Health Care Reform Part IV: The Trumpening

Discussion in 'Politics & Current Events' started by Knave, Dec 3, 2016.

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  1. taosjohn

    taosjohn Member+

    Dec 23, 2004
    taos,nm
    MS. Tysabri
     
  2. dapip

    dapip Member+

    Sep 5, 2003
    South Florida
    Club:
    Millonarios Bogota
    Nat'l Team:
    Colombia

    IIRC, as long as he buys another house within a year the income is not taxable, but if he's selling a second home, or he just keeps the money, it is taxed heavily, being the goal to incentivize home ownership. Also, unless you cash out everything within the same year, probably most of the stock gains are not taxed either, and that's how the rich keep rolling their monies.
     
  3. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    I’m surprised. Normally drugs you need to have administered by a physician are covered under Part B.
     
  4. song219

    song219 BigSoccer Supporter

    Apr 5, 2004
    La Norte
    Club:
    DC United
    Nat'l Team:
    Vanuatu
    Gains on the sale of your house are only taxable over a certain amount. Gains on stocks are usually taxable.

    Dapip beat me to the post with more detail.
     
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  5. taosjohn

    taosjohn Member+

    Dec 23, 2004
    taos,nm
    It wasn't on label yet-- only thing approved at that point IIRC was Copaxone.
     
  6. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    Tysabri is also available in a self-administrated form but it’s a non-covered drug that runs about $98k a year. That’s why most opt for going to the doc to get it infused and covered by Part B.
     
  7. taosjohn

    taosjohn Member+

    Dec 23, 2004
    taos,nm
    Mine were infusions, but they weren't covered at the time.

    Self administered Tysabri didn't exist at all. As it developed, I couldn't stay on it due to allergies, and was moved to Gilenya, then Mayzent. But for the first not-quite-a-year it made more sense to put off MC and stay on the COBRA even though I was already on SS. The change to Gilenya, election of MC, and the expiration of COBRA all came at roughly the same time.
     
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  8. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    That was the case until the tax reforms of 1986 under Reagan. Now, with some caveats on length of ownership/occupancy it's $250k/$500k single/married tax free and then everything beyond that is taxed at long term capital gains rates. That's for a primary residence.

    https://www.nolo.com/legal-encyclopedia/the-250000500000-home-sale-tax-exclusion.html
     
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  9. xtomx

    xtomx Member+

    Chicago Fire
    Sep 6, 2001
    Northern Wisconsin, but not far from civilization
    Club:
    Chicago Fire
    No, this is not correct.

    In 1997, when President Bill Clinton executed the Taxpayer Relief Act of 1997, the way home sales were taxed changed dramatically. Prior to the change, the Seller of a home could delay paying tax on a home sale only if they “rolled-over” the gain and purchased a more expensive home within two (2) years of the sale. A separate rule applied to those over age 55 that gave them a single $125,000 exclusion.

    Under the current law, as long as this profit (also called the “gain”) is less than $250,000 ($500,000 for joint filers) the gain will not be taxed. Any amount above these limits may be subject to Capital Gains Taxes.

    To determine if a property qualifies as a “principal place of residence,” certain criteria must be satisfied. In order to qualify for the exclusion, the Seller must have owned and used the property as the Seller’s principal residence for two (2) out of the five (5) years prior to the date of sale,
    The Seller must not have sold another principal place of residence within the 2-year period prior to the sale.
    The property could not have been used for any commercial purpose.

    For married taxpayers who file a joint return the exclusion is up to $500,000 of the gain. In this case, only one spouse need meet the two (2) out of the five (5) years ownership requirement, but both spouses must meet the two (2) out of the five (5) years year use requirement. That is, if the wife has owned and used the house as her principal residence for two (2) out of the five (5) years, but her husband did not use the house as his principal residence for the required two (2) years, then the exclusion would only be $250,000.

    There are also rules for people who have to move due to disability or if a spouse has passed away.

    These rules do not apply if part of the property was being used for any commercial purpose. It does not apply to investment property, rental property, vacation property (there can only be one principal place of residence) and does not apply to vacant land.

    Clinton 1997, not Reagan 1986.
     
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  10. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    #5260 M, Jun 21, 2020
    Last edited: Jun 21, 2020
    So crunching the numbers on late enrollment penalties, it definitely pays for me to delay Medicare enrollment until the general enrollment period that ends at the end of March 2021. Given the way the part B late enrollment penalty applies, I won't pay a penalty (I'll be late less than a year). Of course, this being Medicare, the part D penalty is calculated differently, so I'll pay an approx. $3 penalty per month for the rest of my life (which I am well aware can increase). But my part B cost is going to be so high until 2022, that it's a no brainer to do this financially.

    So, once my COBRA expires late summer, we'll both get an ACA policy- unlike Medicare, the end of COBRA allows immediate ACA enrollment 60 days before/after termination. I'll remain on that until July 2021 (first day of Medicare coverage) and my wife for an additional two years until Medicare-eligible. Of course, if the Supreme Court chucks out the ACA this fall, that strategy will change! Actually our country of residence may change...

    Sorry, but I think all this is a complete nonsense and caused solely by all the disparate systems of healthcare access in the US. I will also say I think the actual healthcare I've received in the US has been consistently excellent; it's the means of access that is crazy.
     
  11. Are headache pills free in the States? You really need those while trying to sort out what you should do choosing a health insurance.:ROFLMAO:
     
  12. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    You should be able to find a drug plan to enroll in until you want to get into Medicare that would satisfy the Credible Coverage requirement, eliminating the $3 penalty.

    And I will state again, your situation is not in the same zip code as normal. Your specific situation is experienced by probably 1% of new Medicare enrollees which are numbering around 10,000 a day.
     
  13. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    Hmm, didn't even realize I could enroll in part D without enrolling in partA/B. That might be an option. But I think I'd have to enroll in a part D plan during my initial enrollment period (which expires Jan 31st, 2021) because.... of course, part D does not have a general enrollment period that matches the one for parts A/B.. Oh, and I will point out that for part D, unlike for parts A and B, COBRA coverage could be creditable for prescription coverage. But not ACA prescription coverage it seems?
     
  14. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    It wouldn’t be a Part D plan because it wouldn’t be Medicare. It would be a stand alone Rx plan that meets the criteria of being credible coverage.

    Like with your taxes and money management, your situation should involve a professional.
     
  15. I think you can graduate in the states on a thesis about how to find the health care solution fit for you.:ROFLMAO:

    Edit: I bet stanger has a phd in it.
     
  16. Well, that's the point. We keep it simple. Sell your house/stocks, not income/profit.
    In the states, ....not income/profit in case x, yz etc.;)
     
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  17. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    Regardless of M’s situation, Medicare is very simple for the majority of people.

    You sign us either when you turn 65 or when you retire and are no longer eligible for your employer plan. You give me the date your employer plan ends and the Medicare plan begins the first of the next month.

    If you don’t have an employer plan, your a Medicare plan starts the first day of your 65th birthday month.

    M’s situation is getting so far into the weeds I’m beginning to think he is just trying to throw me curveballs yo try to see if I really know what I am doing.

    Here’s a hint, I do.

    I work with people of all income levels, from Medicaid members to the very wealthy.

    Most people don’t have M’s issues.
     
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  18. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    I think you underestimate the number of people with issues similar to mine. After all, many stop paid employment before age 65. Many of those will be on COBRA, ACA etc. All of those will have to deal with the byzantine rules regarding Medicare's interaction with those things, as well as the inconsistencies within Medicare itself - for example, given we've been talking about drug coverage, it's truly bizarre that the rules for part D are inconsistent with those for parts A/B. Really, the only straightforward transition is from either zero health insurance or employer group insurance. It really looks like Medicare was never tweaked to take account of the transition from either COBRA (mid 80's iirc) or the ACA. Or the introduction of HSAs.

    Oh, and every single thing I've posted on here regarding Medicare is something relevant to my situation.
     
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  19. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    There are reasons why healthcare eats up a far higher percentage of GDP in the US than in any other country. This is one of them.
     
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  20. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    Thing is, I’m not estimating anything. I meet with around 500-700 people a year either in their home, at group meetings or over the phone.

    The percentage of people that choose COBRA to extend their benefits if retiring before 65 is maybe 1 or 2 in my entire career. Most people aren’t willing or able to pay for COBRA coverage.

    So no, you are just dead wrong on that.

    And most ACA plans are compliant, or at least they were.

    Most people that retire early either negotiate staying on their employer plan as part of their retirement package or go on to a spouse’s plan.

    Add in your issue with IRMAA and you are truly a unicorn.
     
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  21. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    I disagree. My suspicion is that people on COBRA/ACA simply throw their hands up and go for the path of least resistance and sign up for Medicare at the first opportunity. I really doubt that your average punter could even wrap their head around some of the inconsistencies of this stuff. Also no one I know negotiated staying on an employer plan. And, of course, many have no spouse, an older spouse or a self-employed spouse.

    The ACA issue I'm referring to is the backdating of part A coverage up to six months. That backdating stops you being eligible for an ACA subsidy during that time. Which is entirely... illogical. During that backdated time you have part A, but not part B and are thus only partially insured. A real catch 22.
     
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  22. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    Your suspicion and my actual, real life experience in the subject at hand are at complete odds, so I’m going to let you stew in your opinions and bid you good luck.

    If anyone is looking for information as opposed to trying to counter my professional experience with suspicions, ask away.
     
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  23. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    Why are you so defensive about Medicare and all it's inconsistencies as regards other forms of insurance and between differing parts of iIt? t's as if you have a vested interest in it somehow. Oh wait, you do. So your "actual experience", I will suggest, isn't exactly as a neutral in this discussion.

    Of course, I will also point out that _nothing_ I've highlighted about Medicare has been shown to be incorrect. That's telling.
     
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  24. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    Your experience is not in any way, shape or form typical, yet you continue to argue that it is.

    It isn’t.

    Medicare has issues just like everything else but what you have been complaining about for pages only really affects a minuscule number of people it isn’t even worth discussing.

    The only thing I am being defensive about is your insistence that somehow your individual experience somehow trumps my professional experience.

    It doesn’t.
     
  25. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    It does. You've been singularly unwilling to acknowledge any of the inconsistencies and gotchas I've pointed out. Had I posted inaccurate information, you'd have a point. As I haven't, you don't.

    And, for the sake of argument, let's agree that my experience is "untypical". So what? It still shows the issues involved in having multiple insurance-based systems for healthcare access. Really, I don't know how you can defend this stuff.
     
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