Kevin Knauss: Health, History, Travel, Insurance
The Roadmap report generates the Maximum Social Security income scenario. We can also enter other age-based claiming scenarios that are detailed within the report. In the sample below, Mick was born in 1963, and his spouse Diana was born in 1977. Because Mick and Diana have children, the analysis concluded that Mick and Diana would receive the largest lifetime Social Security income benefit if Mick filed at age 63 and Diana claims Social Security when she turns 62 in 2039.
If the enhanced subsidy lapses, and Covered California must return to the pre-2021 subsidy curve, the consumer responsibility for health insurance increases. For the individual estimating $50,000, based on 2025 federal poverty level, they are still 343 percent FPL, but the consumer responsibility percentage increases from 7.08 percent to 9.78 percent*. (*Consumer Responsibility from IRS 2020 form 8962 instructions.)
It was my physical interaction with the Prologue that sold me. The Prologue is 2 inches higher off the ground than the EV6 or Optiq. The ground clearance is in the Subaru Soltera (8.2 inches) range, another EV I considered, but the range was under 250 miles. It was easier for me to get in and out of the car. Behind the rear bench seat, I could visualize where all the luggage and gear could be situated.
When we extrapolate the savings to an annual basis, Plan N rates are $214 lower than Plan G by age 68. This means that at age 68, an individual could incur ten $20 office visit copayments during the year and still pay less than Plan G (annual premiums plus copayments.) The individual could also have two emergency visits at $50 and five office visits at $20 and still pay less money.
The next set of calculations are truly mind bending. The SSA has to bend your AIME into a Primary Insurance Amount (PIA.) The PIA is what you will receive at your Full Retirement Age, 67 if born in 1960 or later. The AIME is bent lower by a series of calculations using Bend Points. The specific Bend Points are from the year you turn 62.
The main takeaway is that the calculations for the ACA health insurance income estimates are separate from determining the tax on Social Security benefits. Specifically, all the Social Security income is included on the Covered California application as income, but only ½ is used for the combined income calculation of Social Security income taxes.
The 2026 asset test will be $130,000 and $65,000 for each additional household member. In other words, a single adult with assets over $130,000 will not qualify for Non-MAGI Medi-Cal. A married couple with assets over $195,000 will be ineligible for Non-MAGI Medi-Cal for either individual.
Under the leadership of Dr. Oz, Medicare is rushing to implement Artificial Intelligence (AI) to review, authorize, or deny health care services received by Original Medicare beneficiaries. The primary goal is to save money not necessarily improve patient outcomes. CMS calls the new AI health care initiative “Wasteful and Inappropriate Service Reduction (WISeR) Model.
The underlying rational for the new rules is that CMS perceives consumers to be cheating the system. With no evidence presented, CMS believes that consumers are receiving subsidies and health insurance they are not entitled to. They accuse individuals, families, and agents of committing fraud. Again, they present no evidence to support their supposition. The focus of CMS is to save money and if people are denied health insurance and health care, that is simply collateral damage to achieving the goal of less federal expenditures. The new rules are meant to save money and help the health insurance companies.
The Covered California application has been updated to better recognize and process documents related to confirming the identity of the applicant. With just the information on the application (name, address, date of birth, and social security number) the system can now quickly verify the applicant. Covered California has done away with the identity proofing questions.
