2015-16 Healthcare Premiums to be released Sunday

[Mulligan]

The local paper and the BCBSNC websites both sent emails telling me the new policies were available. I guess that I will just wait a week then spend (waste?) a day on line.


Have the day you deserve, and let Karma sort it out.

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That is what I first read too. Who knows...I was hoping the info would get passed on to others like ehealth immediately so I could bypass the govt site since I do not buy it from .gov anyways. And I sure do not want to mess with opening an account if that is required.


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[MichaelB]

In addition to exchange policies, health insurance companies are offering policies directly to consumers. They are typically not eligible for premium assistance, but in all other ways meet ACA requirements.

BCBS in some states released policy and pricing information on Oct 1.

 

[rbmrtn]

This site might be of interest, https://www.healthinsurance.org/state-health-insurance-exchanges/

It has a state by state review of exchanges. 2016 rates are discussed in general, not specific plans or rates.

FWIW, logged on the exchange site several times today with no problems. The browser you use may be an issue and also clear your cache and cookies, https://www.healthcare.gov/apply-and-enroll/tips-and-troubleshooting/

 

[grasshopper]

Thanks for the heads up. My plan is being discontinued. Not only that but BCBS here in Arizona apparently no longer offers a PPO individual plan. I've been with them for over 20 years and their huge statewide PPO network was one of their key advantages over others. From looking at their two smaller HMO networks, the doctors I regularly see are split between them and the hospital closest to me is in neither network. I realize that the larger PPO network would cost more but why not give the customer the option of going that route if they wish? From what I can tell, the larger PPO network is still available for non-individual plans the company offers.

I turn 65 next August so this will be my last ACA enrollment and only part year at that. From what I gather, BCBSAZ still offers a medigap policy with the large statewide network so that may entice me back to them if I decide to switch to an alternate provider for January through August.

Same boat as you Medicare in 2016, but, a big but, Ms G and I have a grandfathered BCBS of AZ PPO Blue Preferred Basic which, good until forever so we are told. Our rate went up 18% in November and the younger Ms G decided to up our deductible from $2500 to $10K. I am not in a metro area, and BCBS doesn't have an Advantage plan in my zip, I will get a Medigap Plan F. So the 2 of us will pay a bit under a grand until Medicare kicks in for me.

 

[Ian S]

Same boat as you Medicare in 2016, but, a big but, Ms G and I have a grandfathered BCBS of AZ PPO Blue Preferred Basic which, good until forever so we are told. Our rate went up 18% in November and the younger Ms G decided to up our deductible from $2500 to $10K. I am not in a metro area, and BCBS doesn't have an Advantage plan in my zip, I will get a Medigap Plan F. So the 2 of us will pay a bit under a grand until Medicare kicks in for me.

I also had Blue Preferred PPO until I switched to the ACA this year. The last Blue Preferred increase I got would have forced me to go to a $10,000 deductible to have it affordable. I figured with those grandfathered plans, since they couldn't take on any new subscribers, the cohort would gradually get older and sicker causing premiums to skyrocket. I've been happy with my ACA plan (I've been able to adjust my income to make use of subsidies) but as I said, it's been discontinued along with all the BCBSAZ individual PPO plans for 2016. Although, I'd add that the BCBSAZ HMO plans are unusual in that you supposedly don't need a referral to see a specialist which is one of the drawbacks to HMOs in general.

 

[Sue J]

I just checked and the 2016 window shopping is working

https://www.healthcare.gov/see-plans/

 

[Mulligan]

I just checked and the 2016 window shopping is working

https://www.healthcare.gov/see-plans/

Thanks Sue. I was not able to find a way on my Ipad to access without having an account. And you gave me good news... I was guessing my plan to be similar in price to BCBS since paper said my carrier was averaging 27% increases. But to my pleasant surprise mine is only up 16% to $335 a month. Kind of sad when you are "thrilled" with a 16% increase. They must have stuck it to the young people and gave the old folks a break here; or the Feds jawboned them down on rate hike.


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[aaronc879]

Looks like my BCBS plan is going up 42%

 

[Sue J]

Well, this is looking fairly awful for us. Keeping our income exactly the same as last year we lose $132 of our subsidy. On top of that our current plan (HDHP - $6450 each with HSA) has increased in cost by $122, so to keep our same plan will cost us an additional $254.

And on top of that...now it's no longer HSA eligible!!

Without any subsidy the plan cost went from $884/mo to $1006/mo for us as a MFJ couple. That's a 13.8% increase and the deductible went up by $400 to $6850.

I'm going to play around with some income manipulation. DHs pension has to remain taxable but my part time income of about $4500/year usually goes into a Roth IRA. I could put it into a Traditional IRA if it would make a big difference.

 

[Mulligan]

Well, this is looking fairly awful for us. Keeping our income exactly the same as last year we lose $132 of our subsidy. On top of that our current plan (HDHP - $6450 each with HSA) has increased in cost by $122, so to keep our same plan will cost us an additional $254.

And on top of that...now it's no longer HSA eligible!!

Without any subsidy the plan cost went from $884/mo to $1006/mo for us as a MFJ couple. That's a 13.8% increase and the deductible went up by $400 to $6850.

I'm going to play around with some income manipulation. DHs pension has to remain taxable but my part time income of about $4500/year usually goes into a Roth IRA. I could put it into a Traditional IRA if it would make a big difference.

My condolences Sue. What I find confounding is the HSA's actually cost a few bucks more. And they offer no reduced office visit cost that a lower priced premium gives. Makes no sense to me.... But my tax bracket and earned pension income makes it beneficial to use pay the extra bucks and take the HSA.


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[Ian S]

Only one company in Maricopa County AZ with PPO plans. Everything else is HMO. Bleeecchhh! The alternative to BCBS here I was thinking was Healthnet but they've eliminated their PPO too. Looks like I'll be sticking with BCBS and adjusting my income to maximize my benefits.

 

[homestead]

I just checked and the 2016 window shopping is working

https://www.healthcare.gov/see-plans/

This site does seem to be working but I am having a hard time believing the subsidy amount, for couple 62 & 67 with one on medicare and income of 63k it says the tax credit is $693/mo. Does this sound right?

 

[golfnut]

What does "hsa ineligible" mean? Does this mean you cannot contribute to a hsa plan and have medical expense payed thru the hsa plan?

 

[jim584672]

I am glad I do not have to worry about premiums, make too little.

 

[MBSC]

What does "hsa ineligible" mean? Does this mean you cannot contribute to a hsa plan and have medical expense payed thru the hsa plan?

For my zip code, there are now plans available that exceed the 2016 HSA OOP max making them HSA ineligible.

To answer your question, if a plan has a copay (first dollar benefit) for non-preventive services before the high deductible is met, it is not HSA compatible and you cannot contribute to an HSA.
HSA Health Insurance Plans - High Deductible Health Plans HDHP - HSA Insurance

 

[ziggy29]

To answer your question, if a plan has a copay (first dollar benefit) for non-preventive services before the high deductible is met, it is not HSA compatible and you cannot contribute to an HSA.

That was more or less my understanding. I wasn't sure whether or not PPACA changed anything about the definition of HSA-eligible, but I didn't recall anything. At one point, you couldn't even provide first-dollar preventative care with an HSA-eligible HDHP, but that changed a couple years before ACA, IIRC.

 

[Sue J]

After getting over the shock of our price increase if we kept our current plan, I checked out why it went from HSA eligible to non-HSA eligible.

HSA plans for 2016 have a minimum deductible of $1350/person and a max out of pocket of $6550. Our current HSA plan has a max out of pocket of $6450 this year and that's going up to $6850 for 2016, making it higher than the max. So the plan not HSA eligible in 2016.

The link is titled HSA contribution limits but it also shows deductible and MOOP limits.

HSAcenter - Health Savings Accounts - Health Care and Savings for You and Your Family

 

[rbmrtn]

At one point, you couldn't even provide first-dollar preventative care with an HSA-eligible HDHP, but that changed a couple years before ACA, IIRC.

I think that is still the case. If any benefits are paid before the deductible is met it doesn't qualify. Mine didn't qualify because it paid for some generic drugs before the deductible. They can provide some preventive care but can only provide "first dollar coverage" after the deductible is met per this link...

HSA Health Insurance Plans - High Deductible Health Plans - HDHP - HSAConnect

 

[MichaelB]

Checking the Florida BCBS plans, they also are no longer offering HSA on the exchange, but they offer 2 when bought directly from them. Apparently Humana and Aetna are doing the same thing.

 

[rbmrtn]

Couple of things I noticed with the increase for mine. One is age creep, I ran the numbers for different ages it went up for being a year older.

Main thing for mine is the cost of the second lowest silver plan actually went down while my bronze went up. Well that calculation makes the subsidy shrink so I'll be paying a good bit more because of that...

 

[Sue J]

I'm trying to reconcile why our subsidy dropped so much. I'm looking for the table that shows the income level used to determine your percentage to be used for premiums. Has anyone found the one for 2016?

 

[hnzw_rui]

So your talking at least $200/mo for decent coverage. That may not be a great deal to you but not so much for people who are living on $1000/mo and are paying less than $100/mo thru ACA. Most of those people don't have the mental and/or physical ability to make any more money. I don't think they should have to pay 20%+ of their income for health insurance. There should be a cap of say 10% or maybe a little less.

I think for someone with limited income, Medicare Advantage with Medicaid paying part B premiums is the only option. That's net $0 monthly premium for health insurance and co-pays are $0 or very small. The PDF from MichaelB's post explains it pretty well.

Medigap policies are for people who can afford them.

 

[rbmrtn]

I'm trying to reconcile why our subsidy dropped so much. I'm looking for the table that shows the income level used to determine your percentage to be used for premiums. Has anyone found the one for 2016?

The 2015 FPL table is here 2015 Poverty Guidelines | ASPE

The cap limit table is here, Understanding the Affordable Care Act (ACA) Subsidies and another one from Kaiser, Explaining Health Care Reform: Questions About Health Insurance Subsidies | The Henry J. Kaiser Family Foundation

I think 2016 will use the 2015 tables , 2015 Federal Poverty Line (FPL) Charts

 

[Theseus]

And on top of that...now it's no longer HSA eligible!!

Not sure of your specific parameters, but I noticed the 2016 search filters in my case don't include HSA eligibility. Keeping same plan for instance, it doesn't become clear that it is still HSA eligible until drilling down and viewing plan specifics. Still not sure what's up with premiums though, it is showing much higher jump than what was requested (approved believed to be slightly lower), even if adjusting age back to last year.

 

[Sue J]

What I was looking for was the detailed table of what percentage is assigned to every incremental increase in income.

I found the specifics at the IRS site, in the instructions for Form 8962 which is the form to reconcile the Premium Tax Credit when you file.

https://www.irs.gov/pub/irs-pdf/i8962.pdf

The detailed table is on Page 6.

The reason that I wanted all the incremental details is that our 2016 income is just over 250% of FPL but that can be adjusted with Traditional IRA contributions.

Still not able to reconcile the subsidy shown on HealthCare.gov. Comparing our 8.10% of income vs the second lowest cost silver plan and the subsidy seems low by about $87/mo.