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Old 10-25-2015, 01:03 PM   #21
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I know you were joking.... but remember that there is a maximum and minimum rate they can charge for all ages.... I believe it is 3X.... so the young folks are going to be paying this increase also.... not really age related...

Yes, only joking and the only reason I feel I could do it is because I am sharing the same pain you are facing.


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Old 10-25-2015, 01:24 PM   #22
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Originally Posted by ERD50 View Post
That's fine.

I also was informed that my current BCBS plan would be eliminated at the end of the year, but I don't think they have opened up the new plans for me to review yet.

I need to check, I hope I don't have to go through another doctor switch again (my previous doctor was only in some very high proceed plans). It took a considerable amount of effort just to determine if a doctor I was considering actually was in the plan I was looking at or not. It seems it should be easy, but even when that doctor, their phone number and address was listed under that plan, it turns out that there is also some other twist about which 'group' they are in, and I needed help from a third party that my former-employer arranged to help with the transition. It took a few conference calls between us to get it straightened out. And if you need to do that with every plan you might consider, it turns into a lot of time and effort.

I figure a rate increase is practically a given, I'm concerned about all the other hoops to jump through.

-ERD50
You've hit upon what I believe is one of the weak spots of the ACA: networks. Medal ratings don't take into account the breadth of the plan's network of doctors and facilities. The insurance companies have taken advantage of that by using smaller networks and woe unto ye should you need a doctor who is not in network! And be aware that the comfort implied by the cap on out of pocket costs is non-existent for out of network balance billings. The sky's the limit there. Sometimes you don't even have control over whether or not an out of network doctor sees you. An example would be if you're in a hospital which is in-network but has out-of-network doctors that it uses to treat you.
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Old 10-25-2015, 01:27 PM   #23
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I received my open enrollment package from my ex-employer yesterday. The good news is that they won't be making any "structural changes" until 2017. The bad news is that this year's increase is 87% as they continue to move more of the costs to the retirees. They also state that from 1/1/2016 there will be no retiree insurance for new hires or re-hires. (They did away with the DB pension plan for everyone the year after I retired).

The plan for myself and DW is a PPO costing $687/month
.................... Network ......... Outside Network .......
Deductible $500/$1,500 ........ $1,000/$3,000
Out Of Pocket $2,000/$4,000 .. $4,000/$8,000
Coinsurance ... 20% ................ 35%
Office visit ... $30 .................. Deductible then coinsurance
Urgent care ... Deductible then coinsurance
Diagnostic X-Ray & Lab .. Deductible then coinsurance
Wellness visits ... pays 100% ....... Deductible then coinsurance


Everything else including Emergency Room, and Ambulance (when medically necessary) is deductible then coinsurance.
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Old 10-25-2015, 02:40 PM   #24
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Old 10-25-2015, 03:12 PM   #25
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Ugh. I just window shopped my state's exchange. Our policy is still offered and the deductible and max OOP have not changed. However, the premium is up a bit over 20% versus the 2015 premium. It will not take more than a few years of this to put health insurance premiums out of reach for most people.


The challenge now is to figure out how much income to declare. My high paying contract gig is over at the end of the year, so I can essentially dial up anything I want. At a minimum it looks like we would want to stay under 260% FPL because that way the kids could go on a CHIP plan. Anyone have experience with CHIP plans?


Cripes, with the way premiums are shooting up it won't be long before I look for a permanent job again just to get employer-provided health insurance.
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Old 10-25-2015, 03:36 PM   #26
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Originally Posted by brewer12345 View Post
Ugh. I just window shopped my state's exchange. Our policy is still offered and the deductible and max OOP have not changed. However, the premium is up a bit over 20% versus the 2015 premium. It will not take more than a few years of this to put health insurance premiums out of reach for most people.


The challenge now is to figure out how much income to declare. My high paying contract gig is over at the end of the year, so I can essentially dial up anything I want. At a minimum it looks like we would want to stay under 260% FPL because that way the kids could go on a CHIP plan. Anyone have experience with CHIP plans?


Cripes, with the way premiums are shooting up it won't be long before I look for a permanent job again just to get employer-provided health insurance.

The problem is 80% will get subsidized premiums and wont feel the same sting. The other 20% will be left swinging in the wind. The only reason why I say that is that govt officials frequently mention "very few people" actually pay full cost when questioned about rate increases. Factually true, but doesn't strike any confidence in me that we are a priority. Any proposals that would benefit us would probably be a detriment to someone else I suppose.


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Old 10-25-2015, 03:43 PM   #27
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Originally Posted by Mulligan View Post
The problem is 80% will get subsidized premiums and wont feel the same sting. The other 20% will be left swinging in the wind. The only reason why I say that is that govt officials frequently mention "very few people" actually pay full cost when questioned about rate increases. Factually true, but doesn't strike any confidence in me that we are a priority. Any proposals that would benefit us would probably be a detriment to someone else I suppose.


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Even with a subsidy, the rack rate is pretty spicy. I have been fooling with my state's exchange website. When I plug in income at a hair under 250% FPL I get a sub $50/month premium subsidy when the cheapest option bronze plan for the four of us is close to $700. When I plug in a hair under 200% FPL I get a $18X/month subsidy. That still leaves a pretty big line item on the budget for premiums. And this is for a policy that has a $5000 individual/$10000 family deductible. You have to get pretty far down on the income scale to get a material subsidy.

Anyone know if CHIP is considered Medicaid and therefore subject to clawbacks?
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Old 10-25-2015, 04:20 PM   #28
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Originally Posted by brewer12345 View Post
It will not take more than a few years of this to put health insurance premiums out of reach for most people.
With median household income at $52K (US Census, 2015) and the average group policy costing $17.5K (KFF 2015), I think we're there.

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Originally Posted by Mulligan View Post
The problem is 80% will get subsidized premiums and wont feel the same sting. The other 20% will be left swinging in the wind. The only reason why I say that is that govt officials frequently mention "very few people" actually pay full cost when questioned about rate increases. Factually true, but doesn't strike any confidence in me that we are a priority. Any proposals that would benefit us would probably be a detriment to someone else I suppose.
The data I've seen shows about 10M exchange policies and another 8M individual policies directly from the insurers. If 90% of the exchange policies have some level of assistance, that means 1/2 of all individual policies (exchange + direct) are paying full rate.

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Anyone know if CHIP is considered Medicaid and therefore subject to clawbacks?
I thought with the Medicaid expansion, clawback now only affects >age 55 nursing home costs.
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Old 10-25-2015, 04:31 PM   #29
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With median household income at $52K (US Census, 2015) and the average group policy costing $17.5K (KFF 2015), I think we're there.

The data I've seen shows about 10M exchange policies and another 8M individual policies directly from the insurers. If 90% of the exchange policies have some level of assistance, that means 1/2 of all individual policies (exchange + direct) are paying full rate.

I thought with the Medicaid expansion, clawback now only affects >age 55 nursing home costs.

I have no doubt your info is the correct one in totality. I imagine why it was quoted the way I mentioned was because they were probably only referencing the people using the exchange. So bottom line is more people are not shielded. I poked into BCBS which is not my carrier but had similar price. Looks like mine will be going up another 30%.


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Old 10-25-2015, 07:33 PM   #30
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Originally Posted by brewer12345 View Post
Even with a subsidy, the rack rate is pretty spicy. I have been fooling with my state's exchange website. When I plug in income at a hair under 250% FPL I get a sub $50/month premium subsidy when the cheapest option bronze plan for the four of us is close to $700. When I plug in a hair under 200% FPL I get a $18X/month subsidy. That still leaves a pretty big line item on the budget for premiums. And this is for a policy that has a $5000 individual/$10000 family deductible. You have to get pretty far down on the income scale to get a material subsidy.

Anyone know if CHIP is considered Medicaid and therefore subject to clawbacks?
Is all of your income pension or can you alternate years so you are 300% FPL one year and 150% of FPL the next year? Give up $50 a month one year and the next year get $500 a month subsidy and cost sharing on those family and individual deductions.

IE, sell your Google stock this year for a gain and sell your Seadrill stock next year for a loss
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Old 10-25-2015, 07:33 PM   #31
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Just got my letter from Regence BCBS stating my pre-ACA plan is being terminated.
It was a HSA HD $295/mo. for the last 2 years. The new plan they are transferring me to is $594/mo. for a Silver HSA 2000 PPO plan. Of course I can take a lower cost bronze
plan or go on the ACA exchange and try to get a subsidy there.
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Old 10-25-2015, 08:32 PM   #32
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My plan is also eliminated for next year. We chose a bronze plan which feels like catastrophic but isn't.

We'll look on November 1. If we have to change primary physicians we'll deal with that.

It is absolutely disgusting what is happening with health care. I know an orthopedic surgeon who makes $3million/year. The hospital charges for OR time and equipment are insane.

Generic prescription costs have generally increased 10 fold over the past 2 years, just because they can get away with it.

It sounds like collusion and monopolistic control by the health care industry. I've been a part of this industry my whole working life, but have never seen this outrageous cost before.

Now the insurance companies are partnering with health care and hospital groups. The consumer is getting screwed.

Yikes! What can we do?


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Old 10-25-2015, 08:36 PM   #33
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I received noted from Anthem/BCBS that my old grandfathered Missouri plan will (once again) be extended for 1 more year. My increases on this $5,500 deductible plan over the recent past:
(monthly premiums)
2016 $97.94 +19%
2015 $82.25 +27%
2014 $64.55 +15%
2013 $56.38

I've taken peeks at what the cheapest bronze plan is for MO over the years, and have seen roughly $250/mo premiums. Guess I should enjoy this one final encore year...unless they extend it another year?
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Old 10-25-2015, 08:46 PM   #34
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Is all of your income pension or can you alternate years so you are 300% FPL one year and 150% of FPL the next year? Give up $50 a month one year and the next year get $500 a month subsidy and cost sharing on those family and individual deductions.

IE, sell your Google stock this year for a gain and sell your Seadrill stock next year for a loss
My income flops around from year to year and is mostly 1099 and W2. 2015 we got no subsidy. When I plugged in 137% FPL the max subsidy I saw was $372/month.
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Old 10-25-2015, 08:49 PM   #35
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I received noted from Anthem/BCBS that my old grandfathered Missouri plan will (once again) be extended for 1 more year. My increases on this $5,500 deductible plan over the recent past:
(monthly premiums)
2016 $97.94 +19%
2015 $82.25 +27%
2014 $64.55 +15%
2013 $56.38

I've taken peeks at what the cheapest bronze plan is for MO over the years, and have seen roughly $250/mo premiums. Guess I should enjoy this one final encore year...unless they extend it another year?

If anyone should file a protest its you, MooreBonds. How can you stand to take those increases! I remember 3 years ago when I was on same plan you had. BCBS stayed silent until the very end about allowing grandfathered plans to continue. I panicked as Coventry already said they would extend grandfathered plans a year so I jumped ship... Maybe one of the worst decisions in my life. If I had stayed calm like you, I could still be complaining like you about my 20% increases forcing me to pay $100 a month!


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Old 10-25-2015, 08:57 PM   #36
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My income flops around from year to year and is mostly 1099 and W2. 2015 we got no subsidy. When I plugged in 137% FPL the max subsidy I saw was $372/month.
At 137% of FPL you need to be looking at silver plans, not bronze plans.

For a family of four with the adults in their 40s, you are going to be getting a $500+ subsidy on a silver plan with 137% FPL and your max out of pocket is going to be something ridiculously cheap, like $1000 a year.

Bronze plans are only for (income) rich people :-)
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Old 10-25-2015, 09:05 PM   #37
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At 137% of FPL you need to be looking at silver plans, not bronze plans.

For a family of four with the adults in their 40s, you are going to be getting a $500+ subsidy on a silver plan with 137% FPL and your max out of pocket is going to be something ridiculously cheap, like $1000 a year.

Bronze plans are only for (income) rich people :-)
I was referring to premium subsidy only. If the rack rate for the silver plan is over $800, even the max premium subsidy still means a $450 monthly nut.
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Old 10-25-2015, 09:28 PM   #38
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I was referring to premium subsidy only. If the rack rate for the silver plan is over $800, even the max premium subsidy still means a $450 monthly nut.
Are you sure about that? Maybe for some reason your state is special? Let me check Washington state, but I think the subsidy here for a $800 premium for someone just over 133% FPL is a lot more than $350 even ignoring cost sharing. I think it is more like a $700 subsidy and you are left with a $100 nut.

Edit: I just ran the numbers for national average subsidy:

$22,000 MAGI, 140% FPL
Estimated financial help: $674 per month ($8,089 per year)
as a premium tax credit. This covers 91% of the monthly costs. Your cost for a silver plan: $63 per month ($753 per year)
in premiums (which equals 3.42% of your household income). The most you have to pay for a silver plan: 3.42% of income for the second-lowest cost silver plan Without financial help, your silver plan would cost: $737 per month ($8,842 per year)
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Old 10-25-2015, 09:51 PM   #39
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Are you sure about that? Maybe for some reason your state is special? Let me check Washington state, but I think the subsidy here for a $800 premium for someone just over 133% FPL is a lot more than $350 even ignoring cost sharing. I think it is more like a $700 subsidy and you are left with a $100 nut.

Edit: I just ran the numbers for national average subsidy:

$22,000 MAGI, 140% FPL
Estimated financial help: $674 per month ($8,089 per year)
as a premium tax credit. This covers 91% of the monthly costs. Your cost for a silver plan: $63 per month ($753 per year)
in premiums (which equals 3.42% of your household income). The most you have to pay for a silver plan: 3.42% of income for the second-lowest cost silver plan Without financial help, your silver plan would cost: $737 per month ($8,842 per year)
I have not logged into the state exchange, so I can't see real numbers. Its possible I am seeing a distortion.
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First look at next years rates
Old 10-25-2015, 10:21 PM   #40
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First look at next years rates

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Originally Posted by Texas Proud View Post
I know you were joking.... but remember that there is a maximum and minimum rate they can charge for all ages.... I believe it is 3X.... so the young folks are going to be paying this increase also.... not really age related...

Texas, I played with the website to see what age did. My plan this year is $288. Site says I will pay $335 next year. I added a year to my age (52) to see what it would cost. It was $351. So I assume about one third of my 16% increase is age related and not inflation. That is a bit higher of the percentage than I would have guessed.


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