civilservant

Well with an annual family income of a princely $34,000 we got a subsidy of..... $24 p/m.

cranston

All signed up with BCBS TX through Healthcare.Gov. I choose a cheap Bronze policy with a $5k deductible which is what we had previously (also with BCBS).

I'm a big fan of Obamacare..

Michael

Is that quoted through healthcare.gov? Some of the red states have made it difficult for "navigators" to put out any positive information about the program.

civilservant

Yep, completed it just last night.

Im not that bothered though, since our hospital has just been bought and our premiums are going from $188 month/$1500 deductible to $80/$500.

The buying power of a larger group policy.

jeffreyhy

The $80 is before or after the subsidy?

If after, the subsidy is 23% of a $104 premium - a pretty good subsidy when looked at that way. Even better of the $80 is before the subsidy.

Regards, JEff

civilservant

That's before any subsidy - to be honest I'm not exactly sure how you can claim that subsidy against an employer plan, since the only option it seemed to give us on HC.gov was to put it against plans from the marketplace.

jeffreyhy

So after the $24 subsidy the $80 premium becomes $56? The subsidy is 30% of the premium, even better. That measely $24 isn't looking so measely after all. I expect that you can't. But then an employer plan is often subsidized to some extent already, by the employer.

Was your old plan an employer plan? Regards, JEff

Steve_

Having looked through plans I've got to say, thank God I don't have to. Or rather, thank Canada.

civilservant

I didn't think so, honestly I'm not disappointed because the new one is a substantial saving already. Yes it was.

cindyabs

Because Ga didn't opt to go with Federal program not so much in choice.

Michael

It's very confusing but this is my understanding.

I think he is referring to employer provided health insurance through healthcare.gov for small businesses. Healthcare.gov allows small businesses to pool together to form larger pools so that they can get prices similar to large companies but the employer must pay at least 1/3rd of the cost of the premiums.

I believe small businesses below 50 employees also are eligible for a federal subsidy of between 33%-50% depending on it's size for the first 3 years. I believe any subsidy is already calculated into the cost of the premium that the employee pays.

So the employee of a small a business gets the advantage of larger group plans, employees are guaranteed that the employer will pay at least 1/3rd of the premiums, and some employers may also pass on the savings of the 3 year subsidy to the employee in further reduced premium costs.

Steerpike

I'm on Cobra at the moment, and the cost for next year is $600/mo with my former employer's United Healthcare plan. This is for a plan with $450 deductible and $2,250 Max Out Of Pocket (in network; double that for out of network).

For grins, I called United Healthcare and asked if they had anything 'in the individual market' for me. To my surprise, they offered a premium of only $275/mo, with a $5,000 deductible and $3,000 Max Out Of Pocket (did not capture whether this was in network or not). But there were catches - this was only available in AZ, not CA (I'm going to be resident in CA in 2014, so need CA-based insurance) and was 'medically underwritten' - meaning, based on my individual health (which happens to be good, despite being 55 y/o). This plan will be illegal / unavailable in 2014 so I'd have to sign up by Dec 31 (and it's no use to me anyway since I need a CA based plan).

Anyway, does this seem logical -
$600 / mo for 450 deduct. / 2,250 OOP (group plan)
$275 / mo for 5,000 deduct. / 3,000 OOP (individual plan)?

Under 'Covered CA', a bronze plan for me costs $450 with 5,000 deduct. / 6,350 OOP.

Michael

They probably can't cover you in California since a lot of the fine print allowing policy cancelations, placing you in a very expensive risk pool if you get sick with high deductibles, high co-pays, and unlimited out of pocket expenses, not covering certain procedures, and all kinds of other loopholes are likely not allowed in California.

Also whatever they quote you over the phone is not binding and only after they've reviewed your health record will they give you a firm quote. If your medical records are 100% clean with no major medical incident over the past 20 years or pre-existing condition, then the $275 would probably be offered for AZ. If you lived in Arizona, you'd probably have little to lose taking the plan at $275 since next year, you could always get your insurance through ACA for whatever it costs a 56 year old.

The pre-ACA individual policies make their money on the front end while customers are healthy, then they may have a losing year and then the premiums, deductibles, co-pays, and out of pocket expense usually skyrockets. Sort of similar to car insurance except with health insurance, once you have a bad year, you can never again get good rates from that insurance company and other insurance companies will never likely offer you health insurance.

That is probably one of the main reasons that ACA policies for healthy young people or people with no health problems may possibly be more expensive than the pre-ACA insurance since the insurance companies can't raise the premiums, deductibles, out of pocket expense, when someone gets sick. Therefore they have to calculate premiums based on what it may cost to carry a person to age 65 without being able to increase premiums and/or change coverage when people get sick. That is also why ACA has a maximum $6,350 ($12,700 per family) out of pocket expense for any policy since if it was much higher, young healthly people would carry the cheapest highest out of pocket expense and only when they got sick, they'd opt for one of the better policies. With the maximum out of pocket expense of $6,350, they can't game the system very easily by buying the cheapest policy on ACA and then when they get sick, chose the most expensive policy since currently they are primarily paying extra for lower co-pays, deductibles, and maximum out of pocket expense but if their medical bills are high, it won't make much difference in their final cost including premiums. For example, a bronze plan with a $6,350 maximum out of pocket expense with a $5,000 deductible, and a 40% co-pay at $443 per month for a 40 year old will likely cost about the same as a platinum plan with a maximum $4,000 maximum out of pocket expense, no deductible, and 10% co-pay at $803 if there are major medical bills (the platinum plan may even cost more if there are very high medical expenses).

Pre-ACA I've seen young people get low deductible, low co-pay, and low out of pocket expense at a good price but once they got sick, they were put on a high deductible, high co-pay, and very high out of pocket expense at premiums that were 2-4 times what they were previously paying. Although HIPAA defines high risk pools for pre-existing conditions or for cancelations for health reasons, it is up to the states to define whether insurance companies or the states provide high risk pool and what minimum coverage is required and any possible limitations for premiums charged.

RoadWarriorFromLP

United Healthcare is withdrawing entirely from the California individual plan market. It would be illegal for them to sell you a plan; the state department of insurance would not be pleased.

http://articles.latimes.com/2013/may...nsure-20130523

If you read between the lines, they can't compete with the majors (Kaiser, Anthem, Blue Shield). I suspect that the exchanges may lead to insurance industry consolidations and mergers, as those would provide scale and make the insurers more efficient.

Michael

I wonder what their strategy is for California or if they are just trying to make a point and will be back in the market next year. Being the largest health insurer in the US and giving up the largest market without a fight doesn't seem to make a lot of fiscal sense.

Although I will have to admit that they screwed me for drug prescription Part D benefits. Last year I applied for their cheapest plan ($25 per month) and they sent me a form indicating that their records didn't indicate that I previously had prescription drug coverage and that I would have to pay more unless I met certain criteria (VA coverage was one of the criteria) so I sent the form back indicating that I have VA coverage. I didn't notice what they charged me since there was auto debit from Medicare which included Part D but a few days ago, I received my Medicare benefits letter and it indicated that Part D was costing $41 per month (one year after I signed up and after I could cancel for this year). So instead of paying $25 per month for something I don't use (I still use VA), I'm paying $41 per month for at least another year.