Lion in Winter

Yes, it's a "good" plan as these things go. But very expensive. It's not an ACA plan at all, it's a privately-organised group plan by my former employer for long-term former employees who are fully vested in their private retirement plan but are not yet of retirement age, so essentially it's like getting the same plan that I was getting when I worked for them, but paying the full whack, like Cobra. I looked at the ACA plans available and could not do better - in fact I could only do worse, an equally high premium for less coverage and a higher out of pocket. That 3k OOP is each, btw, not just for me. So there's no more cost this year for the OH, who incurred the 3k charge, but should I need anything I will also be charged up to 3k.

Steerpike

Wow, I've never heard of such an arrangement, but glad you were able to get it! When you say 'like Cobra', did it differ in any way - were you also eligible for Cobra, and rejected it due to this 'other' plan being available? Perhaps your plan lasts longer than the 'time-limited' Cobra arrangement? I presume it's only good as long as your company stays in business ... so you have to hope they don't go away! I presume it is 'ACA compliant'.

As for OOP, mine is $8,550 for me, $17,100 for 'family'! My deductible is $5,500 for me, $11,000 for family.

Last year, I 'rolled the dice' and took a non-ACA compliant plan. It had a $1M lifetime cap, and excluded any pre-existing conditions (both things that were outlawed by ACA, but re-admitted under-the-radar by Trump). Since I had no pre-existing conditions, I decided to give it a go. The premium was quite a bit less, and the deductibles and OOP were lower. But I never felt comfortable with it (risk-wise), and this year switched back to ACA-compliant. I don't know if Biden administration is going to allow those non-ACA compliant plans to continue. Technically, they were called 'short term' policies and only lasted 3 months. Their stated 'intent' was to act as stop-gap policies, but - they also had a 'scheme' where you could bundle 4 3-month policies together in a weird way, and treat it as a regular policy ... almost.

Lion in Winter

It's a large, old, national charity with an established plan that is offered by its own retirement fund as a benefit (also established a long time ago). The plan is the exact same plan I had as an employee, but I now pay the full premium, unsubsidized by them, which is what I meant by "same as Cobra". There are some smallish co-pays, plan pays 80% of everything until I hit that max out of pocket, then it pays 100%. No deductibles, just the OOP. Had I not been eligible for this plan, I could have taken Cobra but it would have been the same plan at the same price, and I can stay on the charity's own plan until I reach US federal retirement age. Planning to go back to the UK in 22, so hopefully that won't be necessary. They've been around a very long time, and if covid didn't finish them then I think I'm good for another year! I wouldn't be able to manage it for longer I don't think, but with so little time left to go needing it, and with an OH who I knew would have to make full use of it this year (a planned, necessary procedure) it made sense.

tht

not to split straws, but COBRA includes a 2% markup to pay for administration.

Lion in Winter

Well there you go. I've saved myself 2%

Steerpike

Party at LIW's house!

Lion in Winter

Can I offer you a glass of cooking sherry?

Giantaxe

And this year, thanks to the American Recovery Act, you get six months free COBRA, paid for in full by your ex-employer:

https://www.littler.com/publication-...-cobra-subsidy

Steerpike

From my quick reading of that article, the employee (ex-employee) gets six free months of COBRA, but it's actually paid for by the government, 'through' the employer, in the form of a subsidy, right?

Lion in Winter

Too late for me. I was booted over a year ago. And I wouldn't have been able to pick up the plan I have now, either, at that point. It was a rollover.

spouse of scouse

Sounds like you made the best decision from what was available at the time, quite a feat on its own. Here, have a large sherry on me

Giantaxe

Yes, I believe that's correct. Not sure who ends up paying that possible 3% administrative fee but obviously that's a small part of the puzzle. I was on COBRA last year until I was eligible for Medicare; had this provision existed then it would have saved me $$$. Thanks, Trump !

sid nv

The marketing blurb from the Medicare Advantage Plan offered a $50 gift card for completing a colonoscopy. Instead of this, we received a bill for $275. Well, when I say "we", I mean wife as I am too much of a coward to volunteer for a colonoscopy.
Apparently the colonoscopist snipped a couple of polyps while traversing this avenue, which changed the billing code. But to be fair, we received a comprehensive report with a series of pictures in full technicolor detailing the exploration and operational measures undertaken in this labyrinth. This is perhaps superior to NHS service, I have no personal experience.

spouse of scouse

My husband had a colonoscopy in the UK (England) about 3 years ago. No pretty pictures (not that he wanted any!), but of course a full report sent to his GP. The thing he didn't like about having the procedure in the UK is he wasn't sedated so it was very uncomfortable. They knock you out in Oz, probably the US as well?

Lion in Winter

Haven't done it yet myself, but yes, full sedation. Not unconscious, since they want you to be able to respond to instructions, but so sedated that you don't remember the procedure afterwards.

Which is weird.