ACA plans for 2015

[GTFan]

How is anyone able to view the rates for catastrophic plans using the exchange, ehealthinsurance.com etc.? I never found an option that lets you opt-in for an exemption when comparing plans so the cat plans never show up.

Answering my own question here, I had to go to Humana's website directly to see what they call the 'Basic' plan, which is essentially a bronze plan with a slightly higher deductible ($600/$1200 more). I'm guessing this is their cat plan, but the monthly premium is about $125/mo. cheaper than the bronze so it's going to be a no-brainer to me to get this one. Same POS (non-HMO) plan as bronze, same network etc.

In Cobb County GA (just west of the ATL), the bronze plan is $688/mo. for a 51 and 53 year old household, the basic plan is $577. I'm going to get separate individual plans as recommended due to the family deductible combo penalty. This is just less than a 10% increase over 2014 rates.

EDIT: Oops yep the Basic plan is a cat plan and I'm not going to eligible for that because I don't have a hardship exemption, but the bronze plan is reasonable enough for me next year. After that I'm going to go for subsidies with the ACA (I'll have substantial severance income next year).

 

[gbstack]

Just curious if my 2015 income is the same as 2014 why would my subsidy be less in 2015!

I also checked the Kaiser site and the subsidy is higher by $69.00 per month!

Is it possible the subsidy information on Healthcare.gov has not been updated?

 

[MRG]

Think it's due to lower price plans being available in your area. That's what I'm seeing too. There may be smaller networks that I could use, need to start searching the HI's network to see what's in or out. Last year a large provider in this area was out of the smaller networks at first, but came in late in the process.

My same plan from last year is up 25% after subsidies. It's still way cheaper and better than my COBRA was.

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[Accidental Retiree]

Had we stayed in the Bay Area, our premiums would have been around $1200, our tax credit would have been close to $1200 (can't recall the exact figures) and our share of the premium was going to be $3/mo. Yes, THREE dollars.

For the same plan, same company, same income, but now in SW Riverside County, our premium is around $1000, our tax credit would be about $700, and our share of the premium would be $300/mo.

From $3 to $300 for an address change, according to the CoveredCA calculator.
I am not complaining about the figures; it is just a very surprising difference.

I don't understand how they calculate these rates, but I'm not going to worry about it. I'm going to sit back and see how CoveredCA fares the next couple of months before I try to wade into the fray. They still don't have me sorted out for 2014. I don't want to mess with 2015 just yet.

Edited to Add: OK, I DID just look, and the prices and plans are different from what I saw yesterday. They have added Kaiser Bronze HSA plans back in, for example, and the rates are lower.

What a difference a day makes.

 

[shotgunner]

Just curious if my 2015 income is the same as 2014 why would my subsidy be less in 2015!

I also checked the Kaiser site and the subsidy is higher by $69.00 per month!

Is it possible the subsidy information on Healthcare.gov has not been updated?

I believe it is due to competition and more choices in your state's marketplace. That is what happened in my case. A new company came in and their 2nd lowest priced Silver plan is less expensive than the 2nd lowest priced Silver plan from the current year. That reduced my subsidy.

 

[explanade]

Well the Bronze plan I enrolled in beginning in October is going away, the provider is not offering plans on the CA exchange.

So I search again and there are plans at about the same price, maybe $20-30 more a month.

However, these low-priced ones don't include the PCP I've had for years. The plan which would include my PCP would be another $100.

Thinking hard about whether it would be worth $1200-1400 more a year in premiums to keep the same doctor.

 

[Accidental Retiree]

Just for the heck of it, and because I was told I have to do this before November 19 or I am stuck with my current provider, I tried to log on.

They can't recognize my email address in the system -- although they just sent me an email the other day and I see that same address in my profile.

I tried the online chat, but I am no. 204 in the queue. Or was.

Sigh. Nothing has changed. It's like a "Twilight Zone" movie.

Edited to add: "Twilight Zone" turned suddenly to a Disney film. While the site would not let me update important info, it did--once I stopped trying to change info-- let me select a new provider with about 2 clicks.

DH and I are apparently now signed up for a Bronze HSA Kaiser plan. We have to find new doctors, anyway, and thought having Kaiser might alleviate the refusal issue we've encountered before for Covered CA.

Our new neighbors have been pleased with Kaiser, so we'll give it a go.

 

[MichaelB]

I spent the day browsing Florida health insurance plans. Lots of changes for 2015. In our area:

- UHC is now offering HMO plans
- Assurant has replaced Aetna, apparently uses Aetna's NW, prices look to be around 15% higher.
- Cigna kept the same plans, raised prices between 15% - 20%
- BCBS had already announced price increases of 11% for their small NW and 22% for the broad NW.
- Humana kept the same plans and NW, raised prices around 5%.

My guess is BCBS policies are now in the top price tier in the country. Strangely enough, their Medicare plans all rose less than 3%.

After spending a couple of hours attempting to review the networks, Humana is the only insurer that makes it simple to look them over and see how deep they are. The other insurers still make that difficult. This is unfortunate since NW coverage is such a critical component.

 

[steelhead]

Covered CA

We just renewed our Covered CA Anthem Blue Cross Silver Plan for 2015. Premiums increased about 6.2%, but all of that appears to be related to DW and me being a year older. When I reduced our ages by one year, the premium for 2015 is the same as 2014.

 

[Free To Canoe]

Renewed in PA today! I was just going to browse and you know, build my courage up. But once I started the process it was relatively painless.


Current plan insurer raised rates to where my premium tripled for 2015 (still low though). The competitor's premium cost double last year but much cheaper now. Competitor's cost for 2015 is about the same as I am paying this year so we switched providers. It pays to shop.

 

[pb4uski]

.....EDIT: Oops yep the Basic plan is a cat plan and I'm not going to eligible for that because I don't have a hardship exemption, but the bronze plan is reasonable enough for me next year. After that I'm going to go for subsidies with the ACA (I'll have substantial severance income next year).

Just no longer having access to employer provided health insurance is one of the criteria to be able to by cat coverage.

 

[GTFan]

Just no longer having access to employer provided health insurance is one of the criteria to be able to by cat coverage.

Did you claim the hardship exemption this year to get cat coverage? I know you had to fight with them to get it. From what I saw on the healthcare.gov page I didn't think that losing coverage qualifies as a hardship.

https://www.healthcare.gov/fees-exemptions/hardship-exemptions/

 

[MooreBonds]

Did you claim the hardship exemption this year to get cat coverage? I know you had to fight with them to get it. From what I saw on the healthcare.gov page I didn't think that losing coverage qualifies as a hardship.

https://www.healthcare.gov/fees-exemptions/hardship-exemptions/

This is a list of hardship exemptions from the so-called "Fee" ("tax", per the SCOTUS) if you don't have health insurance. However, it is also the same list of exemptions from the following website on healthcare.gov, which talks about buying a catastrophic health insurance plan if you are over 30:

https://www.healthcare.gov/choose-a-plan/catastrophic-plans/

Catastrophic plans with a hardship exemption

• People 30 and over with a “hardship exemption” may buy a catastrophic plan. Hardship exemptions from paying the fee are granted to people based on income or other factors that prevent them from getting coverage. Learn about the 14 types of hardship exemptions.
• If you had an individual insurance plan that was cancelled and you believe other Marketplace plans aren't affordable, you may qualify for a hardship exemption. If you do, you can buy a catastrophic plan.

Interesting that among their list of 14 types of hardship exemption are the following:

"Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable"
(the only documentation they require is a copy of the insurance cancellation, no other requirement to prove it's "unaffordable")

and

"You recently experienced the death of a close family member"
(didn't realize a "close" (whatever that's defined as is anyone's guess) family member passing away suddenly renders you unable to purchase health insurance, whether it's for financial, emotional, psychological, or lack-of-time reasons. It's a shame the IRS isn't as automatically lenient and free-wheeling with their excuses for not having to file your taxes)

and

"You received a shut-off notice from a utility company"
(guess you can just let your water bill go unpaid until you get the notice, then hurry up and pay it so you have an official notice to send in to meet the requirements to buy a catastrophic policy)

The form you fill out and list of what 'proof' you have to submit is here:
https://marketplace.cms.gov/applications-and-forms/hardship-exemption.pdf

 

[bamsphd]

I live in New Hampshire and in 2014 we had only one insurer in the MarketPlace, Anthem BC/BS...

I live in NH as well, and had FIREd after it was clear that Cobra could carry us to HealthCare.gov. I won’t know at least till I file taxes what if any subsidy we will actually get, but guaranteed issue was mandatory for me to retire. At some point I’ll probably want to perform Roth conversions instead of getting healthcare subsidies, but I won’t be shocked if changes to the law eliminate our eligibility for subsidies within a few years anyway.

I was a bit disappointed when only Anthem offered plans in NH, and even more disappointed that they all shared the same severely restricted provider network. I live on the Massachusetts border near Boston’s fine hospitals, but as far as I know none of the Boston hospitals are in plan for 2014. Thankfully we have not needed to visit any Boston hospitals so far this year, and the 2015 choices include two insurers with nationwide networks!

Our unsubsidized Anthem Silver HSA plan’s premium is changing from $725.18 to $736.27 if we stay in the same plan. However, I am currently seriously considering changing insurers and selecting a Bronze HSA plan with a $696.28 premium because that plan has a nationwide network and includes out-of-network coverage. Unfortunately the deductibles and out-of-pocket maximums are worse than the Anthem plan, and actuarially it is a 60% Bronze plan instead of the 70% Silver plan. So actuarially the premium equivalent would be $812.33 (assuming $696.28 divided by 60 times 70).

IIRC-The family deductible issue only applies to HSA-eligible plans.
http://www.irs.gov/pub/irs-drop/rp-14-30.pdf

Most of the HSA plans being offered on HealthCare.gov in NH this year do require a couple to meet the Family Deductible before paying benefits other than preventive care. However, the plan details and the telephone representative for Community Health Options both maintain bronze plan “Community Option H.S.A.” does not.

“No individual pays more than the individual deductible. Once family deductible is met, it is met for all.”

As far as I can tell, that does not conflict with the IRS regulations because the individual deductible for this plan is $5,000 which is more than the IRS's $2,600 family deductible requirement.

When you proceed to the part where you shop for plans there is a place to assign health plan groups. It put both of us in one group but it was simple to create another group and put one of us into it, which left us with DH in one group and me in another. From there I could shop for plans for each of us as an individual.

I tried that last year, but HealthCare.gov would not let me. I’m glad to hear they changed/fixed it.

 

[ernow]

I'm in NH and have had this concern with the Anthem narrow network: say I'm hit by a car while on my bike and get taken to an out of network hospital (I'm incapacitated) and rack up a $200k bill. My concern is that my insurance would pay just the greatly reduced amount they would pay an in-network hospital, say $20k and the hospital comes after me for the $180k balance. I have not heard much said about this issue with narrow plans. I'd be ok with a narrow network otherwise if it offered some premium savings but can't help wondering if it's being penny wise pound foolish. There are 3 other issuers for 2015 with all NH hospitals, but other than the very pricey Assurant, the Harvard Pilgrim and Community have fewer practitioners in network than Anthem, raising the risk of OON charges from docs while at an in network hospital.

 

[sengsational]

If it is an emergency, most policies will treat the whole thing as in-network. Of course as soon as you regain consciousness or maybe before, you better get transferred!

 

[Buck2520]

Got our official letter today, as I feared our Idaho BCBS plan is increasing from $115 to $223 for 2015. Still thankful the ACA makes it possible for us to have insurance, but sure not happy about the cost to us going up nearly 100%. Our subsidy went down (same income) and the plan cost went up. Still a supporter of the ACA but our retirement budget just took a hit.


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[MBSC]

I'm in NH and have had this concern with the Anthem narrow network: say I'm hit by a car while on my bike and get taken to an out of network hospital (I'm incapacitated) and rack up a $200k bill. My concern is that my insurance would pay just the greatly reduced amount they would pay an in-network hospital, say $20k and the hospital comes after me for the $180k balance. I have not heard much said about this issue with narrow plans. I'd be ok with a narrow network otherwise if it offered some premium savings but can't help wondering if it's being penny wise pound foolish. There are 3 other issuers for 2015 with all NH hospitals, but other than the very pricey Assurant, the Harvard Pilgrim and Community have fewer practitioners in network than Anthem, raising the risk of OON charges from docs while at an in network hospital.

An emergency inpatient admission to an out of network hospital should be treated as in-network until the insurer (not necessarily the hospital) determines you can be transferred to an in-network facility.

An emergency visit to the Emergency Department of an out of network hospital without admission will be paid at the in-network rate and, if your state insurance regulations allow for balance billing, you can be billed for the difference. "The regulations establish a baseline reimbursement level that health insurers must pay to out-of-network emergency providers.
Once minimum payment amounts are made, out-of-network emergency providers can balance bill patients with the difference between its billed charges and the amount paid by the insurance. In states where balance billing is prohibited, the minimum reimbursement amounts may not apply, and emergency providers can look to recover greater amounts directly from insurance companies."

Link: Out-of-Network Emergency Services and the ACA | Physician's Weekly

 

[pb4uski]

Did you claim the hardship exemption this year to get cat coverage? I know you had to fight with them to get it. From what I saw on the healthcare.gov page I didn't think that losing coverage qualifies as a hardship.

https://www.healthcare.gov/fees-exemptions/hardship-exemptions/

At first I was going down the unaffordability route (lowest cost bronze plan exceeded 8% of our income) and had "applied" for the unaffordability exemption in December 2013 but later found out the feds were not processing those applications (which makes one wonder why they bothered to put out the application forms if they were not going to do anything with them).

In December 2013 the administration introduced another exception that if you lost your 2013 coverage and new coverage was unaffordable and that was what we ultimately used.

 

[explanade]

Anyone get an email from Costco for quotes?

https://www.costcoquote.com/indv-quote/member-info

Seems to be the same plans and prices as the one for the CA state exchange.

Not sure why they bother, unless they are able to offer cheaper plans than the exchanges.

What is the deadline for 2015 enrollment? Going away for a trip Saturday, assuming I can wait until I get back in a week.

 

[Mulligan]

Anyone get an email from Costco for quotes?

https://www.costcoquote.com/indv-quote/member-info

Seems to be the same plans and prices as the one for the CA state exchange.

Not sure why they bother, unless they are able to offer cheaper plans than the exchanges.

What is the deadline for 2015 enrollment? Going away for a trip Saturday, assuming I can wait until I get back in a week.

You have until February 15th, so relax and stay longer on your trip if you want.
I doubt if you will find much price differentiation. If the plan is the same, the price has to be the same also. I have tried to change my plan through my carriers website and it says there are no plans available. That is clearly wrong as they have 10 plans for me on government website and have offered me an off exchange plan already.


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[audreyh1]

BCBS TX jumped $90 per month Bronze PPO. This is about 30% increase.

But the real unfortunate change is our bronze plans are no longer HSA compliant as they decided to add copays for doctors visits - similar to the silver plan.

They have two bronze plans. The other plan is still HSA compatible, so we'll have to switch to that. It's marginally lower in premium, but the HSA tax savings are significant.

That one bronze PPO plan is the only one BCBSTX offers. I hope they keep it. They probably feel compelled to keep one.

 

[ERhoosier]

Anyone get an email from Costco for quotes?

https://www.costcoquote.com/indv-quote/member-info

Seems to be the same plans and prices as the one for the CA state exchange.

Not sure why they bother, unless they are able to offer cheaper plans than the exchanges.

What is the deadline for 2015 enrollment? Going away for a trip Saturday, assuming I can wait until I get back in a week.

I was also thinking about looking in to Costco HI. Their ads say they offer extras for Executive members, but no idea what that means.

 

[aja8888]

BCBS TX jumped $90 per month Bronze PPO. This is about 30% increase.

But the real unfortunate change is our bronze plans are no longer HSA compliant as they decided to add copays for doctors visits - similar to the silver plan.

They have two bronze plans. The other plan is still HSA compatible, so we'll have to switch to that. It's marginally lower in premium, but the HSA tax savings are significant.

That one bronze PPO plan is the only one BCBSTX offers. I hope they keep it. They probably feel compelled to keep one.

Thanks, my DD called me and said her bronze BCBS TX plan went up 20% and has copays. We have not looked into it yet with her, but it sounds like the same deal. We will research this after Thanksgiving when she is around.

 

[explanade]

BCBS TX jumped $90 per month Bronze PPO. This is about 30% increase.

But the real unfortunate change is our bronze plans are no longer HSA compliant as they decided to add copays for doctors visits - similar to the silver plan.

They have two bronze plans. The other plan is still HSA compatible, so we'll have to switch to that. It's marginally lower in premium, but the HSA tax savings are significant.

That one bronze PPO plan is the only one BCBSTX offers. I hope they keep it. They probably feel compelled to keep one.

What are the HSA tax savings for a retiree?

I can understand people with earned income, who can contribute pre-tax dollars to their HSAs.

But wouldn't retirees self-fund their HSAs with post-tax dollars anyways?