PER PERSON deductable, he supplied the.best.answer.ever. "Just call and get a $1000 deductible policy."

 

Yea, dude, because they are going to totally offer that at a reasonable rate. I must be stupid.

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Have you looked into if any of your local doctors offer a subscription/concierge type service? That's what I'm trying to get my parents to switch to. If you can use that for regular healthcare and then find some kind of insurance that covers catastrophic/emergency care only it may be cheaper.

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http://www.whitehouse.gov/health-care-meeting/proposal/titlei/hardship

 

I found this recently. We don't qualify for subsidy, but the premiums are more than 8% of our income, which qualifies us for this. I hadn't heard anything about it though, which surprised me, and I'm wondering how many people will fall into this category.

 

"Hardship" Waiver

Individuals and families are eligible for a waiver from the requirement to purchase health insurance if coverage is unaffordable – if premiums exceed 8 percent of income.

 

Americans under the age of 30 and other Americans who are exempt from the requirement to purchase insurance are eligible for a low-cost catastrophic plan that covers serious illness and injury.

Thanks for this. Premiums now eat up much more than 8% so if things don't change once the federal exchange opens (we r in Florida, land of Rick Scott) we will look into this.

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I am still trying to figure out how this is going to "help" people who can't afford insurance.  What, they want to give tax rebates?  We don't have the money to spend to get it back at tax time!

Exactly!  This is what everyone has been saying for years. 

 

If you can't afford it now, you sure can't afford it as the rates rise exponentially to cover all of the ridiculous requirements.  But if you don't buy it - you will be penalized.

Lose-lose for all of America, except a few small pockets, like those under a certain income level - and older people.  Big losers are young people. 

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I just printed out their application and will be looking very closely at this.  

 

My brother just found an article that quoted the Nebraska Insurance Commissioner as saying that rates in Nebraska are going up anywhere from 21% to 143%.   The rates from BCBS are pretty much in line with what other insurance companies have proposed based on the rates that the state department of insurance is providing.  

 

Yvonne in NE

 

Send me a pm if you want any more specific info than what you see on there. The claims we had were for a broken collarbone (gym accident), a blackout in the horse pasture (check to make sure nothing was wrong), and when youngest developed epilepsy. There was absolutely no problem with any of them - all bills were covered - and we could choose any doctor we wanted. The fourth claim will be as they figure out what the mass is behind my left eye. When we thought it was a vision issue we were prepared to pay for it ourselves. Now that it is a medical issue it is a claim they will take. I've already called to make sure. My appts are at Johns Hopkins, so I doubt it will be inexpensive.

 

Every single one of these would have been more expensive with the insurance we used to have as that had a deductible and only 80% coverage up to 10K. Our monthly premiums were also more expensive.

 

The difference in monthly costs alone more than allows us to pay for our own check ups, dental, and vision (two of mine wear glasses).

 

I think the difference in cost is due to the health sharing ministries being non-profit and low overhead.

 

I definitely recommend signing up for the Save to Share program for anything > 250K. We signed up for it - just in case - and it's quite possible (though not yet definite) this last one will need it. We've sent shares to others with similar needs. I'm glad we've had the opportunity to share this way (directly to real people). It honestly "feels better" than sending in another insurance payment as with car/farm, etc.

 

But it's not for everyone, so read the guidelines and decide what works best for you.

 

You can check out at tax time and pay the penalty.  Here are the penalties by year..

 

 

Your tax penalty for not having insurance is paid on your taxes at the end of the year. If your taxable income is below 133% of the FPL you are exempt from this tax.

2014 = $95 per person per year or 1% of your Income

2015 = $325 per person per year or 2% of your Income

2016 = $695 per person per year or 2.5% of your Income

2017 = Tax Penalty will increase by the rate of inflation going forward, or 2.5% of your Income

The problem with "nothing" is what happens when you go for what you think is a basic eye issue and find out it is not that and could be a whole lot more. Or what happens when one develops epilepsy (or heart disease or...). Everywhere we go now, the first question asked is "How are you going to pay?" There is basic care for those who can't pay, but I wonder how that works when it's no longer a basic problem. If we had nothing, I don't think they'd be able to do the tests they plan to do to see exactly what it is I have. They're expensive tests.

 

 

Are there any others besides Samaritans Ministries??

Last I knew there were 3 groups (Samaritans is one). I haven't looked/compared since we decided to go this route rather than insurance as even back then, insurance was costly - costly enough that we looked to see what else was possible akin to the OP. It's getting really out of hand now IMO. A google search should bring any up. To my knowledge, no similar group exists for non-Christians - I wish there were MANY of these groups for all sorts of different people as it is far less costly than our current "for profit" companies, but I digress.

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Exactly!  This is what everyone has been saying for years. 

 

If you can't afford it now, you sure can't afford it as the rates rise exponentially to cover all of the ridiculous requirements.  But if you don't buy it - you will be penalized.

Lose-lose for all of America, except a few small pockets, like those under a certain income level - and older people.  Big losers are young people. 

 

With the subsidies, most families of 4 making under about $80,000 will qualify for some subsidies. Young people make less and are going to qualify for subsidies.

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I am not covered (lost benefits in a job change. Chose to see my children occasionally instead).

 

I got notice recently that 1) the state will not cover my kids through CHIPS anymore and 2) I lost the appeal.

 

I am *seriously* considering filing for disability for my dd - something I'd rather not do and haven't done in the nearly 8 years she's been diagnosed.

 

My xh was informed that the kids are not covered and is coming unglued. He's telling me to "get coverage" and "call my insurance company." When I informed him that a $345 a month policy would come with a $10k PER PERSON deductable, he supplied the.best.answer.ever. "Just call and get a $1000 deductible policy."

 

Yea, dude, because they are going to totally offer that at a reasonable rate. I must be stupid.

 

Double check on those deductibles.... Many of the per person deductibles also have a per family.... I got a bit freaked out when I saw per person on our policy but then read further, and found where it said that there was also a family limit, which was the same as the per person. We've had the policy for about 4 years now... how it works is if one person uses it up quickly, the family is met by the one per person. If several family members use small amounts, they are combined to meet the family amount. Only one needs to be met and our deductible is considered reach, and then the insurance company pays 100% of everything else (or whatever amount your policy indicates, ours is 100% after deductible but our deductible is much lower than 10k).

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The problem with "nothing" is what happens when you go for what you think is a basic eye issue and find out it is not that and could be a whole lot more. Or what happens when one develops epilepsy (or heart disease or...). Everywhere we go now, the first question asked is "How are you going to pay?" There is basic care for those who can't pay, but I wonder how that works when it's no longer a basic problem. If we had nothing, I don't think they'd be able to do the tests they plan to do to see exactly what it is I have. They're expensive tests.

 

 

 

I'm not advocating going without, just providing the amount of the tax for opting out.  OP said 'where do I check out?'  That's the only way unless you meet requirements for an exemption.  I think the tax is outrageous and adds insult to injury.  My Dh is unemployed right now and we are paying for COBRa for ourselves and kids receive state funded healthcare, but *I think* when I checked, we don't qualify for subsidies or exemption.  The more I read about ACA the more nervous I get about OCt 1st.    

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I'm not advocating going without, just providing the amount of the tax for opting out.  OP said 'where do I check out?'  That's the only way unless you meet requirements for an exemption.  I think the tax is outrageous and adds insult to injury.  My Dh is unemployed right now and we are paying for COBRa for ourselves and kids receive state funded healthcare, but *I think* when I checked, we don't qualify for subsidies or exemption.  The more I read about ACA the more nervous I get about OCt 1st.    

 

This calculator will help you figure out if you qualify for subsidies.

 

http://kff.org/interactive/subsidy-calculator/

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This calculator will help you figure out if you qualify for subsidies.

 

http://kff.org/interactive/subsidy-calculator/

Thank you.  I tried it and it says a bunch of confusing stuff and does not address whether COBRA is considered insurance offered by the employer or not.  If it is, we are not eligible.  COBRA costs us big time per month and I don't know how long we can continue to pay.  I will have to research further.  

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Thank you.  I tried it and it says a bunch of confusing stuff and does not address whether COBRA is considered insurance offered by the employer or not.  If it is, we are not eligible.  COBRA costs us big time per month and I don't know how long we can continue to pay.  I will have to research further.  

 

Looks like you'll be able to use the exchange.

 

http://www.nbcnews.com/health/workers-leaving-jobs-health-exchanges-offer-insurance-choices-beyond-cobra-4B11181097

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