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Anybody signing up without a subsidy?
Old 10-21-2013, 10:04 PM   #1
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Anybody signing up without a subsidy?

I understand that some people will save money when subsidies are taken into account. But has anybody found competitive prices without subsidies?
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Old 10-21-2013, 10:08 PM   #2
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I'm trying to sign up without a subsidy - so far unsuccessfully
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Old 10-21-2013, 10:33 PM   #3
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My current individual policy (roughly equivalent to a "silver" policy) costs $730+ per month. The most expensive platinum policy in my area (Los Angeles) costs $600/month for someone my age (55) with no subsidy, so I will be saving money.
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Old 10-22-2013, 12:01 AM   #4
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Using a rough "Apples to Apples" comparison between the plan I had in 2009-2011 versus the Silver plan I will be buying into next year (excluding the subsidy), I will be paying 50% of what I would be paying today for that old plan had I remained in it. And according to ehealthinsurance.com, that plan is the cheapest plan other than the bare-bones plan I switched into in the middle of 2011, not comparable to any ACA-compliant plan because that plan was not ACA compliant.

Furthermore, what I was paying for COBRA back in 2007-2008 (not counting dental) before I ERed is between the Silver plan without the subsidy and the Silver plan with the subsidy. So if you count inflation for 5 years, I am basically paying a COBRA-like rate for my new Silver policy next year, and that is a good deal because I was very happy with COBRA and wish it had continued. I got my wish and then some because of the subisdy.

I have chosen to reject using the monthly subsidy toward paying my new premium next year because I will use the "overpayment" of monthly premiums as a backhanded tax withholding, offsetting some of the taxes I pay via estimated income tax payments.
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Old 10-22-2013, 07:11 AM   #5
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Originally Posted by Bdroc View Post
I understand that some people will save money when subsidies are taken into account. But has anybody found competitive prices without subsidies?
We have selected a plan with BCBS with similar coverage and network and could sign up tomorrow. There is no subsidy and the total premium would be about 15% less than what we pay this year.

We have also identified another plan with Humana that is an additional 1/4 less and appears to have similar network. They are not ready, though, so we cannot get any details on the plan or network. The most probably outcome is we will sign for one of these two plans, once we return to Florida.
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Old 10-22-2013, 09:38 AM   #6
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In Missouri (KC area), the lowest cost Silver Plan, and the second lowest, are from Coventry. My inputs (male, 57, single, no dependents, non-smoker, MAGI=$16000) show a pre-subsidy premium of $454/mo, or $45 with subsidy. And the cost-savings subsidies result in a $0 deductible with a $1000 out-of-pocket max. The Blue Cross plans have somewhat higher premiums, but the one I've enrolled in has a $250 deductible, and a $500 OOP max, and an excellent network (BCBSKC Blue & U Saver Preferred Care Blue Silver.) The premium will be $160/mo (for a $569/mo plan).

Compare this to my current plan (also with BCBSKC) costing $420/mo, with a $5000 deductible and a $7000 OOP max -- so, essentially just catastrophic coverage, IMO.

Best part of all, though, is being able to enroll in any plan, and not be asked to recite 5 to 10 years of medical history. Amazing.
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Old 10-22-2013, 10:07 AM   #7
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Been looking for a plan for my GF whose COBRA runs out in mid year. Colorado requires first to go through Medicaid enrollment process and be rejected before you can really see what the plans will cost with subsidies. She currently pays $583.00/month for med/dental/vision. My guess is that she will pay a bit less than currently with a small subsidy.

Will be an interesting process when it comes to income verification. She worked full time in 2012 so her last tax return is going to put her above limits for subsidies. Part time last year so will probably ultimately will qualify for subsidy for 2014. Guess we'll have to deal with that on 2014 taxes.

What a pain...but worth it in the end.

Colorado has signed up a grand total of like 300 people. Not exactly a resounding success at this point.
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Old 10-22-2013, 10:10 AM   #8
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Originally Posted by Rpharmer View Post
In Missouri (KC area), the lowest cost Silver Plan, and the second lowest, are from Coventry. My inputs (male, 57, single, no dependents, non-smoker, MAGI=$16000) show a pre-subsidy premium of $454/mo, or $45 with subsidy. And the cost-savings subsidies result in a $0 deductible with a $1000 out-of-pocket max. The Blue Cross plans have somewhat higher premiums, but the one I've enrolled in has a $250 deductible, and a $500 OOP max, and an excellent network (BCBSKC Blue & U Saver Preferred Care Blue Silver.) The premium will be $160/mo (for a $569/mo plan).

Compare this to my current plan (also with BCBSKC) costing $420/mo, with a $5000 deductible and a $7000 OOP max -- so, essentially just catastrophic coverage, IMO.

Best part of all, though, is being able to enroll in any plan, and not be asked to recite 5 to 10 years of medical history. Amazing.
You are doing better in MO than I am... At age 49, my present $5500 deductible, 0 co-pay after deductible is $88 a month. The closest plan is a $6k plus deductible for $290 a month. No subsidy opportunity.
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Old 10-22-2013, 10:18 AM   #9
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I've found the Maryland prices to be very competitive without subsidies. A BCBS gold plan is roughly equivalent to the BCBS COBRA plan I was paying for most of this year, but the ACA plan for 2014 is a few dollars cheaper than the 2013 COBRA prices. I can get a BCBS silver or bronze plan for considerably less. I haven't decided which plan I want, nor whether it's worth my while to seek a subsidy by keeping my MAGI under 400%. To get the subsidy, I'd have to forgo some of my LT Cap Gain harvesting or Roth conversions.
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Old 10-22-2013, 10:31 AM   #10
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Originally Posted by MichaelB View Post
We have selected a plan with BCBS with similar coverage and network and could sign up tomorrow. There is no subsidy and the total premium would be about 15% less than what we pay this year.

We have also identified another plan with Humana that is an additional 1/4 less and appears to have similar network. They are not ready, though, so we cannot get any details on the plan or network. The most probably outcome is we will sign for one of these two plans, once we return to Florida.
Just being nosy curious, but I guess the plans are PPO plans for folks like yourself who spend significant time in different States?
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Old 10-22-2013, 11:01 AM   #11
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Just being nosy curious, but I guess the plans are PPO plans for folks like yourself who spend significant time in different States?
That's is the critical question. BCBS Fl phone reps all say they are PPO. The plan documents say EPO or EPO/PPO. The website product manual for providers (I found it searching) says they all access the same network. That's pretty clear.

My uneducated guess is: it is an EPO, which is a two tier network where the victim policyholder effectively pays less for a tier 1 choice and more for a tier 2 choice. The total of both tiers represent a large network which should satisfy most needs, and even at the higher tier 2 costs, it is far preferable to out of network pricing.

So far, I haven't found nearly enough information from any other insurer to do similar analysis. The multi-state plan option, which is not available yet in Florida, will resolve most of this concern. Very little information available on those.
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Old 10-22-2013, 11:13 AM   #12
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Thanks Michael, very interesting.
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Old 10-22-2013, 11:21 AM   #13
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I am shopping the exchange and BCBS directly for my wife. No subsidy. There is a Bronze plan with an excellent network, no co-insurance that costs less than her cost for the policy she has at her employment. Works for me.
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Old 10-22-2013, 01:58 PM   #14
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We are in MN- will sign up for a platinum plan with BCBS with nearly identical coverage, and it will cover 100% of prescriptions after the deductible. The new deductible plus the 20% copay we pay on prescriptions currently nets out even. Our premiums however will be reduced by about 20% less. Plus we will be eligible for a small subsidy until we draw on the retirement money at 59.5
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Old 10-22-2013, 05:53 PM   #15
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We're (DD, DW, and I) moving to a 40% copay Bronze plan that is HSA eligible. This one will be slightly cheaper for the three of us combined than our current high deductible/high copay HSA eligible plan. It's even cheaper when compared to the estimated 9% hike the old plan would have had for 2014.

Individually, DD's coverage goes up in cost by a huge percentage that works out to $60/month, while DW and I get a small percentage break that works out to about $100 combined.

I do plan to re-apply for the same plan later this year through the state exchange, just in case our 2014 income drops below the magic threshold so we can qualify for the tax credit when we file in 2015. (I hate leaving money on the table...)
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Old 10-23-2013, 07:23 PM   #16
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I'm coming off the Texas Health Risk Pool which shuts down Jan 1. It looks like I'll save a lot over this year's premium with the Silver (25%), and even more with the Bronze (44%) - no subsidy, BCBS PPO which is what I have now.
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Old 10-23-2013, 09:06 PM   #17
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I'm going from a BCBS 5000K deductible HSA to a BCBS Bronze PPO HSA with a 6000K deductible. Premium with the bronze is about $30/month less than current premium with the 5K deductible HSA.
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Old 10-23-2013, 09:09 PM   #18
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No subsidy here, in CO getting a bronze plan with a lower deductible (~1k lower but higher out of pocket max) for the same price my private insurance just offered to early renew me for so I could keep my old coverage for 1 more year. I do private insurance because I get access to an HSA and its still cheaper than my share of a gold plated 80/20 plan that wouldn't do me any good through my work.
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Old 10-24-2013, 04:14 PM   #19
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Originally Posted by Rpharmer View Post
In Missouri (KC area), the lowest cost Silver Plan, and the second lowest, are from Coventry. My inputs (male, 57, single, no dependents, non-smoker, MAGI=$16000) show a pre-subsidy premium of $454/mo, or $45 with subsidy. And the cost-savings subsidies result in a $0 deductible with a $1000 out-of-pocket max. The Blue Cross plans have somewhat higher premiums, but the one I've enrolled in has a $250 deductible, and a $500 OOP max, and an excellent network (BCBSKC Blue & U Saver Preferred Care Blue Silver.) The premium will be $160/mo (for a $569/mo plan).

Compare this to my current plan (also with BCBSKC) costing $420/mo, with a $5000 deductible and a $7000 OOP max -- so, essentially just catastrophic coverage, IMO.

Best part of all, though, is being able to enroll in any plan, and not be asked to recite 5 to 10 years of medical history. Amazing.
Your doing much better in KCMO than I am, must be different counties( I'm in Jackson). I can't get into that network. I'll call back to BCBSKC tomorrow, just to double check. Where I'm at BCBS has a select network and one other. My issue is providers, according to my DR. 'HCA is not participating in these low margin ACA plans'. So while there's a level 2 trama center 7 miles from home, staying in network would get me 11 miles to a 'hospital', with an ER. Or 26 miles to the nearest network trama center. Not a choice I want to make now or while I'm having a heart attack or stroke.

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Old 10-24-2013, 10:11 PM   #20
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That's is the critical question. BCBS Fl phone reps all say they are PPO. The plan documents say EPO or EPO/PPO. The website product manual for providers (I found it searching) says they all access the same network. That's pretty clear.

My uneducated guess is: it is an EPO, which is a two tier network where the victim policyholder effectively pays less for a tier 1 choice and more for a tier 2 choice. The total of both tiers represent a large network which should satisfy most needs, and even at the higher tier 2 costs, it is far preferable to out of network pricing.

So far, I haven't found nearly enough information from any other insurer to do similar analysis. The multi-state plan option, which is not available yet in Florida, will resolve most of this concern. Very little information available on those.
I've done extensive research on our one Multi-State Plan option. It is identical to another plan offering (both Blue Cross) with the exception that the Multi-State plan does not offer coverage for elective abortions. The premiums are $1 less per month for the Multi-State.

I believe there are other intentions for these plans which have not come to fruition yet and the law required that a certain number of states offer a Multi-State in the first year. So at least our Multi-State offering appears to be a placeholder for statistical purposes.
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