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Old 11-20-2013, 02:27 PM   #141
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Originally Posted by audreyh1 View Post

I get the impression that BCBS operates somewhat independently in each state - they certainly aren't consistent in their approach from state to state.
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They even use different vendors to meet their needs. Just selling software or services to one BCBS does not get you into any of the others. May help open a door, or it may not.

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Old 11-20-2013, 03:59 PM   #142
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Originally Posted by audreyh1 View Post
DH and I are signing up separately. Once I sign up, he'll probably sign up next week.
I'm not sure that is permitted if you want a premium subsidy. I asked healthcare.gov online chat:
Quote:
Can a married couple apply for two individual policies instead of one family policy without changing their combined premium subsidy?
The response was:
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[4:00:54 pm]: Arias
A married couple would have to apply as a family.
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Old 11-20-2013, 04:05 PM   #143
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No subsidy. Signing up directly with insurer "off exchange". That we file taxes MFJ has no bearing.
Missed that. Yes, if you don't care about the exchange, then do what you want.
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Old 11-20-2013, 04:24 PM   #144
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Originally Posted by ziggy29 View Post
Interesting. That sounds like Kaiser.

I assume, though, that emergency care is covered in-network until transfer to a network facility can be safely arranged?
Yes.
From their brochure
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Out-of-network (or nonparticipating) refers to doctors, hospitals and other health care providers that are not contracted with your health plan to provide services at a negotiated rate. Our plans do not offer out-of-network benefits (with the exception of emergency and urgent care). This means you will pay the entire cost for any service you get from out-of-network providers.



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Old 11-20-2013, 04:30 PM   #145
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An interesting thing to me is after reaching a certain level of expenses the total annual costs tend to level out, there is not a lot of total cost difference between bronze to gold.
I think the PPACA's out-of-pocket maximum mandate combined with the actuarial restrictions tends to cause that. Though there is definitely some wiggle between the plans, they are much closer than I would have predicted.

In my state we only have one provider, all the plans are HMO, and almost all the providers are in-state or just over the border. If you travel you only have ER and urgent care coverage. In addition to non-HSA plans, we do have two Bronze HSA plans and a Silver HSA choice. If I did not make any typos, below are the numbers for the highest deductible Bronze plan, and the Silver HSA plan.
BronzeSilverdifference
Our Annual Family Premium$7,164$8,702$1,538
OOP Max $12,700$8,000$4,700
Medical Deductible$11,000$5,000$6,000
Drug Deductible Indv $5,500$2,500$3,000
Drug Deductible Family $11,000$5,000$6,000
Co-insurance most items 0% 10% 10%
The differences in deductible and OOP max makes Silver the better choice for a pessimist, though the Bronze plan is obviously a better deal until the Silver plan's lower deductible causes insurance to pay out the premium difference.
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Old 11-21-2013, 06:37 PM   #146
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Insurance web sites have their bugs too.

Apparently my application has been accepted and I am enrolled, even though a couple of things didn't get transferred correctly from the on-line enrollment UI to the application they printed for me at the end (after already submitted).
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Old 11-22-2013, 07:56 AM   #147
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Looks like I misunderstood the original healthcare.gov chat answer. The relevant part of my latest chat confirms ziggy29's answer that you must apply together, but can have separate plans.
See thread ACA: "Recommended Health Plan Groups" (Family versus 2 Individual Policies) for more details.
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Old 11-22-2013, 11:49 AM   #148
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This is my analysis exported to Excel format - hopefully the formulas transfer OK. Originally done in Numbers.
Nice spreadsheet.
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Old 11-22-2013, 12:05 PM   #149
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Nice spreadsheet.
So the formulas seem to work OK in Excel?

I had no way to test it.
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Old 11-22-2013, 12:48 PM   #150
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So the formulas seem to work OK in Excel?

I had no way to test it.
Well, I've only done a little testing, but so far it looks good.
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Old 11-22-2013, 01:26 PM   #151
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So the formulas seem to work OK in Excel?

I had no way to test it.
The formulas work great for me. I'm using OpenOffice Calc.

Kudos! Very nicely done!

Using your spreadsheet and the plans available in my state I've done 3 different scenerios with OMAGI of $30k, $35k and $40k. As expected the premium/subsidy varies but what surprised me was how much the deductible and oop varied for seemingly the same plan at different levels of OMAGI.

I can see where this could be a real reconciliation headache at tax time
should one grossly underestimate their OMAGI, gaining cost share benefits, only to have to pay them back at tax time.
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Old 11-27-2013, 09:28 AM   #152
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HCSC (corporate overlord for BCBS plans) drafted the first month's premium out of our bank account today. So I guess I'm good to go!

Once I had finished my on-line application, they generate a printable version of an application that you would otherwise submit by mail. That's a bit buggy - not all of the information transferred to the mail-in application correctly. This included NOT checking bank draft as an option, even though all the other information was there. Direct bill was selected instead - huh?

Since DH had exactly the same result during his signup even though we were super careful, we concluded that the application PDF was just something generated for us to see, and not what BCBS actually uses. That's probably why it's not completely debugged.

Anyway - the bank draft thing is apparently working, which is a great confirmation. Although I didn't expect it to happen so soon. I was going to call to follow up on this detail - but now I don't need to! I am actually quite relieved about this early draft because it settles a lot of anxious questions I had.

On the phone about a month ago, I was told this draft would occur on Dec 15th. Not!

Moral of story - make sure you have sufficient funds for an immediate draft.
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Old 11-27-2013, 09:31 AM   #153
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Since I told them to contact me by email, I'll see if I get anything in the mail at all.

Well - they at least have to send me ID cards by mail.....
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Old 11-27-2013, 09:50 AM   #154
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This is a digression but may be of interest for some of you who have been waiting to blunder back into healthcare.gov. I logged in yesterday for the first time since week one and my experience was night and day. I was able to click through all the screens presented to me with no need to clear the cache or anything. It still presented some stupid design features (redundancy, strange page formatting, etc) but, while irritating, those issues were not deal killers. Unfortunately, I couldn't test the critical identity verification process (other than to not pass) because I am using false information since I don't qualify (65 yo) and am just rubbernecking.
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Old 11-27-2013, 09:51 AM   #155
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HCSC (corporate overlord for BCBS plans) drafted the first month's premium out of our bank account today. So I guess I'm good to go!
I'm not there yet, but today I did receive my "welcome" letter in the mail with my member ID and group number listed. Still haven't paid, but the welcome letter suggests the ID card will be coming shortly.
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Old 11-27-2013, 10:51 AM   #156
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I'm not there yet, but today I did receive my "welcome" letter in the mail with my member ID and group number listed. Still haven't paid, but the welcome letter suggests the ID card will be coming shortly.
I got a welcome email

And an email to call in - which ended up being a call to a nurse who was there to get a bit of data on me and advise me on how best to use the network to save costs.

And another thank you email last night that was a plan summary PDF that I had already downloaded.
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Old 11-27-2013, 10:55 AM   #157
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This is a digression but may be of interest for some of you who have been waiting to blunder back into healthcare.gov. I logged in yesterday for the first time since week one and my experience was night and day. I was able to click through all the screens presented to me with no need to clear the cache or anything. It still presented some stupid design features (redundancy, strange page formatting, etc) but, while irritating, those issues were not deal killers. Unfortunately, I couldn't test the critical identity verification process (other than to not pass) because I am using false information since I don't qualify (65 yo) and am just rubbernecking.
That's good to hear!

BTW - the BCBSTX site had plenty of oddities. Including a weird date format on one field which I thought I had figured out (but which it turns out I did get wrong - they had updated when DH enrolled online, but he still had trouble).

Anyway - plenty of irritation with the private website enrollment UI, but still got through.
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Old 11-27-2013, 10:59 AM   #158
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I applied to a bronze plan directly through BCBS in Oct.

I got a letter about my current plan (the one I'm switching out of) saying effective 1/1, the new rate will be such and such. Then I get an email today showing a summary of the current plan.

That was confusing so I had to call and confirm that yes, starting 1/1 I'll be on a Bronze plan and not this current plan. Should get the new insurance card and packet in mid Dec.
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Old 11-27-2013, 11:13 AM   #159
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I applied to a bronze plan directly through BCBS in Oct.

I got a letter about my current plan (the one I'm switching out of) saying effective 1/1, the new rate will be such and such. Then I get an email today showing a summary of the current plan.

That was confusing so I had to call and confirm that yes, starting 1/1 I'll be on a Bronze plan and not this current plan. Should get the new insurance card and packet in mid Dec.
When I signed up, I used my existing login on BCBSTX. They recognized and accepted that for enrollment purposes (user name and password), so I didn't create a separate account for the new plan.

But when I log in to the BCBSTX system, it shows my current plan, of course. I expect on Jan 1 it will magically show the new one.

When I log into the enrollment system - which is a different website (hcsc.retail.net or some such), it shows my application submitted.
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Old 11-27-2013, 01:27 PM   #160
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When I signed up, I used my existing login on BCBSTX. They recognized and accepted that for enrollment purposes (user name and password), so I didn't create a separate account for the new plan.

But when I log in to the BCBSTX system, it shows my current plan, of course. I expect on Jan 1 it will magically show the new one.

When I log into the enrollment system - which is a different website (hcsc.retail.net or some such), it shows my application submitted.
Same here -- in the letter I received today, they recognized and reused my existing member ID from the temporary policy I have through the end of the year, but nothing shows about future coverage starting on January 1. And I probably need to call them to figure out where I need to pay...
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