Currently I have no insurance to speak of. Been told I need knee surgery and therapy afterwards. Told I need cataract surgery. Rough estimate of cost without insurance is about $15, 000. 62 years old. Took early retirement so I make little and will get a large supplement from the government to do Obama care. Could probably get a gold plan for about $700 a month out of pocket that would pay for everything. My question is, if anyone knows, what if I have all my medical things done in January and February, get the insurance to pay, then drop my insurance in May? Can I do this? I know I might have to pay that IRS penalty for not having insurance, but that would still be cheaper than7 more months of $700 dollars. I don’t care if it seems unethical, is it allowed and legal?
How much the Obamacare penalty costs
I don’t know about the legality, but the link lists exemptions that allow you not to pay the penalty.
Yes. I did something very similar 2 years ago.
The Instructions for IRS Form 8965 give some exemptions to paying the fine for not having health care. Perhaps the exemption for the cost of heath care being greater than 8.05% of your household income would apply. The link I provided is for tax year 2015, these rules may change by 2017. Hopefully though this will give you an idea about whether you’d even have to pay the fine for the months you dropped out of coverage.
Have you priced airline tickets and hotels in Belgium?
Cataract eye surgery - around $450 in Poland. A straightforward op that doesn’t require staying overnight in hospital. It has a high success rate too. Polish eye surgeons have developed a reputation for being highly trained and have been taught outside their country.
Knee replacement: around $4000 in France.
I bet there are agents in the US who arrange packages for this kind of problem.
This is aimed at UK patients wanting to jump NHS queues, but would also apply to US citizens (apart from the extra travel cost). http://www.mirror.co.uk/news/uk-news/cut-price-surgery-abroad-safe-way-5846462
The trouble with overseas stuff is if you do have a complication and are forced to stay (infection blood clot) I’ll bet any money you might save will be quickly lost And if you have a later complication and already home, good luck finding a doctor to take you on or correct the problem.
If cataract surgery is $450 in Poland, and $15,000 in the U.S., I doubt any complications would be more than the money you saved. And given the reputation of overseas doctors (e.g., Poland for cataract surgery), complications don’t seem to be any more of an issue there than they are here.
If you have a later complication that develops in the U.S., why wouldn’t a U.S. doctor be willing to treat you?
The total cost for the knee and eye was $15,000. I can get the cataract by itself for About $4000. So if the flight cost from NY to Warsaw is about $1,800 per person (orbitz) and the wife would also go and that doesn’t include the hotel, I ain’t really saving. And while you can get a DR. to fix a problem another Dr. has made, its more expensive than having the original Dr. do it. Then there’s the language problem. I like to know what my doctors and nurses are telling me and even if they speak english, sometimes I miss stuff if they have a heavy accent. And this topic really isn’t about how to get cheap surgery, it’s about can I screw the insurance companies legally by getting them to pay for stuff and then dropping them.
It’s a cost/benefit question … and remember with insurance in hand those few months, you can get all the routine check-ups we both know you’re behind on … $1800 NY to Warsaw? … How much to London and get a train pass, tourism has value, make a vacation of it … bring grandkids to haul the luggage.
Good luck screwing the insurance companies, you certainly have my support … hope it works …
Sorry. I misread.
Does a gold plan really pay all of the surgery costs? I have my own health care so I haven’t read too much about the plans, but I did help a friend look over them when they started. I don’t recall them paying more then 80%. Platinum plans covered 90%. And this is after the deductible is met, which I thought was $2000.
So you have to pay the first $2000, then 20% of the $13,000, or $4600. Plus the monthly premiums until you can switch or drop out.
Are there restrictions for pre-existing conditions that would apply?
How about getting the surgery and then dropping back to a less expensive plan?
Dennis
Can you, as the OP suggests, drop the Obamacare coverage, or as the previous poster suggested, change to a different plan, mid-year?
I thought that’s why insurance plans had enrollment periods. (Of course if you have a “qualifying life event” they allow changes out of the enrollment period.)
I was lucky and found out I needed surgery before the enrollment period in late 2013. Things may have changed in the last few years, but at the time I paid $2000 total for 4 months insurance (top tier plan) plus $1050 out of pocket and received about $57000 of medical care. Do I feel bad… No. The US military cannot account for $6.5 TRILLION and yet we cannot afford universal healthcare.
It is amazing that the US still has a system that allows this.
In the 1990s, Washington State had a system with universal guaranteed covererage but no mandate. After a few years of people signing up only when they needed coverage, no insurers would sell policies to individuals.
So as I understand it the OP wants to Join ObamaCare in January for $700 per month, have $15,000 of medical work done, then drop the insurance in May.
So 2800 in premiums, have a 15,000 procedure and then get out, and people wonder why the insurance companies are dropping out of the ObamaCare plans.
Oh yeah, and folks here scream all the time about those evil insurance companies.
jasg / davida03801 - these are some of the reasons why Obamacare is a shitty law. People looking to game the system so that someone else will pick up the tab.
Crappy compared to the rest of the civilized world but better and more humane than what we had.
Yeah, in Canada the procedures would cost him $3/hr for every hour spent in the hospital, or else just taxi fare if he didn’t want to pay parking. (Probably better to take the taxi if you’re having an eye operation.)
Seriously, you want a Rube Goldberg medical system, you get RB-type users of the system.
In Montreal, parking at the hospitals I use is more like $15/hour and you have to drive. Go with taxis. I also had to pay $300 each for “flexible” lenses. Not sure what the difference is, but they are supposedly better.
But yes, the system is very straightforward and not gameable. We pay for it through taxes of course. Something like 47% of Quebec’s budget is for medicare. And there is some federal subsidy besides. So over 50% of my taxes go towards medicare. Worth every cent. Seriously.
It wasn’t deigned that way. But it’s the only way it could be passed.