ObamaCare Whips Federal Employee Health Benefit, Tricare?


Fellow Govvies and Veterans, I hope you’re sitting down.  For those of you at one of those fancy stand-up desks, find a director’s chair to sit in.

The Patient Protection and Affordable Care Act (will be referred to as shorthand ‘ObamaCare’) might make your retirement health care benefit comparatively worth a lot less.

The nation’s most populous state just announced the plan to roll-out its version of the ObamaCare Public Health Exchange-  It’s called “Covered California”.  You can test drive the cost of being on Callifornia’s public exchange by using their cost calculator.

For the uninitiated, the Public Exchange Health Insurance Plans are the plans that will be made available  in 2014 to individuals who are self-employed, unemployed, or otherwise not provided health coverage by their employer.  These are also the plans that will be made available for small businesses to provide to their employees.  These small businesses (under some circumstances) may then be provided tax-credits in exchange for providing their employees with health care.

Back to California’s Public Health Care Exchange Cost Breakdown.  Here are some plug-and-chug examples:

  • Family of 4, Eldest member age 50, Family Modified Adjusted Gross Income (MAGI) of $100k- Pay $1285/month in premiums, with an out-of-pocket (OOP) maximum of $12,100/year.
  • Same Family of 4 earning $70K/yr MAGI pays $554/mo. with an OOP max of $8067/yr (Age independent).
  • Same Family of 4 earning $50k/yr pays $287/mo. with an OOP max of $6050/yr. (Age independent)

These are just the numbers from California’s plan.  You can price out what will be the national average using UC Berkeley’s National Public Health Exchance cost estimator (UC Berkeley).  Their national estimates seem to match the CA exchange estimated costs for the Family of 4 above.

For another cost comparison, if you Live in Massachusetts you can go directly to their already-established exchange calculator.  I plugged in the numbers from our Family of Four above, who may purchase the cheapest Mass. Blue Shield plan for :

  • $878/mo. in premiums and an OOP max of $10k/year.

It also looks like Massachusett’s cutoff for any sort of premium subsidy is at the $70k/year income level. The MA plans look rather expensive in comparison to California- Is everyone in Boston at-risk to get struck by a horse-drawn cart?  I digress.

So how does it affect you?

Let’s compare the “Covered California” Public Exchange benefits to some other Health Plans provided by the Federal Government- The plans available to Veterans and Federal Employees.

 

Tricare Standard Tricare Retired Reserve Tricare Reserve Select FEHB (BCBS Basic)* ObamaCare (<$50k MAGI) ObamaCare ($100k MAGI)
Available to:

Active Duty Retired

Retired Reserves/NG

SELRES (Paid) NG/Reservists

Active or Retired FERS

Everyone

Everyone

Family Deductible $300 $600 $300 $0 TBD TBD
Monthly Premium $0 $970 $196 $300 $287 $1,285.00
=Yearly Premium $0 $11,640 $2,352 $3,600 $3,444 $15,420
Yearly OOP Max $3,000 $3,000 $1,000 $5,000 $6050 $12,100
Yearly Total (Worst Case) $3,000 $14,640 $3,352 $8,600 $9,494 $27,520

Takeaways:

  • Retired from Active Duty?  No-brainer- Keep your Tricare Standard benefit for $0/month premium.
  • Retired from Reserves/Guard?  An ObamaCare public exchange plan may be less costly than Tricare Retired Reserve, depending on your income level and anticipated level of care. Use your state’s Public Health Exchange calculator to decide.
  • Drilling (SELRES, ie ‘paid’) Reserve/Guard ? At  $196/month, Tricare Reserve Select is likely your best deal (note that Federal Employees covered under FEHB are not eligible for TRS).
  • Retired Federal Employee or Govvie considering a VERA/VSIP/RIF offer?  An ObamaCare public exchange plan may be a better deal for you than FEHB if your MAGI in retirement will be less than $50,000 per year.  An Obamaphone   may or may not be included with the Public Exchange Health Plan ;)
  • Note that under most situations where you are eligible for FEHB benefits in retirement or Active/Guard Retired Tricareyour’e not eligible for ObamaCare.

 

References:
Find info on your State’s Exchange plan here:
http://healthreform.kff.org/State-Exchange-Profiles-Page.aspx
Note:*FEHB Worker/Retiree pays $300/mo (BCBS code 112), OOP max $5k/yr, no deductible.

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