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Covered California exchange announces preliminary rates
05-23-2013, 11:24 AM
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#1
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Administrator
Join Date: Jan 2008
Location: Chicagoland
Posts: 40,586
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Covered California exchange announces preliminary rates
Covered California, the state health exchange, has announced rates for 2014.
The announcement is here News Magazine | Style Demo
Quote:
The rates submitted to Covered California for the 2014 individual market ranged from two percent above to 29 percent below the 2013 average premium for small employer plans in California’s most populous regions. This is impressive since the 2014 products include doctor visits, prescriptions, hospital stays and more essential benefits; protecting consumers from the "gimmicks and gotchas" of many insurance policies.
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Consumer guide is here http://www.coveredca.com/news/PDFs/C...ns_Booklet.pdf
A comparison of Silver level policpy rates is here http://www.coveredca.com/news/PDFs/S...RatesChart.pdf
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05-23-2013, 11:42 AM
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#2
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Moderator Emeritus
Join Date: Oct 2007
Location: Portland
Posts: 4,946
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Well, I'm happy. DD's rate went up by a "huge percentage", or about $60 a month. Rates for DW and I went down a bit percentage-wise, but a much bigger savings dollar-wise than the raised cost for DD. This is pretty much what I expected. Our HMO is slightly more expensive than the rates for the two big non-HMO companies, but the lower 'hassle factor' with the HMO (no in-network vs out of network, electronic records available to our GP and specialists instantly, and overall ease of use) far outweighs the very small pricing difference.
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05-23-2013, 12:51 PM
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#3
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: May 2009
Posts: 9,343
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Quote:
Originally Posted by M Paquette
Well, I'm happy. DD's rate went up by a "huge percentage", or about $60 a month. Rates for DW and I went down a bit percentage-wise, but a much bigger savings dollar-wise than the raised cost for DD. This is pretty much what I expected. Our HMO is slightly more expensive than the rates for the two big non-HMO companies, but the lower 'hassle factor' with the HMO (no in-network vs out of network, electronic records available to our GP and specialists instantly, and overall ease of use) far outweighs the very small pricing difference.
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Congratulations M! Good news to hear for you. $60 would be an 80% increase for me, but I would take it in heartbeat an sign the contract cheerfully!
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05-23-2013, 04:55 PM
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#4
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Nov 2010
Location: Sarasota, FL & Vermont
Posts: 36,266
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Rates look very reasonable to me. Are about what I pay now or less.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
Retired Jan 2012 at age 56
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05-23-2013, 06:03 PM
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#5
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Recycles dryer sheets
Join Date: Jun 2011
Posts: 144
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I have not read up much on the affordable health care plan so I decided to get going by reading this thread. Thanks for starting it by the way. While reading I decided to learn more about the FPL (federal poverty level) as I noticed that rates are detemined as a result of your income %to the FPL. Whie googling FPL and income > and < 400 % I came across an interesting article that talks about the income level traps that are out there. Thought I would pass it along.
Tom
http://www.dailykos.com/story/2012/1...ck-In-For-Real
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05-23-2013, 06:39 PM
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#6
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Thinks s/he gets paid by the post
Join Date: Apr 2006
Location: North Bay
Posts: 1,246
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Rates seem reasonable to me also...except the rates for a 55-yr-old aren't shown.
So all the plans offer the same (or almost the same) coverage at each bronze, silver, etc level. Does anyone know whether actual charges from providers will be more-or-less the same for the various plans? I.E. Do the different providers have significantly different negotiated rates with hospitals, medical groups, labs, etc? Do you think your overall medical costs if you sign up with one of the big boys (Blue Cross) will be significantly lower since they have more clout to negotiate lower rates with provider groups, or are all the insurance groups likely to have similar provider rate sheets?
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05-23-2013, 06:39 PM
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#7
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Thinks s/he gets paid by the post
Join Date: Mar 2013
Location: Southern California
Posts: 3,995
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The cost estimator is showing a monthly estimate for me of $345/month assuming no subsidy. That is less than my former employer used to pay per employee for a large group policy. If these figure are correct that is fantastic news!
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05-24-2013, 04:39 PM
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#8
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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05-24-2013, 04:53 PM
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#9
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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Posts: 9,343
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Quote:
Originally Posted by explanade
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The last paragraph in the article concerns me, where it mentions Texas and Florida as possibly facing higher costs due to hostility towards The Act. My state of MO is following the path of Texas, so it may not be as favorable. Good news for California people though!
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05-25-2013, 10:05 AM
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#10
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Thinks s/he gets paid by the post
Join Date: Aug 2010
Posts: 1,089
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Thank you, Michael, for your continuing effort of providing ACA information.
DW and I are not retired yet. Hopefully in 2014. I am in Los Angeles (South) with a family of 4. I am using these ages (58, 52, 2 under 21), and plan to limit my retirement income below $73,000 (15% tax rate). From the Covered California Calculator, I get a monthly premium of $578 ($6,936 annually).
I understand this is based on a Silver plan. The Covered California also estimates the OOP amount as below:
"The benefit plans also feature out-of-pocket maximums: $6,400 for individuals and $12,800 for a family. In other words, if you get very sick or injured, that is the maximum amount you will have to pay outside of your premium."
Our family is blessed with good health and we have not had a large amount of OOP so far.
If $12,800 is the max OOP for a family, I am thinking of using half of that amount as my annual budget. I am interested in knowing how much OOP amount, would members of this forum budget annually participating ACA?
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05-25-2013, 01:56 PM
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#11
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Thinks s/he gets paid by the post
Join Date: Aug 2010
Posts: 1,089
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Quote:
Originally Posted by fh2000
Thank you, Michael, for your continuing effort of providing ACA information.
DW and I are not retired yet. Hopefully in 2014. I am in Los Angeles (South) with a family of 4. I am using these ages (58, 52, 2 under 21), and plan to limit my retirement income below $73,000 (15% tax rate). From the Covered California Calculator, I get a monthly premium of $578 ($6,936 annually).
I understand this is based on a Silver plan. The Covered California also estimates the OOP amount as below:
"The benefit plans also feature out-of-pocket maximums: $6,400 for individuals and $12,800 for a family. In other words, if you get very sick or injured, that is the maximum amount you will have to pay outside of your premium."
Our family is blessed with good health and we have not had a large amount of OOP so far.
If $12,800 is the max OOP for a family, I am thinking of using half of that amount as my annual budget. I am interested in knowing how much OOP amount, would members of this forum budget annually participating ACA?
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I can see how my own explanation could be confusing: my health care budget is actually $6,936 + $6,400 (1/2 of OOP max) = $13,000+.
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05-26-2013, 05:05 AM
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#12
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Administrator
Join Date: Jan 2008
Location: Chicagoland
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Fh2000, thanks for the kind words. Many forum members contribute to the body of knowledge we have accumulated here.
In our case we don't budget the total OOP, we do budget the average of what we spent over the past 4 to 5 years in unreimbursed healthcare expenses. At the same time, we carry the entire total OOP amount in our emergency fund, along with other large amounts we are certain to spend over the next 5 years or so.
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05-26-2013, 06:25 AM
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#13
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: May 2009
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Quote:
Originally Posted by fh2000
I can see how my own explanation could be confusing: my health care budget is actually $6,936 + $6,400 (1/2 of OOP max) = $13,000+.
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I am single and have a $5500 deductible. I fully fund my $3000 plus HSA. So, I fund about half the deductible. But I have enough already built in savings to cover the rest as needed, so I do not budget per se for it. I hope I can build a nice amount in my HSA before any illnesses develop.
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05-26-2013, 09:46 AM
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#14
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Recycles dryer sheets
Join Date: Sep 2007
Posts: 464
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Thank you Michael. I am about to lose my health insurance due to a change of ownership of our company, the Obamacare is quite important to me. Also, with my pre-existing condition, I would have been out of luck finding my own coverage.
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05-26-2013, 10:24 AM
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#15
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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__________________
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05-26-2013, 02:15 PM
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#16
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Recycles dryer sheets
Join Date: Apr 2013
Posts: 98
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Sorry to sound like a naysayer but color me extremely skeptical. This all sounds good on paper but talk to me a year or two after full implementation, since I am happy with both the cost and quality of my current health care.
Just today there was a news story on the shortage of doctors and the shortages are predicted to get worse. Local legislators are trying to get ahead of it Grimm, Crowley, Reintroduce Legislation to Address Looming Doctor Shortage | Congressman Michael Grimm
My best childhood friend is a Neurosurgeon in CT who has seen a quantum shift of talent away from medicine and has himself abandoned his practice due to onerous regulations, obtuse governmental mandates and falling reimbursement rates. He went so far as to get a law degree (he sees medical malpractice as the next boom industry) stating that in short order med students will be "fast tracked" to get them into practices sooner, lowering the quality of care.
Many of his peers have gone to private practices that will not accept any insurance as concierge doctors which will only make the problem worse. I can only hope that I am wrong.
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05-26-2013, 03:39 PM
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#17
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Thinks s/he gets paid by the post
Join Date: Jan 2004
Posts: 2,049
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Quote:
Originally Posted by killingme
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Because of the aging boomers and the AMA. Wouldn't this happen/hasn't this been happening without Obamacare?
'“Our country needs us to do all we can to alleviate the coming doctor shortage, yet an outdated limit on the number of doctors that can be trained ties the hands of our medical schools and our teaching hospitals,” said Rep. Crowley.'
USATODAY.com - Medical miscalculation creates doctor shortage <=== Ooops
Quote:
My best childhood friend is a Neurosurgeon in CT who has seen a quantum shift of talent away from medicine and has himself abandoned his practice due to onerous regulations, obtuse governmental mandates and falling reimbursement rates.
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My childhood best friend is an anesthesiologist in CA and he's still making a ****-ton of money and he's never complained about onerous regulations. He's also working part-time because he can do so and easily make 6 figures. What's your point again?
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05-26-2013, 11:57 PM
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#18
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Thinks s/he gets paid by the post
Join Date: Jul 2005
Posts: 2,223
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Quote:
Originally Posted by scrinch
Rates seem reasonable to me also...except the rates for a 55-yr-old aren't shown.
So all the plans offer the same (or almost the same) coverage at each bronze, silver, etc level. Does anyone know whether actual charges from providers will be more-or-less the same for the various plans? I.E. Do the different providers have significantly different negotiated rates with hospitals, medical groups, labs, etc? Do you think your overall medical costs if you sign up with one of the big boys (Blue Cross) will be significantly lower since they have more clout to negotiate lower rates with provider groups, or are all the insurance groups likely to have similar provider rate sheets?
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I could not get the full pdf in the op link to load, but found the "Silver" plan elsewhere on the same site for a 54 year old at $491 before any subsidy.
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05-27-2013, 05:24 AM
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#19
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Recycles dryer sheets
Join Date: Oct 2010
Location: In a van down by the river
Posts: 407
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My understanding of it is that CA has had relatively low rates however insurers there could pick and chose who they covered.
To see the rates there go down with the implementation of community rating and a mandate would seem to be a good sign, at least in terms of pricing.
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05-27-2013, 05:34 AM
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#20
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Administrator
Join Date: Jan 2008
Location: Chicagoland
Posts: 40,586
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Quote:
Originally Posted by keegs
My understanding of it is that CA has had relatively low rates however insurers there could pick and chose who they covered.
To see the rates there go down with the implementation of community rating and a mandate would seem to be a good sign, at least in terms of pricing.
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Policies offered on the state health exchange must accept all takers, once they satisfy exchange eligibility criteria.
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