Did You Have Health Insurance Prior to Signing Up With an Exchange?

[youbet]

Quote:

Originally Posted by MichaelB Neither DW not I were able to buy individual health insurance until now.

A bit of a confusing answer in regard to the poll. Having read zillions of your posts Michael, I'd have a hard time believing you went uninsured prior to the ACA. So, while you couldn't buy individual health insurance, you did have health insurance, right? Or did I misinterpret some of your long ago posts?

[MichaelB]

Quote:

Originally Posted by youbet A bit of a confusing answer in regard to the poll. Having read zillions of your posts Michael, I'd have a hard time believing you went uninsured prior to the ACA. So, while you couldn't buy individual health insurance, you did have health insurance, right? Or did I misinterpret some of your long ago posts?

Let's see. Our retirement began with a fairly long period of inadequate coverage, occasionally interrupted by periods of no insurance or insurance that didn't cover anything. We were eventually able to get decent coverage, which we currently have, but our application, even under the new rules, is still subject to recission. You can appreciate my reluctance to discuss.

My previous post was correct. We have applied for individual coverage 6 times since moving to Florida, with all the major carriers, and all have declined coverage. Three declined to accept our application once we answered affirmatively " have you previously applied for HI and been denied ?"

Since my retirement this has cost me more sleepless nights than either of the two recessions.

[AllDone]

Quote:

Originally Posted by MooreBonds For many people, if their policy expires in Jan/Feb/March 2014, they might assume they "have to" go to the exchange now for 2014. They don't realize that they could enroll in a new 2013 policy in December 2013 and put off going to the Exchange until December 2014. Also, I assume that I personally would have to go to the Exchange to buy an individual policy after January 1, 2014, so next year this time, EVERYONE for individual policies will be buying on the exchange. Unless you go for off-exchange policies - which I personally don't know much about, and which many average Americans don't either, since it seemed that previous talk was always about everyone going through the exchange for individual policies, and the average person (including myself) may not know much at all about what an off-exchange policy can be, legality of it (avoid the penalty).

If you are not going to qualify for a subsidy, there is no reason not to buy a policy of the exchange ... as long as an insurance company is willing to sell you one. There are no penalties for doing so. The insurance companies still have to meet medical loss ratios, etc. The exchanges are meant to be an easy way to shop for plans and calculate subsidies at the same time. However, if you prefer, you can call an insurance broker and shop the old-fashioned way.

[jowi]

Quote:

Originally Posted by nvestysly Yes, I see your point. Although I think I've seen several threads and posts on E-R that indicated some of the members were without insurance for various reasons. DW said the results were not surprising because most people on this forum are more savvy than the Average Joe. Giving this further consideration, the results make me wonder why so many people that already had insurance have switched to an exchange policy. Lots of reasons I guess... subsidy, easier to purchase (assuming the exchange web sites work well), better coverage for some. Hmmmm... maybe this leads to another poll if it's not already been done - why did you switch from your existing insurance to exchange insurance?

I switched because I know my rates would have gone up anyway and both my kids and DH lost their insurance (DH was in HIRSP and my kids both in the state plan, which *used* to allow ANYONE, regardless of income, buy into it (not subsidized but we paid the entire premium, but it was a good rate - about $95 per child - which they decided to not allow anymore). And for a few years, until my oldest is 18, we will qualify for a small subsidy, since we're right at the cutoff. So while we all have a much higher deductible, our monthly family rate (about $600) is the lowest we've paid in insurance for as long as I can remember! Pre-subsidy it was just about the same as before, but much higher deductible, still.

As for just renewing in Dec 2013 like someone else suggested - no THANKS. I've had enough of underwritten insurance applications in my life that I'm glad to be DONE with that! I probably would have been denied by my OWN insurance company for some dumb reason.

[youbet]

Quote:

Originally Posted by MichaelB We were eventually able to get decent coverage, which we currently have

I'm glad to hear that.

As a matter of fact, DW and I never had individual policies either. We both switched directly from being covered on our parents' employer-based policies to being covered by our own employer-based insurance. But we were always covered.

It appears that the vast majority of poll responders here did have coverage prior to the ACA, but as others have said, I doubt this group would be a typical sample of the population as a whole.

[Hamlet]

I suspect that your state was subsidizing their high risk pool rates.

Most likely you were paying rates that the state set, not the full cost of providing insurance to the people in the pool.

Quote:

Originally Posted by jowi DH (52) was paying $350/mo on HIRSP for a 3K deductible with IIRC a $4700 OOPmax. On our new plan, his portion is about $400 or so and our deductible is $11K and OOPmax almost $13K. I thought it was pretty strange when the news started coming out about the rates for ACA and that his rates would be GOING UP. I thought, How can that be? He was in the 'high risk' pool with supposedly sickly people and now, with a mixture of everyone, the rates are more. Just kind of negates the argument that this is 'affordable' for those with pre-existing conditions when compared to HIRSP. I guess the only way it's 'affordable' is if the person is in the category of getting a subsidy and/or cost-sharing. But at least it's EASY to apply now and to shop around. I'm thankful for that! Those old insurance applications were about as fun as walking through glass. ** I know I compared indiv deductibles to family above - but even for an individ plan for him, his rates would go up. And at the VERY least (since HIRSP may have gone up next year, too) they stay the same (are no more affordable) for like coverage.

[MichaelB]

Quote:

Originally Posted by youbet I'm glad to hear that. As a matter of fact, DW and I never had individual policies either. We both switched directly from being covered on our parents' employer-based policies to being covered by our own employer-based insurance. But we were always covered. It appears that the vast majority of poll responders here did have coverage prior to the ACA, but as others have said, I doubt this group would be a typical sample of the population as a whole.

Yes, beginning early retirememt with employer based ínsurance is a world of help. Employer policies can be continued using COBRA, then rolled over into conversion policies. The policies themselves can still be cancelled (for entire groups) but individuals cannot be dropped. My case, my employer was not a US company and the insurance coverage we had was a type of self-insurance, so it was not subject to COBRA regs, which I discovered after leaving. As agents have pointed out to me many times, the key to health insurance is getting into a group.

Since my retirement I have always kept open the possibility of returning to work, and others that are close have done the same with me, not for money but for the health insurance. That's been like an itch I can't scratch. While I don't expect any big immediate change in the US either in insurance or employment marketplaces, I do think this will "loosen up" the job market in an important way that is helpful to small businesses and people that want to change their employment.

[REWahoo]

Quote:

Originally Posted by Hamlet I suspect that your state was subsidizing their high risk pool rates. Most likely you were paying rates that the state set, not the full cost of providing insurance to the people in the pool.

+1

Quote:

Originally Posted by jowi DH (52) was paying $350/mo on HIRSP for a 3K deductible with IIRC a $4700 OOPmax.

Compare his $350/mo pool premium to the Texas pool where 2013 rates for a similar ($2,500 deductible) policy range from $578 to $824 per month depending on county of residence.

[REWahoo]

Quote:

Originally Posted by MichaelB Since my retirement I have always kept open the possibility of returning to work, and others that are close have done the same with me, not for money but for the health insurance.

+1

From the time I lost COBRA eligibility until age 65 I had a health insurance contingency plan. It involved acquiring a concealed carry permit then taking a part-time job driving a school bus...

[jflynn4]

Yes ... Had insurance.

Employer provided for many years prior to ER then COBRA and then the hell of private coverage for 10 months where my premiums skyrocketed to over $1900 per month due to pre existing conditions (DW had breast cancer in 2003 and I suffered a neck injury in 2009).

New coverage thru the exchange is significantly better than I've had and is saving me $1300 per month.

[aaronc879]

I've been without health insurance since Aug 2011 when I became unemployed. Since i'm 34 and have no health problems, I forgot about the ACA deadline until a couple days ago and now it's too late to get coverage so I guess i'll continue to be uncovered for now. I don't have the assets that most people on this forum have so not too worried about being uncovered. Little stuff I can pay out-of-pocket. If i'm in a major accident, my finances will be the least of my worries.

[AllDone]

Quote:

Originally Posted by aaronc879 I've been without health insurance since Aug 2011 when I became unemployed. Since i'm 34 and have no health problems, I forgot about the ACA deadline until a couple days ago and now it's too late to get coverage so I guess i'll continue to be uncovered for now. I don't have the assets that most people on this forum have so not too worried about being uncovered. Little stuff I can pay out-of-pocket. If i'm in a major accident, my finances will be the least of my worries.

It's too late to get insurance that starts January 1, however you can still sign up for insurance that starts February 1, 2014.

[aaronc879]

Quote:

Originally Posted by AllDone It's too late to get insurance that starts January 1, however you can still sign up for insurance that starts February 1, 2014.

How does the subsidy work? Say I get the lowest cost plan for $200/mo and get a $100/mo subsidy. Do I just pay $100/mo or do I pay the full $200/mo and get reimbursed after filing taxes?

[audreyh1]

Quote:

Originally Posted by aaronc879 How does the subsidy work? Say I get the lowest cost plan for $200/mo and get a $100/mo subsidy. Do I just pay $100/mo or do I pay the full $200/mo and get reimbursed after filing taxes?

AFAIK you pay the $100, and the insurance company gets reimbursed from the govt.

[AllDone]

Quote:

Originally Posted by aaronc879 How does the subsidy work? Say I get the lowest cost plan for $200/mo and get a $100/mo subsidy. Do I just pay $100/mo or do I pay the full $200/mo and get reimbursed after filing taxes?

You can set it up either way.

[oldtrig]

Quote:

Originally Posted by MichaelB Neither DW not I were able to buy individual health insurance until now.

Why? didn't you have insurance? Just curious

[aja8888]

Quote:

Originally Posted by oldtrig Why?

Probably for the same reasons my wife was rejected several times at age 62: pre-existing conditions and no disclosure of the fact that she was "old".

[oldtrig]

I don't mean to sound mean in this reply but I just wonder if someone could not get insurance could not they do exactly do what I did when I almost 50. My son had a condition that no insurance company would write a policy that covered it. I took a job that supplied group insurance. I had to do it. I did not really like closing a business I had enjoyed for over 20 years but I had no choice in the matter. Oh I could have took the gamble but it was not worth it at the time. When in a group everybody get covered with no questioned asked. I always thought that was unfair but so is life sometimes. It just seemed crazy in 1996 to pay $400 per month and my son's condition would not be covered. No way am I for this government insurance. Somebody has to pay for it and its scary where they are going to come up with the money. Like I mentioned before something had to be done to stop these every rising costs in the medical field but our government puts their hands in it, come on. oldtrig

[Hamlet]

Do you understand that the group insurance that you get through a large employer is already "government insurance" in the same way that the new individual insurance is going to be "government insurance"?

The large group insurance market works the way it does because the government set rules saying that insurance companies weren't allowed to charge different rates to individuals working at a large company.

When you work for a big company, the young health folks subsidize the older sicker folks' insurance costs. That isn't the free market at work-- the government wrote the rules forcing that to occur. Without government involvement, it is unlikely that people would get insurance through their employers at all.

The large group market works so well because it already has the rules that the ACA is trying to put in place for the individual and small business market.

Quote:

Originally Posted by oldtrig I don't mean to sound mean in this reply but I just wonder if someone could not get insurance could not they do exactly do what I did when I almost 50. My son had a condition that no insurance company would write a policy that covered it. I took a job that supplied group insurance. I had to do it. I did not really like closing a business I had enjoyed for over 20 years but I had no choice in the matter. Oh I could have took the gamble but it was not worth it at the time. When in a group everybody get covered with no questioned asked. I always thought that was unfair but so is life sometimes. It just seemed crazy in 1996 to pay $400 per month and my son's condition would not be covered. No way am I for this government insurance. Somebody has to pay for it and its scary where they are going to come up with the money. Like I mentioned before something had to be done to stop these every rising costs in the medical field but our government puts their hands in it, come on. oldtrig

[AllDone]

Oldtrig: Hamlet +1

When you went to work for that big company, you got a subsidy from the other, healthy employees, a subsidy from your employer, and a subsidy from the government. The ACA effectively extends the healthy-to-unhealthy subsidy to everyone and the government subsidy to some people who don't work for a large employer. The ACA doesn't level the playing field completely, but it does make it possible for everybody to get access to insurance.

The other stuff is just the hyperbole of politics. Most of the people being brought into the system are working poor and people who were willing to risk leaving the corporate world without insurance. They're not sick, they're generally healthy and unlikely to be wildly expensive to cover. The subsidies are not as generous as people get in the corporate world. The other stuff like "security breeches" and "death panels" is just made up to get people spun up about voting and contributing. There are a lot of people who have spent their lives studying health care economics, health care delivery, etc. and who say that system, while not optimal, will work.