Obamacare premiums

[ripper1]

There seems to be a huge variance in the premiums for a Silver plan under obamacare for different States. As an example I used 60 year old couples making over 62040 from Wyoming, Indiana, and Illinois. Wyoming was the highest at 19100. Indiana at 15500. For Chicago, Illinois it came in at 10200. What gives here?

[ripper1]

Quote:

Originally Posted by ripper1 There seems to be a huge variance in the premiums for a Silver plan under obamacare for different States. As an example I used 60 year old couples making over 62040 from Wyoming, Indiana, and Illinois. Wyoming was the highest at 19100. Indiana at 15500. For Chicago, Illinois it came in at 10200. What gives here?

Source: Kaiser Family Foundation Calculator.

[Animorph]

Each state has different coverage rules, in addition to different costs of healthcare.

[2B]

A key point in the cost will be the number of doctors and hospitals in the network. I would recommend looking carefully at the choices available of any plan. I've seen a report that said that some of the lowest cost plans were predominately with doctors that primarily treat medicaid patients. Feel free to join their crowded waiting rooms and minimalist time with the doctor.

Doctors and hospitals need to agree with the in-network pricing to be included. A company that wants to have a presence in the market may drive to be the low cost provider. That may not get the doctors you would like to see. The fewer doctors in an area makes it less likely they will join a highly discounted plan.

[daylatedollarshort]

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.

[MichaelB]

An interesting article this morning about this from KFF Where You Live Determines How Much You Pay For Health Insurance - Kaiser Health News

Quote:

When buying health insurance, where you live matters. In Pennsylvania and more than a half dozen states, consumers in some cities will pay at least 50 percent more for the same type of coverage than their friends and relatives in other parts of the state.

[ERhoosier]

Quote:

Originally Posted by Animorph Each state has different coverage rules, in addition to different costs of healthcare.

As MichaelB said, even the widely quoted state ave premiums can be VERY misleading since almost all states are divided into regions with diff HI premiums for similar metal-level plans. In Indiana, monthly premiums for 60yo "2nd lowest Silver" plan range from $581 to $747, (+ 28% low-to-high), and in MO the intrastate range is 51%, and it's over 100% in GA!

You might be able to tease out what your anticipate rates would be (by region, or MSA- Metro Statistical Area) from these links-

ASPE

Market Rating Reforms - Centers for Medicare & Medicaid Services

[ripper1]

Well, this obamacare cliff thing is going to crucify 60 year olds with a little over 62000 in income and no way to reduce.

[FANOFJESUS]

I will get insurance for free. But I saw on the news that for some private insurance will go up 3 fold.

[M Paquette]

Quote:

Originally Posted by rec7 I will get insurance for free. But I saw on the news that for some private insurance will go up 3 fold.

It's all either private insurance or Medicaid for very low income persons.

But yes, some folks will find that the price for a policy is a good bit higher than what they have been paying for. In college DD had a cheap health insurance policy, mandated by the school. It was linked to the on-campus health center, a place to go for minimal care services (colds/flu, minor bicycle accidents, etc). The plan had a MAX annual benefit of $2,500, and didn't cover cancer, pregnancy care, mental health, etc. The cost was something like $35/month. (and the insurer paid out about 10% of the premiums for claims.) Replacing that coverage with anything allowed to be called health insurance under PPACA, which would include cancer, pregnancy care, mental health, and have no annual or lifetime benefit cap will cost several times what the cheap plan cost.

When looking at rate differences between plans, it can be important to check what the plans cover, particularly if one of the plans is not PPACA compliant. it's much easier to compare PPACA plans as they have fairly standarized minimum benefits and actuarial payout requirements, which provides some transparency into what one is paying for.

[Rosie]

Quote:

Originally Posted by ripper1 Well, this obamacare cliff thing is going to crucify 60 year olds with a little over 62000 in income and no way to reduce.

Just for yukks, I put some numbers in this Subsidy Calculator:


-------------------------------------------------

Enter Information About Your Household:

1.Select a State: Illinois
Enter your zip code: 60626
( --> a randomly selected Chicago zip code)

2.Enter income as: 2014 Dollars

3.Enter annual income (dollars) $62,000
( ---> Note that this is not a Modified AGI, it's simply the number that ripper1 provided. His MAGI could be lower).

4. Is employer coverage available? No

5. Number of people in family? 2

6. Number of adults (21 and older) enrolling in exchange coverage: 2
Age: 60 Uses Tobacco? No
Age: 60 Uses Tobacco? No

7. Number of children (20 and younger) enrolling in exchange coverage: No children


... [Submit] ...


Household income in 2014: 400% of poverty level

Unsubsidized annual health insurance premium in 2014: $13,761*

Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy: 9.5%

Amount you pay for the premium: $5,890 per year*
(which equals 9.5% of your household income and covers 43% of the overall premium)

You could receive a government tax credit subsidy of up to: $7,871*
(which covers 57% of the overall premium)

*The premium and subsidy amounts above are based on a Silver plan. You have the option to apply the subsidy toward the purchase of other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive).

-------------------------------------------------

So ~ $500 per month for 2 people aged 60 with an income of $62,000, with no limitations for prexisting conditions, is being "crucified" ?

[FANOFJESUS]

Quote:

Originally Posted by M Paquette It's all either private insurance or Medicaid for very low income persons. But yes, some folks will find that the price for a policy is a good bit higher than what they have been paying for. In college DD had a cheap health insurance policy, mandated by the school. It was linked to the on-campus health center, a place to go for minimal care services (colds/flu, minor bicycle accidents, etc). The plan had a MAX annual benefit of $2,500, and didn't cover cancer, pregnancy care, mental health, etc. The cost was something like $35/month. (and the insurer paid out about 10% of the premiums for claims.) Replacing that coverage with anything allowed to be called health insurance under PPACA, which would include cancer, pregnancy care, mental health, and have no annual or lifetime benefit cap will cost several times what the cheap plan cost. When looking at rate differences between plans, it can be important to check what the plans cover, particularly if one of the plans is not PPACA compliant. it's much easier to compare PPACA plans as they have fairly standarized minimum benefits and actuarial payout requirements, which provides some transparency into what one is paying for.

If I understand it right some folks that are above the ACA levels might see a 3x fold increase(heard it on the news). The folks that would get no help from the government.

[sheehs1]

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.

[FANOFJESUS]

Quote:

Originally Posted by Rosie Just for yukks, I put some numbers in this Subsidy Calculator: ------------------------------------------------- Enter Information About Your Household: 1.Select a State: Illinois Enter your zip code: 60626 ( --> a randomly selected Chicago zip code) 2.Enter income as: 2014 Dollars 3.Enter annual income (dollars) $62,000 ( ---> Note that this is not a Modified AGI, it's simply the number that ripper1 provided. His MAGI could be lower). 4. Is employer coverage available? No 5. Number of people in family? 2 6. Number of adults (21 and older) enrolling in exchange coverage: 2 Age: 60 Uses Tobacco? No Age: 60 Uses Tobacco? No 7. Number of children (20 and younger) enrolling in exchange coverage: No children ... [Submit] ... Household income in 2014: 400% of poverty level Unsubsidized annual health insurance premium in 2014: $13,761* Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy: 9.5% Amount you pay for the premium: $5,890 per year* (which equals 9.5% of your household income and covers 43% of the overall premium) You could receive a government tax credit subsidy of up to: $7,871* (which covers 57% of the overall premium) *The premium and subsidy amounts above are based on a Silver plan. You have the option to apply the subsidy toward the purchase of other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive). ------------------------------------------------- So ~ $500 per month for 2 people aged 60 with an income of $62,000, with no limitations for prexisting conditions, is being "crucified" ?

Take the income up to 63k the premium is over twice $5,890 per year.

[brewer12345]

Quote:

Originally Posted by Rosie So ~ $500 per month for 2 people aged 60 with an income of $62,000, with no limitations for prexisting conditions, is being "crucified" ?

Of course not, at least for the people in your example. But if you are either "stuck" with a pension that pays over 400% FPL (people who I am sure I will be busy shedding tears for) 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. These are the losers created by the law, at least they are vs. what their premiums would have been until they had any kind of health issue. After that event, guaranteed issue makes everyone a winner.

[daylatedollarshort]

Quote:

Originally Posted by sheehs1 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.

Our premiums alone for our COBRA conversion policy this year are close to $30K, regardless of income. Just sayin.

[samclem]

Quote:

Originally Posted by sheehs1 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.

sheehs1,
Sorry to hear about your situation. If it's any consolation, you've got plenty of company.

[Badger]

Quote:

Originally Posted by sheehs1 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.

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!

[Htown Harry]

Quote:

Originally Posted by brewer12345 ...figure out a way to limbo under the 400% bar...

Here's a new one (to me anyway). Move to Alaska or Hawaii, where the FPL is higher than the lower 48.

[daylatedollarshort]

Quote:

Originally Posted by Htown Harry Here's a new one (to me anyway). Move to Alaska or Hawaii, where the FPL is higher than the lower 48.

It is interesting that California is not higher as well, considering the cost of housing.