Blue Cross huge rate increase what to do

[gquiring]

I got my mail yesterday and BC raised me from $553 to $637. WOW. To top it all off I am getting a discount because I joined prior to 2009. Otherwise the new rate would be $690. I am unemployed, the company I worked for went out of business so there was no Cobra plan.

I looked around and Aetna won't even offer a policy in NJ. For some reason Oxford is cheaper this year than last? I don't how that can be. Are there any pitfalls switching from BC to Oxford? I compared Dr's and hospitals for my area and they are all available on Oxford. Does Oxford raise their rates the first year or are they locked?

[walkinwood]

It looks like they're socking you (and me, for sure next year) with the max 15% that they can raise pre-2009 policies in NJ.

I don't have any knowledge of Oxford, but when I researched the plans in early '08, I think Horizon BCBS HMO w/Deductable & co-pay was the best "unlimited benefit" plan. I guess I better start comparing plans again.

All the best.

[tjscott0]

I would go to :Health Insurance - Affordable Health Insurance Quotes, Individual Health Insurance

It a online quote website. You DO NOT have to provide any contact information. So pesky insurance agents will NOT be bothering you.

At least you will have information regarding insurers that provide health insurance in your area.

[KB]

Is there another plan offered by BC that is less expensive and still meets your needs?

[Orchidflower]

Humana Advantage (works somewhat like a supplement to Medicare) went from $30 a month to $123. Now THAT's an increase.


But for those 65 and up:

Luckily, AARP sponsors a United Health program called Secure Horizons which is good enough for zero cost. We have it in our area, but my friend in upper Michigan doesn't, her sister in Omaha does. If you can get it in your area and are 65 and over, check it out.

[HpRyder]

Look into a professional organization associated with a labor union. In CA, one such organization is a licensed day care provider association. You have to be licensed thru the state.

[gquiring]

I called Oxford back and confirmed the rate is locked for 12 months. I also called BC sales and they have no haggling interest. So I am now waiting for billing to call me back to see what the cancellation policies are. Oxford enrollment is the 1st and 15th for each month, I would like to do the 15th but I want to confirm BC will pro-rate the month. I compared apple to apples and I don't see any difference in coverage between the plans.

What makes no sense is BC of NJ is a non-profit organization. So how is it possible for Oxford to offer a better rate?

[TromboneAl]

Keep fingers crossed for the public option.

[gquiring]

Quote:

Originally Posted by TromboneAl Keep fingers crossed for the public option.

I am certainly 100% for it but from what I understand if congress passes the bill nothing will be offered until 2013.

[Alan]

Quote:

Originally Posted by gquiring What makes no sense is BC of NJ is a non-profit organization. So how is it possible for Oxford to offer a better rate?

Non-profit does not mean low overheads. In the PBS documentary Frontline program "Sick Around The World" the questions was asked of the 4 countries that have universal care provided by competing non-profit insurance companies "what makes them compete?". Low costs and better customer services is what non-profit companies need to attract customers and survive.

[samclem]

Quote:

Originally Posted by TromboneAl Keep fingers crossed for the public option.

With all the efficiency of the DMV and USPS rolled into one.

"If you think health care is expensive now, wait until it is free."

Later edit: This just in! The government plan will make the Blue Cross rates go higher:

Quote:

Another day, another study confirming that ObamaCare will increase the price of health insurance. The Blue Cross Blue Shield Association has found that premiums in the individual market will rise on average by 54% over the status quo, which translates into an extra $3,341 a year for families and $1,576 for singles. . . . Blue Cross found costs will rise if [as in the Senate plan, the government requires insurers] to cover anyone who applies and then limit how much insurers are allowed to charge based on age or health condition. Economists call this adverse selection; people will wait until they're sick to buy coverage, and the Democratic rules make it perfectly rational for them to do so.

And, recall that the CBO said the "public option" insurance premiums would be the same or higher than private insurance. So, no good deals there.

Overall health insurance company profits in 2008 were 2.2%. Health insurance company profits are not the reason we pay so much in the US for health care.

[Gone4Good]

Quote:

Originally Posted by samclem With all the efficiency of the DMV and USPS rolled into one.

Funny. My mail always gets where its supposed to go and my recently renewed vehicle registration took all of 30 seconds.

Meanwhile my latest run in with my private insurance company cost me several hours disputing the $613.30 bill I received for a "100% covered" routine physical. That doesn't include the several hours fighting with the physician who tried to fraudulently bill tack on charges for an additional "office visit".

[Gone4Good]

Quote:

Originally Posted by samclem The government plan will make the Blue Cross rates go higher:

I'm not sure I would trust Blue Cross' analysis on health insurance reform any more than I would trust Philip Morris' lung cancer research. Here is what the CBO said about the legislation's impact on individual premiums . . .

Quote:

The average, unsubsidized premium per person covered (including dependents) for new nongroup policies would be about 10 percent to 13 percent higher in 2016 than the average premium for nongroup coverage in that same year under current law. . . .More than half of the enrollees in nongroup policies would get federal subsidies, and taking those subsidies into account, the amount that subsidized enrollees would pay for nongroup coverage would be roughly 56 percent to 59 percent lower, on average, than the nongroup premiums charged under current law. Average premiums in this market would be higher than under current law primarily because the typical insurance policy in this market would cover both a substantially larger share of the average enrollee’s costs for health care and a slightly wider range of benefits.

One of the things that gets left out in many comparisons of cost is a discussion of what you actually get for your money. Now that I'm moving into the individual health insurance market one of the things I worry most about is whether my insurance will actually be there when I need it. In New Jersey, I'll pay more but I won't have to worry about whether my policy will be dropped if I get sick, or whether my rates will sky rocket once I file a claim, or whether I'll be able to get insurance at all, at any price. Other states may advertise lower rates. But those rates may not be available to you. And even if they are, rest assured that once you get really sick your trusty insurance company is going to send investigators out to see if they can find anything slightly amiss with your application.

So comparing prices between Blue "Cross your fingers and hope they'll pay my claim and not drop my coverage" insurance rates with actual insurance protection that can't go away is kind of like comparing apples and oranges. But it's not surprising that real insurance coverage costs more than the crap that's out there now.

[rescueme]

Quote:

Originally Posted by gquiring I am unemployed, the company I worked for went out of business so there was no Cobra plan.

Depending on the size of your former company, your rate was probably "group experience rated" - that is that the rates were computed for your former group based upon their usage.

When you were moved to the unrated pool (e.g. all the folks that don't belong to a company - individuals, or a company less than around 5 employees), you find that the rates will go up since a lot of the folks in this group tend to have more of a history of medical problems (in other words, they have insurance since they need it - not working, small company, etc; those that are in groups with better rates may just have the insurance because they work for a larger company and younger without major medical problems, which is reflected in their rate).

BTW, BS/BC companies are just not one company, but a "federation" of close to 40 individual insurance companies across the U.S. They do have a common name and belong to a central control/marketing organization (located in Chicago) but their individual rates are determined by the local BS/BC (e.g. health insurance company) that covers your area.

They are different in that they have defined marketing areas and do not cross boundaries - unlike national health insurance companies (such as those marketed via AARP).

If you need individual health insurance, you need to compare coverage/price of your local BS/BC against all other health insurance companies. Also, you can't ask for coverage from a BS/BC plan in another area of the country - it doesn’t work that way (that's just the way the organization is formed).

Not to help you in your goal to get insurance, but just to explain some of the "internals" in the BS/BC "family".

Guess you can tell that I worked for one (over 30 years ago, but I still remember ...)

BTW, the local BC plan I worked for paid back 94 cents for every dollar in premiums received. The overhead was low (actually too low, since they could not stay in business and were absorbed by another BC company within the state). They were non-profit (and my paycheck reflected that fact). Anyway, it worked out for the best anyway - I left for another company for much better pay (not insurance) and was able to retire before the age of 60 (and no, it was not Wall Street...)

[samclem]

At least according to the article at the link I posted, the CBO cost projections are based on modeling, while the BC projections are based on actual claims/cost experience.

On another front, I think the idea that the public option would somehow reduce costs is very much dead. Here's what the CBO said:

Quote:

That estimate of enrollment reflects CBO’s assessment that a public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges. The rates the public plan pays to providers would, on average, probably be comparable to the rates paid by private insurers participating in the exchanges. The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees. (The effects of that “adverse selection” on the public plan’s premiums would be only partially offset by the “risk adjustment” procedures that would apply to all plans operating in the exchanges.)

But, YearstoGo, I am far from a fan of the present "system." We need to reform the way we pay for health care and cover catastrophic care. There are good proposals out there, and I think we'll see more of them when/if the powerful folks in charge give up onthe present proposals. Americans do not favor the present reform plans, if that matters anymore.

Anyway, I'll bow out from discussion of big-picture health reform in this thread--this is about gquiring looking for a good price on coverage. But since the "public option" was raised as a potential long-term fix to the problem I did not think it inappropriate to chime in.

[TromboneAl]

Quote:

My mail always gets where its supposed to go and my recently renewed vehicle registration took all of 30 seconds.

And UPS and Fedex have not been driven to bankruptcy.

[DblDoc]

Quote:

Originally Posted by samclem With all the efficiency of the DMV and USPS rolled into one. "If you think health care is expensive now, wait until it is free." Later edit: This just in! The government plan will make the Blue Cross rates go higher: And, recall that the CBO said the "public option" insurance premiums would be the same or higher than private insurance. So, no good deals there. Overall health insurance company profits in 2008 were 2.2%. Health insurance company profits are not the reason we pay so much in the US for health care.

Their profits are only part of the costs they add to our system. On the physician end you need a cadre of employees to do all your coding, billing and fighting with the insurance companies to get paid (partially) for services rendered. On the other side is the insurance company who also have a cadre of employees fighting with providers AND insurees to minimize what they have to pay out. While all this provides jobs it costs our health care system a lot of money - and leaves a foul taste in your mouth at the end of the day.

DD

[samclem]

Quote:

Originally Posted by DblDoc Their profits are only part of the costs they add to our system. On the physician end you need a cadre of employees to do all your coding, billing and fighting with the insurance companies to get paid (partially) for services rendered. On the other side is the insurance company who also have a cadre of employees fighting with providers AND insurees to minimize what they have to pay out. While all this provides jobs it costs our health care system a lot of money - and leaves a foul taste in your mouth at the end of the day. DD

Agreed. There's a lot of admin overhead. As we discussed previously, one reason the Medicare admin costs look so low is that typically the costs for all this (on your end and on the insurer's end) are not counted in the figures typically cited for Medicare admin. It's misleadingly low figure for that reason.
If we keep the fee for service model, then health care workers are going to be doing paperwork and fighting with whoever is paying the bills (private insurers, a "government option" or even client-paid). There's no getting around that. If we abandon fee-for-service to reduce the paperwork and costs, we could do that either through a government plan or private ones.

[Danny]

Quote:

Originally Posted by samclem With all the efficiency of the DMV and USPS rolled into one.

We have great postal service here and my DMV is very efficient.

[teejayevans]

Quote:

Originally Posted by gquiring I got my mail yesterday and BC raised me from $553 to $637. WOW. To top it all off I am getting a discount because I joined prior to 2009. Otherwise the new rate would be $690. I am unemployed, the company I worked for went out of business so there was no Cobra plan.

WOW, over $8K/yr for an individual....at what point do you decide to do without? I think I would seriously consider it.
TJ