ACA plan poll - What color do you have and why?

[Carpediem]

As I plan for a future with ACA, I'm curious as to which color plan most folks choose and why. I'm thinking mine will be a bronze plan with $0 premium *IF* I can manage our income to $65k (otherwise prems are > $1400). A silver plan in our state would be around $300/month with subsidies.

 

[COZICAN]

Silver is the only option here with an HSA attached. And still $0 premium as of now anyway.

 

[sengsational]

Low utilization makes bronze the obvious choice since to get any mileage out of silver, you need to use services.


I have been pleased with bronze, but for the first time this year I encountered a doctor that didn't take our insurance. They take other 'flavors' of Blue Cross, just not the one sold on as bronze on the exchange. Hopefully that won't be a trend.

 

[joeea]

As I plan for a future with ACA, I'm curious as to which color plan most folks choose and why. I'm thinking mine will be a bronze plan with $0 premium *IF* I can manage our income to $65k (otherwise prems are > $1400). A silver plan in our state would be around $300/month with subsidies.

We have a silver plan.

We are paying $349 (and using a $2001 premium tax credit).

 

[flintnational]

Bronze with an HSA. We are low users of healthcare and in five years of retirement we have not come close to the deductibles. If that changes, we will consider the other plan options.

 

[Dtail]

I use Silver plan as effectively "Married" (Head of Household) with a combined 24k MAGI resulting in a combined monthly premium of $133 for both of us and OOP of $1,400 a piece.
FLA in general is a very accommodating state for the Silver ACA plans when one stays under 250% FPL.

 

[davebarnes]

Bronze. Kaiser. HSA. $820/mo for one person.
Very happy with the service. My wife is very healthy and has used only for examinations and vaccinations.

 

[orchid55]

We chose a Bronze HSA plan as it had the lowest all-in cost for premiums plus maximum out of pocket at $30,500. We are not subsidized. Other options ranged as high as $48,000 all-in (for a gold plan).

 

[RunningBum]

Bronze. With the lower premiums it is clearly cheaper if you are a low user, and at least for me, it is cheaper is I am a high user. That surprised me a bit, but all plans have max out of pocket caps, and for me the bronze I considered had a lower OOP max than the gold. So between that difference and the cheaper premium, bronze is cheaper for high usage.

On the plans available to me, there was a range between $4500-$16,000 where gold was cheaper, but only $1200 max at $10,000 expenses. Bronze was cheaper for me outside of that range. It's over $2800 cheaper if I have no usage and $3200 if I have $32,000 or more in expenses.

I don't recall if this included the HSA benefit of the bronze plan, which for me gives me the ability to convert a little more of my tIRA to a Roth. That's a little hard to evaluate because I don't know for sure how much less I pay in taxes on the conversion vs. distributions later. Or I could consider the fed and state tax savings in my bracket, plus the additional ACA subsidy, if I didn't convert any more due to the HSA. If you're up against the cliff, the HSA reduction to income might be a much larger benefit if it keeps you from going over.

The other factor is which doctors are in each plan. Both my gold and bronze choices had the same doctors so it made no difference, but if they are plans from different companies that may sway you a lot. The previous year I would've had to pay $8000 more to go with a plan with my doctors, so I got the cheaper plan and just went out of network as necessary.

If you qualify for cost-sharing, that would almost certainly swing you to a silver plan.

I think gold, silver, and bronze are misleading in that they imply levels of quality of service, but I don't know of any way that's true. I recall someone here wanting to go bronze but their ex- wouldn't let them because the kids were on that plan and she wanted "better" insurance. I suppose there's something to that if you refuse to see a doctor because you haven't met your deductible yet (more likely on a bronze).

Plans are very different in different areas, and people have different needs, so I suggest you plan to run a spreadsheet and see how you'd come out for various medical expense amounts plus the HSA factor, after looking at the service providers available for each plan.

 

[Aerides]

Bronze ppo with HSA/HD, Florida Blue.

 

[ShokWaveRider]

What DTAIL Said.

DW Has Silver, $0 premium $1 & $2 Copays and $2400 MOOP after sub.

 

[SecondCor521]

Currently I am on a silver plan with CSR. Mostly because my ex still has a say in our teenager's health insurance and she prefers more coverage even if it's more expensive.

In a few years when the kids graduate off my health insurance, I'll investigate what I want to do. I'd be OK with a bronze plan and a higher deductible and OOP; I am currently a low utilizer and would be willing to take the risk for a while at least. But if the price of a bronze plan doesn't use all of my APTC, and a silver plan for me alone isn't too expensive, I might just stay with silver.

 

[Carpediem]

I have been pleased with bronze, but for the first time this year I encountered a doctor that didn't take our insurance. They take other 'flavors' of Blue Cross, just not the one sold on as bronze on the exchange. Hopefully that won't be a trend.

We've had doctor offices tell us they don't take ACA Blue Cross but they accept other Blue Cross coverage. I don't get that at all.

 

[Carpediem]

But if the price of a bronze plan doesn't use all of my APTC, and a silver plan for me alone isn't too expensive, I might just stay with silver.

Sorry, what is "APTC"?

 

[MRG]

Silver with CSR. Pay $348 monthly for me.

Absolutely the worst insurance I've ever had. Custom service tells you something different every time you call. It's a crap shoot to go anywhere for a service. (I've spent many hours with their customer service today and have no progress on either issue I called about. After a specialist put me on hold for an extended time, their VRU was kind enough to send me to the "goodbye queue" where I was told to call back.)

 

[SecondCor521]

Sorry, what is "APTC"?

Advanced Premium Tax Credit - the amount that the federal government pays to the health insurance company towards your monthly premium if your MAGI -Modified Adjusted Gross Income - is less than 400% of the FPL - Federal Poverty Level - for your area and family size. Commonly called the tax credit, ACA subsidy, and similar terms.

The APTC is based on the second lowest cost silver plan in your area and your MAGI as a percent of FPL, but you can apply it to any metal level plan. However, you can't get a refund of the APTC if you spend less than that on your premiums.

So in my case, I might get an APTC of $400 per month. If a Bronze plan costs $100 per month and a Silver plan costs $300 per month, I'll get the Silver plan, because my OOP monthly premium would be zero for both. If the Bronze is $100 and the Silver is $410, I'd get the Silver plan, because I'd rather pay $10 for $410 of value than get $100 of value for free. I am not allowed to buy the Bronze plan and get the $300 difference refunded to me at tax time - the extra $300 of APTC remains unutilized.

 

[ShokWaveRider]

Silver with CSR. Pay $348 monthly for me.

Absolutely the worst insurance I've ever had. Custom service tells you something different every time you call. It's a crap shoot to go anywhere for a service. (I've spent many hours with their customer service today and have no progress on either issue I called about. After a specialist put me on hold for an extended time, their VRU was kind enough to send me to the "goodbye queue" where I was told to call back.)

Location, Location, Location. Ours is the BEST we ever had, even when we were both working and ALL our medical expenses were covered by our employers.

 

[audreyh1]

Only bronze plans with HSA here. Expensive regardless. Unsubsidized.

 

[Dtail]

Sorry, what is "APTC"?

Advance Premium Tax Credit. This is the tax credit one receives when their MAGI (taxable income plus adjustments) stays under 400% of the Federal Poverty Level (FPL).

 

[Dtail]

Location, Location, Location. Ours is the BEST we ever had, even when we were both working and ALL our medical expenses were covered by our employers.

+1
Every doctor around here takes Florida Blue and there is no differentiation between ACA plans or regular plans.

 

[flintnational]

We've had doctor offices tell us they don't take ACA Blue Cross but they accept other Blue Cross coverage. I don't get that at all.

Not sure about your situation, but in Georgia BCBS only offers an HMO option on the ACA. Off ACA they also offer PPO plans. Not many docs take the HMO but most take the PPO. That might be what you are experiencing.

 

[swakyaby]

Chose the Bronze ppo with HSA. Oddly, my PCP was listed as in-network with the Bronze ppo HDHP without HSA, but not in-network in the bronze plan with HSA. I decided to enroll in the Bronze with HSA anyway. Blue Shield kept trying to assign me a different PCP, but I went to my old PCP anyway, thinking I would pay out-of-pocket if needed. My EOB arrived and covered the primary care visit as though she were in-network. Nice.

 

[MRG]

Location, Location, Location. Ours is the BEST we ever had, even when we were both working and ALL our medical expenses were covered by our employers.

+1

This coverage is with Anthem/BCBS and sucks eggs. Our last coverage was with BCBS of KC and they were awesome. Call with a question and get a real answer, not the run around. Heck sometimes I didn't like their real answer but I knew it was correct. These folks all appear to need maps to find their desks.

I'd love to fire them for another insurer but they're the only one. I guess competition might be a good thing.

 

[footenote]

Silver (because I have a chronic health condition requiring at least monthly labs plus daily med) at $210/month

 

[scrabbler1]

Silver plan here. I have Type 2 Diabetes, so I use considerable services, the labwork and one drug being the costliest. Gold plan is too expensive without offering enough added benefits. Bronze plan leaves me too exposed to higher copays which overtake any premium savings. I now pay $647 per month for 1 peron. No APTC this year because I went over the cliff in 2017 and 2018.