Obamacare questions

[Joey G]

22 minutes ago, OnMyWay said:

I was curious about this.  This is the way I think it would work.  Comments?  I used 3% for the annual premium increase.  They really want to push people to enroll at 65.

I like this kind of analysis. Then depending on when (if) you take it with a penalty you can calculate the age you would break even.

There is one other consideration though. If you delay, you can only buy back in during the open enrollment season (! jan through 31 March).  So if you actually had a medical situation between March 31 and 1 Jan... and wanted to buy in... you would have to wait... and "if" you had any significant hospital bills in that period... you could very well end up with a big bill... wiping out any "savings" by waiting.

It's boils down to how much risk you can stomach, given the potential scenarios.

[MikeB]

1 hour ago, Joey G said:

There is one other consideration though. If you delay, you can only buy back in during the open enrollment season (! jan through 31 March).

True. But in all the years I have been around these forums I have never heard of anyone traveling all the way back to US to use Part B for medical treatment. If you do go ALL the way back and you're admitted it would be Part A anyway and you have that. I don't see paying for it unless you are pretty damn sure you're going back for good. jmo.

[Mike J]

1 hour ago, OnMyWay said:

Yes, I made it, not SS.  I never saw anything like this from SS, just "10% per year of delay".

 Source https://www.thebalancemoney.com/current-and-historical-medicare-part-b-premiums-2388483

 

[OnMyWay]

16 minutes ago, MikeB said:

have never heard of anyone traveling all the way back to US to use Part B for medical treatment.

Yes, me too.  Some talk about it, Guam, U.S., etc.  However, the travel costs, maybe lodging, therapy, and other costs, add up and probably none are covered by Medicare.

I have considered all the options for hip replacement.  Getting it done in the U.S. using Medicare would be quite a bit more than getting it done here in PH.  So I am trying to find a top notch doctor here, and there are some.  Expecting it to cost 500-700 k pesos.

[OnMyWay]

On 11/17/2023 at 5:59 AM, Mike J said:

I am assuming the 10 percent is not compounded but that might be a bad assumption? 

It increases 10% every 12 months you missed enrolling.  So, if your were 96 months past due when you start in 2024, the normal premium in 2024 is 174.70 + 80% penalty = $314.16.  Each year when the premium goes up, you add 80%, for the rest of your life. 

So you will have a breakeven at some point in the future.  In 2025, if the normal premium goes up 3%, it will be 183.44.  Add 80% and it is 330.18.  Penalty is 146.76.  Annual penalty is 1761.  This will go up every year.

I calculated 96 months of not paying the normal premium  at $13,638, using the history table you posted.  Based on this and the 2025 annual penalty, your breakeven will probably be in about 7 years.

See next post on this.

 

Edited November 18, 2023 by OnMyWay

[OnMyWay]

2 hours ago, OnMyWay said:

See next post on this.

I put the numbers into a spreadsheet and I come up with 16 years to breakeven, with 4% inflation on Medicare premium.  If I used 5 %, it drops to 13 years.  I may have made a mistake somewhere.  Let me know.

As others mentioned, there are many other factors to consider, and a primary one is that you can't just flick a switch and turn on Medicare for instant coverage.

Edited November 18, 2023 by OnMyWay

[OnMyWay]

This link has some good, official, info:

https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties

[MikeB]

These penalties are far too harsh. If you choose to retire or live overseas and cannot use medical benefits that you paid into your entire working life you should not be so severely penalized. Many are paying lifetime penalties at a time they can least afford it simply because they made a mistake.

There is a bill, the Medicare Part B Fairness Act (HR 1788), that would cap the penalty at 15% of the monthly premium and limit the length of time it could be levied to twice the period of delayed enrollment. It seems to have bipartisan support but, given the dysfunction of congress, I wouldn't hold my breath.

[Mike J]

14 hours ago, OnMyWay said:

I calculated 96 months of not paying the normal premium  at $13,638, using the history table you posted.  Based on this and the 2025 annual penalty, your breakeven will probably be in about 7 years.

See next post on this.

Nice work on those spreadsheets.   In addition to the $13K saved in premiums I would be willing to bet that that my medical/dental expenses here are still less than what I have spent here, even if I had Medicare B and lived in the US.  I know for example that the deductible on my maintenance meds in the US exceeded the cost of the meds here.

[Mike J]

10 hours ago, MikeB said:

These penalties are far too harsh. If you choose to retire or live overseas and cannot use medical benefits that you paid into your entire working life you should not be so severely penalized. Many are paying lifetime penalties at a time they can least afford it simply because they made a mistake.

There is a bill, the Medicare Part B Fairness Act (HR 1788), that would cap the penalty at 15% of the monthly premium and limit the length of time it could be levied to twice the period of delayed enrollment. It seems to have bipartisan support but, given the dysfunction of congress, I wouldn't hold my breath.

I agree the bill is unlikely to pass but it probably has a greater chance then expanding Medicare outside the USA to selected countries for expats.