2015-16 Healthcare Premiums to be released Sunday

[Mulligan]

Mark your calendar for tomorrow if you buy individual insurance. It appears pricing will be released tomorrow on Healthcare.gov.

Window-shopping for Obamacare 2016 starts soon




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[Sue J]

We got a robo-call from The Marketplace telling us to expect a letter soon with our 2016 update to our plan. I checked our HealthCare.gov account for the document to be posted there but it was all older documents.

I like being able to window shop ahead of enrollment. I can play with possibilities for an HSA plan and how the reduction in income for the HSA contribution affects our income/subsidy and taxes.

We liked our plan this year (same plan as 2 individuals) and hope it's continued. I expect the cost to go up.

[DEC-1982]

Thanks Mulligan. Although I don't need it yet (I need it around mid-2017), it's good to go through this for planning purposes (especially understanding the subsidy amount).

[Ian S]

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.

[Theseus]

Quote:

Originally Posted by Sue J We got a robo-call from The Marketplace telling us to expect a letter soon with our 2016 update to our plan. I checked our HealthCare.gov account for the document to be posted there but it was all older documents.

Had similar call, found that the document that 'they would be sending me' was one I had already downloaded a few weeks ago. Went though the exercise of updating income information, since the estimated income I had previously entered was about 20% higher than what we've needed to support our LBYM selves. Just in time to get reduced premiums for December, 'income' actually low enough we could have benefited from $1,400 cost sharing reduction, but I've not seen any indication that is applied retroactively and we had already met deductibles so I guess that's water over the dam.

[Mulligan]

Quote:

Originally Posted by Ian S 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.

Ian, make sure you come back in August to post and rub it in our faces on how cheap Medicare is compared to ACA plans. Being healthy I choose the cheapest HSA plan available. The networks are very narrow too. I wouldn't be surprised this year if the network consists only of the Nurses at Walgreens and the 3 closet Veterinary medical centers.


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[aaronc879]

Quote:

Originally Posted by Mulligan Ian, make sure you come back in August to post and rub it in our faces on how cheap Medicare is compared to ACA plans.

I'm a long way from Medicare but i'm actually concerned by how expensive it is compared to what I pay for my ACA plan after the subsidy. I guess there's no subsidy for Medicare?

[Mulligan]

Quote:

Originally Posted by aaronc879 I'm a long way from Medicare but i'm actually concerned by how expensive it is compared to what I pay for my ACA plan after the subsidy. I guess there's no subsidy for Medicare?

I doubt if you get a subsidy it will be cheaper if you purchase the supplemental policy(s). Part A is currently free, but there are gaps that need to be filled. Now for unsubsidized premiums the "total package" is cheaper than a pre 65 year old high deductible plan. But who knows the future as the current Medicare trust fund has more "trust" than "funds" in it.


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[Ian S]

Quote:

Originally Posted by aaronc879 I'm a long way from Medicare but i'm actually concerned by how expensive it is compared to what I pay for my ACA plan after the subsidy. I guess there's no subsidy for Medicare?

If you're a long way from Medicare, that means you're still fairly young and so rates are still fairly low. They will increase for you as you get older but the age-related premium increases are limited under Obamacare. In the pre-Obamacare days, premium increases due to age became huge as you approached and passed the 60 year mark. Medicare is GREATLY subsidized by the Medicare tax that you and I and everyone else have been paying all their working lives. The hospitalization Part A is free while Part B runs just over $100/mo which is a great bargain. Adding Medigap + Drug coverage policies will run another $100 to $200 or so at least from what I can gather for Arizona. There are also Medicare Advantage plans - mostly limited network HMOs - that can be had for only the Part B amount but replace the Medigap and separate drug policies. So Medicare is a great deal.

[meierlde]

Quote:

Originally Posted by Ian S 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.

Since Medicare sets the physician rates for all medicare beneficiaries under original medicare all medigap plans cover all physicians that accept medicare (as the AARP ads say)

Another interesting fact you start medicare on the first of the month you turn 65 except if you are born on the first then its a month earlier. If your getting SS then the signup with medicare is automatic.

[Texas Proud]

Quote:

Originally Posted by Ian S 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.

There are some rules/law that kinda connects plans etc.... they might not want to get the PPO connected....

My first year there was a PPO, there still might be one, but the price has to be much higher since I did not look at any high priced plans...

[aaronc879]

Quote:

Originally Posted by Ian S The hospitalization Part A is free while Part B runs just over $100/mo which is a great bargain. Adding Medigap + Drug coverage policies will run another $100 to $200 or so at least from what I can gather for Arizona. There are also Medicare Advantage plans - mostly limited network HMOs - that can be had for only the Part B amount but replace the Medigap and separate drug policies. So Medicare is a great deal.

So your talking at least $200/mo for decent coverage. That may 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.

[jetpack]

My provider, Highmark, dropped the plan I was on this year. I have to shop for a more expensive plan, plus the price increase.

[Mulligan]

Until we get national healthcare, there will be push and pull of winners and losers unfortunately. When you were able to receive ACA subsidies my premiums tripled because of ACA. And please do not take that as a personal shot at you Aaron. You have the right to complain about the fairness of it. I would be a hypocrite if I didn't say you should, as Lord knows I have complained about mine going up. FWIW- I do THINK a senior can not only get Medicare, but also Medicaid at the same time, so that would mitigate costs more I believe for the truly poor.


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[MichaelB]

Assistance is available for some seniors with income too low to afford Medicare. This is called "Dual Eligibles". Subject to eligibility, Medicaid will pay Part B premiums and other health care costs not covered. Information here https://www.cms.gov/Outreach-and-Edu...t_a_Glance.pdf

[Ian S]

Quote:

Originally Posted by aaronc879 So your talking at least $200/mo for decent coverage.

Actually, there are quite a few Medicare Advantage plans that provide comprehensive coverage for nothing more than the part B payment of just over $100. They can do that by using the HMO model plus the government kicks in additional $$ so the companies can make a profit. As someone else upthread mentioned, seniors can also be eligible for Medicaid.

IMHO, the ultimate solution is single payer for everyone. That would be easiest to accomplish in this country by extending a revised Medicare to everyone.

[pb4uski]

Quote:

Originally Posted by aaronc879 So your talking at least $200/mo for decent coverage. ....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.

Then you should be happy because the design of the subsidies cap health insurance costs at 9.5% of O-MAGI and cost-sharing subsidies exist for those with lower income.



For example, DS is low income and as I recall pays ~$20 a month after subsidy for a bronze level plan that would cost $180/month without subsidy. Since the subsidy is based on the difference between a sliding percentage of income and the second lowest cost silver plan if someone chooses a bronze plan then the what they have to pay is lower by the premium difference... in DW's case an additional ~$60/month (ie: he would pay ~$80/month if he had that lowest cost silver plan.

In most cases these people would go without health insurance if it wasn't for the subsidies. (DS wouldn't because if push came to shove I would pay for a plan for him.....to protect me.... I wouldn't want to see him have a serious illness and have to write out a big check for his medical bills.

[mpeirce]

Quote:

Originally Posted by aaronc879 I don't think they should have to pay 20%+ of their income for health insurance.

I'm looking forward to paying for food and shelter as a percentage of my income too.

[aaronc879]

Quote:

Originally Posted by pb4uski Then you should be happy because the design of the subsidies cap health insurance costs at 9.5% of O-MAGI and cost-sharing subsidies exist for those with lower income. For example, DS is low income and as I recall pays ~$20 a month after subsidy for a bronze level plan that would cost $180/month without subsidy. Since the subsidy is based on the difference between a sliding percentage of income and the second lowest cost silver plan if someone chooses a bronze plan then the what they have to pay is lower by the premium difference... in DW's case an additional ~$60/month (ie: he would pay ~$80/month if he had that lowest cost silver plan. In most cases these people would go without health insurance if it wasn't for the subsidies. (DS wouldn't because if push came to shove I would pay for a plan for him.....to protect me.... I wouldn't want to see him have a serious illness and have to write out a big check for his medical bills.

I am happy with the affordability of health insurance for low income, but not medicaid qualified, people thru the ACA. What i'm not happy about is the affordability of Medicare for those that are just over 100% of the poverty level.

[cyber888]

How many of you are getting $0 cost for health insurance? Went to healthcare.gov and saw that if your income is below 19,000 a year, you could get Bronze for about $0 due to the subsidy, and Silver is about $90+/month for 2 persons if your income is below $19,000. This is of course for people who are currently using their after-tax savings + not withdrawing more than $19,000 per year from pre-tax savings.