I need some help figuring out the values to put into the fields for insurance premiums & ACA Second Lowest Cost Silver Plan.
I will go on medicare in July (2025) and my wife will be on ACA till mid-2028 before going on medicare too.
Say ACA second lowest cost silver plan is $1000/mo per person;
Our ACA plan costs $900/mo per person
Medigap is $150/mo per person
Are all the entries annual costs?
Is the ACA Second Lowest Cost silver plan entry $1000 * 12 * 2 = $24,000 or is it (6 * 1000) + (12 * 1000) = $18,000?
Same for when one of us is on medicare and the other is on ACA (Period 4) even though the start & end dates are mid-year.
Thank you.
The program breaks up your insurance cost into multiple time periods.
Your first time period is what Pralana calls Period 3 (Retired, not yet on Medicare). Enter the annual cost of sum of the two ACA plans under Insurance Premiums, check the tiny little box that says "Assume ACA Insurance if Eligible" and enter the annual cost of the sum of the two ACA second lowest silver plans.
Your second time period is after you go on Medicare, which Pralana calls Period 4, one on Medicare. For insurance cost, enter the annual cost of the actual ACA plan for your spouse plus the Medigap supplement and you need to add the base Medicare Part D cost as well. Pralana will calculate any IRMAA costs for Part D, but the base cost varies by the plan and location, so you have to enter that. Check the "Assume ACA Insurance if Eligible" box and enter the annual cost of your spouse's ACA plan.
Your last time period is after both are on Medicare. Pralana calls that Period 5. For insurance cost, enter the annual cost of the Medigap plus the base Part D cost.
Be careful on selecting the Medigap (Medicare Supplemental) to look at the reputation of the company. Many/most companies create a Deadpool (or sick duck pool if you prefer) within just a few years after issuance. They do this because as you age, you statistically will cost them more, so to be more attractive to newcomers, they close your plan to new entrants, start a new plan and raise your rates drastically. The only way you can switch out of the old (and now expensive) plan is to qualify through medical underwriting. The folks that are still healthy jump out to get the new, lower priced plan. The sick are stuck and their rates skyrocket because only the sick are left!
Deadpooling is so common that from what I understand, the only plan with a long history of not doing it is the UHC plan from AARP, that's been sold since 1992. I am still working so haven't signed up, but that's the direction I intend to head, though I'm not in love with their politics. The UHC plan ain't cheap and increases not only with inflation but, like most/all supplemental plans, it also increases each year as you age (reaching its peak at age 86), but at least it's a fair deal with a track record of not playing dirty.
Note that Pralana doesn't have an easy way to handle the age based ramp up in the Medicare supplemental cost. The best you can do is put a large inflation factor on medical costs.
I don't have ACA. I have Medicare A&B, Blue Cross Supplemental and Part D. So I don't know how to repond to the queries about ACA.
Thank you for clarifying that I need to use annual costs for all the boxes. Much appreciated.
Thanks for the warning on medigap dead-pools. I'm aware of the issue.
@savannah Make sure you leave the "Assume ACA insurance if available" boxes unchecked and then leave all other ACA-related fields blank.
Stuart