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Old 10-01-2013, 01:02 AM   #21
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Originally Posted by sheehs1 View Post
My husband just received his letter from Anthem BCBS of North Carolina. WE have separate individual policies. His is in North Carolina and mine is in Virginia. (he works in North Carolina).

He was not grandfathered and is 58 years old. His premium was $370 a month and is going to $610 a month for one person. Anthem put him in the Silver Plan. This will be their plan on the federal exchange.

My plan from Anthem in Virginia is allowing me to keep my old plan one more year. The new premium is $434.

Total for both of us = $12,528 a year in premiums. I expect it to go up after I have to go to the ACA compliant one next September.

I'd say a projected almost $15,000 plus in premium cost alone is crucifying for those of us over the subsidy level. And it can go higher. Also need to add in the copays, deductible and out of pocket max.

It remains to be seen if there are going to be anymore competitive plans for either of us.
OK, but your increase is basically $2880 a year. It isn't like your premiums went up $12k a year. You were already paying close to $10k a year.

I'm not saying it is fun to get a big increase in premiums. Last year, on DH's retiree policy, our premium increased over 200% and that was with him going off the policy as he was going onto Medicare! And, this increase wasn't ACA related. It was based upon the claim experience of the group (Megacorp only absorbs a 5% or so increase a year - anything above that is on us). So, yes, I do know it is no fun to get a premium increase and one can get that with ACA or not with ACA...
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Old 10-01-2013, 02:05 AM   #22
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I guess one great thing is that people who were not insurable before are now insurable at a resonable cost. Any of us could have been in their situation, so compared to that, it's all good.
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Old 10-01-2013, 06:04 AM   #23
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tmm, I agree, and insurance companies used actuarial tables to make their determinations which is no different than under Obamacare/ACA, now they are simply spreading that cost across all insured.

Also. the 800lb gorilla in the room is the fact that in addition to premiums there is a $12k out of pocket for a silver plan. Up until this year my previous plans had lower deductibles, cost less and had lower out of pocket. This same type of plan which was always considered part of my compensation while I was employed there (lower pay better benefits), now considered gold, only had a 5k total deductible. HUGE difference.

Bottom line unless something changes, I liked my insurance but can't afford now to keep it as it was, I liked my doctors but they are no longer in network so I can't keep them, and my costs are going up while coverage is going down. That's where the rubber meets the road for me.
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Old 10-01-2013, 06:07 AM   #24
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Our premiums alone for our COBRA conversion policy this year are close to $30K, regardless of income. Just sayin.
Wow! That is unreal. Our cobra premium is $690 a month and I thought that was high! Yikes! Ours is an HSA with very high deductible.
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Old 10-01-2013, 06:17 AM   #25
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Wow! That is unreal. Our cobra premium is $690 a month and I thought that was high! Yikes! Ours is an HSA with very high deductible.
The $30K has been commented on before. I have Cobra available at $830/mo for a $3,000 ded w/HSA. That's just under $10K. If I threw in kids, it would still be under $15K/yr. I can only assume that for $30K it includes spa treatments and on-call doctors that come to the house with no deductible. If not a super plan, they are really getting it stuck to them.
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Old 10-01-2013, 06:36 AM   #26
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I guess one great thing is that people who were not insurable before are now insurable at a resonable cost. Any of us could have been in their situation, so compared to that, it's all good.

In Texas everyone had been insurable if you kept your coverage active. That could involve switching to the Texas High Risk Pool. Similar high risk pools I thought were available in all 50 states. I've not known anyone in Texas over 50 that could get any other policy without substantial exceptions. Who wants HI that doesn't cover heart attacks and strokes?

The cost for a single individual age 62 was $7,500/yr with a $7,500 deductible. There were no family plans. A couple had to get two individual plans. The comparable costs for the new exchange plans are not drastically lower from the limited information I've seen. I'm waiting for the rush to settle down before looking at plans.
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Old 10-01-2013, 08:14 AM   #27
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Our premiums alone for our COBRA conversion policy this year are close to $30K, regardless of income. Just sayin.
ouch daylatedollarshort! Why is your COBRA so high? Is it for 2 people or entire family?
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Old 10-01-2013, 08:16 AM   #28
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sheehs1,
Sorry to hear about your situation. If it's any consolation, you've got plenty of company.
Thanks samclem. I'm sure we will have plenty of company.
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Old 10-01-2013, 08:18 AM   #29
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I think cost of health care is going to be a huge factor in where people decide to live in the coming years, just like state income taxes are currently a big factor.
It will be a factor for me.

Too bad insurance is limited by state. If the insurance companies were able to be national and we weren't restricted by the state where we live, the insurance landscape might be very different.
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Old 10-01-2013, 08:22 AM   #30
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or you aren't smart enough to figure out a way to limbo under the 400% bar, you do take it is the pie hole. .
brewer12345, your post seems to indicate a person has some control over it indicating they are "less than smart" if they can't figure it out. That is not necessarily true.
Some, like us, have no way to reduce our MAGI further, unless we take on MASSIVE debt and risks. We would have to many things including dismantle our lives and our purposes to get under the 400%.
I predict some will do those things but only if they are barely making if over the threshold to begin with.
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Old 10-01-2013, 08:25 AM   #31
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I think Brewer was just referring to folks that can control their income. Clearly people receiving salaries or pensions cannot easily do that.
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Old 10-01-2013, 08:27 AM   #32
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Just curious since I don't know but where can someone get the same health insurance coverage on their own for less than this cost?

And why would you also need to factor in the copays, deductible and out of pocket since most health insurance have these anyway. Seems to me they should not be part of the formula when comparing.

Doesn't "Obamacare" stop once you turn 65 and start Medicare unless you opt for supplimental insurance which would be your own choice. Then the only cost is Medicare at about 1/10 your projected premium.

Cheers!
I don't know Badger. But we will be looking I am sure. From where I sit, one needs to factor in their max pain for health care in any given year or at least consider it. Hence the add ons of the co-pays, deductibles and out of pocket expenses. Meaning that projected $15,000 is JUST for premiums before setting foot in a doctor's office. Why would you NOT factor in your other costs when performing a comparison?

It is part of the analysis as far as I am concerned. There is a big difference between 60% coinsurance and 90% coinsurance. We currently have 0% coinsurance, so we KNOW what our max pain is going to be every year.

None of the ACA plans have 0% coinsurance.
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Old 10-01-2013, 08:31 AM   #33
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OK, but your increase is basically $2880 a year. It isn't like your premiums went up $12k a year. You were already paying close to $10k a year.

I'm not saying it is fun to get a big increase in premiums. Last year, on DH's retiree policy, our premium increased over 200% and that was with him going off the policy as he was going onto Medicare! And, this increase wasn't ACA related. It was based upon the claim experience of the group (Megacorp only absorbs a 5% or so increase a year - anything above that is on us). So, yes, I do know it is no fun to get a premium increase and one can get that with ACA or not with ACA...
No katsmeow, our premiums are going up over $5,000 a year. I think you did the calculation for one person or just based on my husband's increase. I'm expecting costs to increase as this rolls out.

All I am saying is to pay the $15K plus in premiums BEFORE setting foot in a Doctor's office is really rather ridiculous.

I would rather have lower premiums and more costs "for use". Charge me more if I go to the doctor or have an illness but allow me lower premium costs when I don't use it. Of course, pontificating that thought is useless at the moment.
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Old 10-01-2013, 08:56 AM   #34
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ouch daylatedollarshort! Why is your COBRA so high? Is it for 2 people or entire family?
Note she said COBRA conversion, not COBRA.
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Old 10-01-2013, 09:21 AM   #35
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I think Brewer was just referring to folks that can control their income. Clearly people receiving salaries or pensions cannot easily do that.
I'm sure he was. Just wanted to say "a lot of people can't do this".
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Old 10-01-2013, 09:43 AM   #36
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It is part of the analysis as far as I am concerned. There is a big difference between 60% coinsurance and 90% coinsurance. We currently have 0% coinsurance, so we KNOW what our max pain is going to be every year.

None of the ACA plans have 0% coinsurance.
My employer has two insurance options. One is a 0% copay with a $3,000 deductible then it goes to 80% coverage until the ~$10,000 OOP max is reached. For me and DW, this costs $438/yr. Cobra (full cost + 2%) is $9960/yr. There is a second plan with a very low deductible but the premium effectively are the $3000 divided by the number of pay periods. There are copays for the doctor and prescriptions and the OOP max is the same. The copays are not included in OOP and go on after you meet the OOP max. I've tried to convince people that this plan is more expensive than the "high deductible" (not that I think $3000 is all that high) but they like to know they won't get hit with a "big medical expense."

DW and I usually don't hit the deductible. We did this year with our his-and-hers colonoscopies. I am also more interested in a high deductible/lower cost HI plan because we like most people are not heavy health care consumers. We also have the assets to absorb the rare but eventual big bill. Just knowing that the OOP max is manageable is all I need to know.

Unfortunately, the ACA seems to be modeled after the older style "full coverage" plans that seem to have been disappearing in the employer health insurance model. For those of us that are solvent, it will cost us money without providing any value.
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Old 10-01-2013, 09:44 AM   #37
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ACA is the great equalizer for those who feel they got a bit of a shaft being forced into the 401K program instead of a guaranteed pension. While bearing all of the risks of the market in their retirement, at least they can control income to qualify for ACA.

I would still rather have a $70,000 a year pension, but I will take this ACA gift with open arms.
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Old 10-01-2013, 10:51 AM   #38
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In Texas everyone had been insurable if you kept your coverage active. That could involve switching to the Texas High Risk Pool. Similar high risk pools I thought were available in all 50 states.
The trick is that some state high risk pools have a limited number of openings. Back in 2010 that route would have had me wait listed for a year before I would get coverage. There were other pools available if I had a coverage gap of six months or more, with other catches. Prior to retirement I wound up drawing out a huge decision tree to chart a path that would keep our family covered. There were lots of dead end and coverage break paths that I had to avoid. In fact, the safest path involved changing coverage to an in-state HMO prior to retiring, which would allow doubling the length of COBRA coverage and permit a type of continuation coverage for all family members in case we didn't qualify for underwritten coverage, as well as time to meet a 'no medical problems '. Time window for underwriting.
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Old 10-01-2013, 11:13 AM   #39
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My income is below the federal poverty limit here in MO. Since MO did not expand medicaid my insurance will be going up even though I make under 11k a year. That is wild. I am learning that under 11.5k in many states you are in danger.
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Old 10-01-2013, 11:47 AM   #40
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An interesting article this morning about this from KFF Where You Live Determines How Much You Pay For Health Insurance - Kaiser Health News
So much for "affordable"............
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