ACA plans for 2015

[gozer]

I was able to see my health plan options on the HealthCare.gov site today. Used the link Sue provided several posts back. I have twice as many plans available this year (87). 41 of the plans are PPO type plans with a national network. It took me about 20 minutes to figure out what plan I will be most likely to select. Last year so many of the links like; summary benefits, plan brochure and provider directory, were broken it took me 3 weeks of digging to gather the information to make a decision.

[Tandemlovers]

I too was able to look at the plans available in our area this morning when I logged on.

There are many more options available than there were last year, much to my delight!




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[MooreBonds]

Quote:

Originally Posted by Mulligan The site did mention catastrophic plans but they must not want you to buy them, as I did not see one, or you will have to poke harder to find them. Sent from my iPad using Tapatalk

When I looked at it briefly over the weekend, I had to put my age in as 29 to get any catastrophic pricing, since the standard rule is under 30 only. So despite there being tons of exemptions, they set up the website without all of the proper info.

So, to get an estimate, you have to enter your age as 29, see what the approximate ratio is between the catastrophic and bronze plans, then input your real age to see what the same bronze plan is at your real age, and then apply your ratio to get a SWAG on what the catastrophic plan might be roughly. Granted, it's a very big SWAG, but a reasonable guesstimate without any other info.

[Mulligan]

Quote:

Originally Posted by MooreBonds When I looked at it briefly over the weekend, I had to put my age in as 29 to get any catastrophic pricing, since the standard rule is under 30 only. So despite there being tons of exemptions, they set up the website without all of the proper info. So, to get an estimate, you have to enter your age as 29, see what the approximate ratio is between the catastrophic and bronze plans, then input your real age to see what the same bronze plan is at your real age, and then apply your ratio to get a SWAG on what the catastrophic plan might be roughly. Granted, it's a very big SWAG, but a reasonable guesstimate without any other info.

Well this was crazy, MooreBonds. In my locale I put in age 29, and guess what? The catastrophic plan was higher than the bronze! Trouble was the cat. plan came from a different carrier than lowest bronze plan. There was also only one cat. plan even offered and many bronze plans. It just occurred to me that it is possible that a cat. plan may not even be offered in my age range. I took your idea and went the opposite way too. Seeing what I will pay down the road at 5 year intervals...put it this way, my annual COLA in my pension has almost been claimed every year until 65!


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[ERhoosier]

Info for my region just posted on healthcare.gov.
Good news- Finally a few Exchange PPO plans available for 2015.
Bad news- All but the lowest-priced Bronze are already ABOVE "Cadillac Tax" levels. And it ain't 2018 yet.
OUCH!!!!!

[W2R]

Quote:

Originally Posted by Mulligan Since this is the first time a person could just "look in" on premium costs this is also the first time I have actually looked at the website. A low level bronze is less than $200 difference than a gold plan. This is just my musing but the government's definition of gold is different than mine as the differences all things considered are minimal. My definition of gold is my girlfriend's plan. A $150 yearly max deductible. And I could have it also for just $200 a month. The trouble is I would have to get married to get it!

AAAGH!! Nonononono! Look out! (Just kidding!)

https://www.youtube.com/watch?v=OWwOJlOI1nU

Frank has been studying the available PPACA plans for him here in Louisiana, a state where Medicaid has not been expanded. He has pretty much made up his mind not to get one, though. He plans to go with his own retiree medical insurance, and to move from their most expensive plan to the next one down, which still isn't cheap. He has so many worries and concerns about PPACA, subsidies, and more. He is an intelligent man who understands these things much better than I do so I refuse to advise him one way or another.

He could get my federal health insurance if we married, but it's just not worth it to us. What we have going works so well for us, why mess with it. Besides, marriage should be motivated by other reasons than insurance, IMO.

[Looking4Ward]

Looks like my monthly premium is going up by 12.5%

[MBSC]

My 2015 individual bronze non-subsidy premium will be increasing 0.7% including the age adjustment. It would have dropped 3.1% if I had managed to stay the same age. The health coverage and network provider directory are unchanged. The plan is adding one free vision exam for adults.

The premium for the second lowest cost silver plan that subsidies are based on increased $2 per month including the age adjustment.

[Sue J]

I've been digging in the plan details and specifics for 2 insurers that we would consider. Both have the "family deductible" issue where you have to meet the deductible for both of you if it's a family plan.

In this topic -
http://www.early-retirement.org/foru...-68965-10.html
we discussed that you should be able to buy individual plans, each with their own deductible and that the subsidy would be divided in proportion.

If anyone finds out how to get individual policies for a married couple, please post about it. So far in the preview I don't see a place that would offer that and I'm hoping that it becomes evident on Nov 15th when you can actually apply.

Last year I learned that all HSA plans have the aggregate deductible for a family plan. Now I'm seeing that even non-HSA plans are describing the deductible as being for the whole family, which is double the individual deductible. Here's the description for a silver plan with co-pays -

Deductible the Member Pays
With a family plan, your family must meet the entire family deductible before we provide benefits. This applies to all members on the contract.

For the maximum out-of-pocket there's this note -

Maximum Out of Pocket Costs the Member Pays (includes deductibles, medical and prescription drug copays and coinsurance)
With a family plan, your family must meet the entire family maximum out-of-pocket before we pay benefits at 100 percent.

This is for a silver plan deductible 2000 single/4000 family and MOOP of 6600 single/13200 family. I checked a very expensive Gold plan and the deductible and MOOP are described the same way.

Last year these plans were described as having an embedded deductible that applied to each individual.

So some things have changed for 2015.

So, if anyone figures out how a married couple can get individual policies with the subsidy, please post about it. We are considering an HSA plan, would like to get individual policies even if it means going with 2 different insurers.

[gbstack]

Unless the subsidies are just an estimate they seem to be lower compared to 2014!

[gozer]

Quote:

Originally Posted by gbstack Unless the subsidies are just an estimate they seem to be lower compared to 2014!

If everything else is the same for you, this means the 2nd cheapest silver plan is cheaper this year than the 2nd cheapest silver plan was last year. (full price, not subsidized price)

[brewer12345]

I was able to browse the basics of plans on the Colorado exchange. Looks like we can get an HSA-eligible bronze plan for a bit over $600/month with our chosen insurer. The unsubsidized cost for our current silver plan was close to $800/month. Since we will not qualify for subsidies in 2015 and use very little healthcare services in general, this looks more than acceptable.

[MichaelB]

Quote:

Originally Posted by Sue J So, if anyone figures out how a married couple can get individual policies with the subsidy, please post about it. We are considering an HSA plan, would like to get individual policies even if it means going with 2 different insurers.

Just a guess, but each spouse could have an individual account on the exchange, then apply separately.

[ziggy29]

Because of the reported income on my tax return in 2013 (including 3+ months of my Megacorp w*rk plus 6 months severance pay), I have to reaffirm my expected 2015 income in an updated application in order to keep any subsidies and cost sharing in place.

Still no clue what the plans or premiums are here, or if anyone other than BCBSTX will enter the local market based on my zip code.

[ziggy29]

Quote:

Originally Posted by Sue J So, if anyone figures out how a married couple can get individual policies with the subsidy, please post about it. We are considering an HSA plan, would like to get individual policies even if it means going with 2 different insurers.

When I did some "what ifs" a year ago when I wasn't sure whether my wife's church was going to sponsor her for health insurance (they did), I ran a few scenarios and all of them had us in two separate plans applying together as a couple with a shared subsidy. Ours had to be different because I was eligible for zero cost sharing as an American Indian (if we kept income below 300% of FPL) whereas my wife wasn't. So we *had* to be on two separate plans. Our quotes were given combined, with a subsidy essentially shared among the two of us.

The policies can be separate, but you need to file jointly.

[Sue J]

Quote:

Originally Posted by MichaelB Just a guess, but each spouse could have an individual account on the exchange, then apply separately.

But how would you split the household income?

Last year they told me that MFJ couples had to apply together to get the subsidy.

I'm sure we're not the only ones looking to avoid the 2X deductible issue caused by having a family plan vs individual. I'm hoping that when it comes to actually applying for plans after Nov 15th that there is an option to shop for insurance for just one spouse and then shop for a plan for the other spouse. Wishful thinking.....

It's the internets, someone somewhere will have an answer, I'm just looking for the info ahead of time.

[Mulligan]

Quote:

Originally Posted by W2R AAAGH!! Nonononono! Look out! (Just kidding!) https://www.youtube.com/watch?v=OWwOJlOI1nU Frank has been studying the available PPACA plans for him here in Louisiana, a state where Medicaid has not been expanded. He has pretty much made up his mind not to get one, though. He plans to go with his own retiree medical insurance, and to move from their most expensive plan to the next one down, which still isn't cheap. He has so many worries and concerns about PPACA, subsidies, and more. He is an intelligent man who understands these things much better than I do so I refuse to advise him one way or another. He could get my federal health insurance if we married, but it's just not worth it to us. What we have going works so well for us, why mess with it. Besides, marriage should be motivated by other reasons than insurance, IMO.

Ya like procreation....and I am way past that as a reason!


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[ziggy29]

Quote:

Originally Posted by Sue J But how would you split the household income? Last year they told me that MFJ couples had to apply together to get the subsidy. I'm sure we're not the only ones looking to avoid the 2X deductible issue caused by having a family plan vs individual. I'm hoping that when it comes to actually applying for plans after Nov 15th that there is an option to shop for insurance for just one spouse and then shop for a plan for the other spouse. Wishful thinking.....

Well, that's what I remember -- you can get separate policies but you have to file jointly. If it's two people, usually the family deductibles are 2x the individual deductible, BUT (I could be wrong) I think individual deductibles still apply. For example, there may be a $6000 deductible on a Bronze HDHP and a $12000 deductible on a family plan, but even in the family plan the deductible for any individual won't exceed $6000. I could be wrong and misremembering stuff, but I think that's how it went when I was exploring last year.

[ERhoosier]

IIRC-The family deductible issue only applies to HSA-eligible plans. Not all plans with high deductibles at/above HSA thresholds are necessarily HSA-compliant. IOW- In most regions, you can buy plans with 'high' deductibles (>$1300 indiv/$3000 family for 2015) that are NOT HSA-eligible.

Understanding How Your Deductible Works « Health Insurance

Health Savings Account - HSA 2015 Rules & Requirements

http://www.irs.gov/pub/irs-drop/rp-14-30.pdf

[EastWest Gal]

I have been checking healthcare.gov and it seems to be working fine. I am intending to enroll this month, as I will be off my company health insurance Jan 2015. My state (PA) doesn't have an exchange. Good news-- the premiums have gone up but more significantly, so has the income level that one is eligible for a subsidy. I have estimated my income in full retirement next year and I am eligible for a ~30% subsidy. I checked last year and that wasn't the case.

I would like to here why I should look at ehealthinsurance.com as an alternative. My doctor will accept ACA insurance. And other than my husband's allergies and very well-controlled cholesterol, we have no healthcare issues. I could save ~$5K/yr.

Politics--will the SCOTUS gut the ACA? Will Congress try to repeal it (of course the POTUS will veto). What would you do?

Let me know what you think. Thanks for any and all opinions.