First look at next years rates

[ziggy29]

I got another mailing from BCBSIL about my plan being discontinued at EOY. Big red letters "Open and read right away for details and to learn about your options".

Well, the 'details' are mostly, you can't really do anything until Nov 1, but you will need to pick your PCP by Dec 1. Great.

Translation: Your PPO plan is gone and we are forcing you into an HMO?

There is a quadruple whammy hitting a lot of people:

(1) As we get a year older, rates increase;
(2) As health care costs continue to rise MUCH faster than inflation, premiums rise sharply without commensurate increase in incomes;
(3) Even with higher premiums, deductibles and (especially) OOP maximums are rising sharply;
(4) Many HMO and PPO networks are getting narrower with fewer and fewer providers in network.

All of these have been trends for at least 20 years, but this year they all seem to be hitting pretty hard, and that includes employer group plans.

 

[Mulligan]

I got another mailing from BCBSIL about my plan being discontinued at EOY. Big red letters "Open and read right away for details and to learn about your options".

Well, the 'details' are mostly, you can't really do anything until Nov 1, but you will need to pick your PCP by Dec 1. Great.

But there is a default plan I will be switched to. I can't seem to get details on it, but their brief info says my premium will go up about 33%, and every change they note is a negative (higher co-pays, higher deductibles, etc).

Hey, prices on lots of stuff goes up, that's no surprise. But 33% with less service is rather extreme. And the 'hurry up and wait then hurry up', on what will probably be a time consuming, frustrating, circular process is just salt in the wounds.

I wonder how responsive that website will be on Nov 1?

-ERD50

I just got my letter today confirming my price that was quoted on .gov yesterday. $334, up $50 from last year with a network narrower than Walgreen nurses and the 3 local veterinarian medical centers.
So thankful it was lowest price. It was a mess converting last year and I didnt even use .gov. Coventry's system last year was so messed up after about 6 calls and 3 hours (being serious here), they finally admitted it would be better for me to just go to ehealthinsurance and get their policy. Boy were they right. I had it done in 15 minutes with no assistance there.


Sent from my iPad using Tapatalk

 

[MichaelB]

What is the website you use for the Florida exchange? Ive been looking at HealthSherpa but cant find the official State exchange.

The state doesn't have an exchange. The exchange offerings are found on the healthcare.gov website. Healthsherpa used to offer the same info on policies and prices, but I haven't checked this year.

You can also get policies directly from BCBS Florida, and Humana.

 

[utrecht]

Translation: Your PPO plan is gone and we are forcing you into an HMO?

There is a quadruple whammy hitting a lot of people:

(1) As we get a year older, rates increase;
(2) As health care costs continue to rise MUCH faster than inflation, premiums rise sharply without commensurate increase in incomes;
(3) Even with higher premiums, deductibles and (especially) OOP maximums are rising sharply;
(4) Many HMO and PPO networks are getting narrower with fewer and fewer providers in network.

All of these have been trends for at least 20 years, but this year they all seem to be hitting pretty hard, and that includes employer group plans.

If the networks are getting more and more narrow, then whats happening to all the doctors that are no longer in the networks? Nobody can afford to go to a doctor that isnt in their network.

 

[ERD50]

Translation: Your PPO plan is gone and we are forcing you into an HMO?

There is a quadruple whammy hitting a lot of people:

(1) As we get a year older, rates increase;
(2) As health care costs continue to rise MUCH faster than inflation, premiums rise sharply without commensurate increase in incomes;
(3) Even with higher premiums, deductibles and (especially) OOP maximums are rising sharply;
(4) Many HMO and PPO networks are getting narrower with fewer and fewer providers in network.

All of these have been trends for at least 20 years, but this year they all seem to be hitting pretty hard, and that includes employer group plans.

No, it was HMO to HMO - I should have mentioned. I went HMO last year, trying to keep it affordable. It's still ~ $1,000/month for me, DW and one daughter - (who now is employed with her own ins, so I can take her off). MegaCorp offset ~ 65% of that cost though, so not bad really, except for the high deductibles and such (compared with our previous MegaCorp coverage). I haven't heard what they will do for 2016.

-ERD50

 

[ERD50]

Question - Are other people seeing plans where the deductible is roughly (or exactly) equal to the max OOP (Out Of Pocket)?

I noticed this for the plans I was looking at for 2015. It seems very confusing. In the comparisons, they show all these different % coverage for various situations. But, if the % coverage does not kick in until the deductible is met, and the deductible is right around max OOP, doesn't that mean that the % of coverage is moot?

Or am I misinterpreting something (very possible, I prefer a flow chart over convoluted verbiage for these things)?

-ERD50

 

[rbmrtn]

Question - Are other people seeing plans where the deductible is roughly (or exactly) equal to the max OOP (Out Of Pocket)?

I noticed this for the plans I was looking at for 2015. It seems very confusing. In the comparisons, they show all these different % coverage for various situations. But, if the % coverage does not kick in until the deductible is met, and the deductible is right around max OOP, doesn't that mean that the % of coverage is moot?

Or am I misinterpreting something (very possible, I prefer a flow chart over convoluted verbiage for these things)?

-ERD50

That's about right. Most of the bronze plans are that way. I think mine has a $6250 deductible with MOOP of $6600 so that diff ( $350 ) was on coinsuranse

 

[Theseus]

Question - Are other people seeing plans where the deductible is roughly (or exactly) equal to the max OOP (Out Of Pocket)?

The plan I selected for 2015 was one with deductible exactly the same as max OOP, and I intentionally made that choice. Takes away the obfuscation involved with various co-pays, IMO makes it easier to plan for expected costs. Same plan is available for 2016, so far I'm leaning towards sticking with it but I'll let them work out some of the apparent glitches to the healthcare.gov site before committing to that.

 

[ERD50]

That's about right. Most of the bronze plans are that way. I think mine has a $6250 deductible with MOOP of $6600 so that diff ( $350 ) was on coinsuranse

The plan I selected for 2015 was one with deductible exactly the same as max OOP, and I intentionally made that choice. Takes away the obfuscation involved with various co-pays, IMO makes it easier to plan for expected costs. Same plan is available for 2016, so far I'm leaning towards sticking with it but I'll let them work out some of the apparent glitches to the healthcare.gov site before committing to that.

Thanks for that feedback and confirmation. I guess what really concerns me is, people who are less analytical than me (probably 99.762395% of the population ), will look at a plan like that with different % coverage, and assume the % coverage is a factor, and it isn't. Why isn't it simpler than this?

-ERD50

 

[Texas Proud]

I looked and there are no PPO plans offered for me....


I also got a letter from my PCP, who I just got last month, moving to another location.... funny thing is that my previous PCP had moved about a year and a half ago and we just chose her in March.... BCBSTX is not that good at updating their database....

SOOOOO, DW is mad again that we have to find ANOTHER doctor and fill out all the paperwork etc. etc.... when our doc before ACA is still at his practice.... and I would love to go there...

 

[iac1003]

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?


Sent from my iPhone using Early Retirement Forum

Agree 1000%. It is almost as if this has given the insurance companies and hospitals carte blanc to raise rates. Not what ACA was supposed to be about. Now, as an MD, I'm for single payer. I will be on Medicare soon enough. For now I pay $907/month for my AETNA COBRA plan just for me. When I looked at a similar BCBS plan it was over $1100/month.


Sent from my iPhone using Early Retirement Forum

 

[brownred]

Does anyone have a link to just look at the 2016 insurance and rates without having to actually register with the website and/or starting an application?
I'm wanting to retire early at 56 but the more I read here not so sure anymore.

Thanks

 

[Sue J]

Try this one -
https://www.healthcare.gov/see-plans/

 

[rodi]

Question - Are other people seeing plans where the deductible is roughly (or exactly) equal to the max OOP (Out Of Pocket)?

I noticed this for the plans I was looking at for 2015. It seems very confusing. In the comparisons, they show all these different % coverage for various situations. But, if the % coverage does not kick in until the deductible is met, and the deductible is right around max OOP, doesn't that mean that the % of coverage is moot?

Or am I misinterpreting something (very possible, I prefer a flow chart over convoluted verbiage for these things)?

-ERD50

All of the HSA compatible plans I saw had the following for family coverage:

Deductible: 4500 individual, 9000 family
Max OOP: 6500 individual, 13000 family (up from 12.5k last year.)

Big numbers... despite our excessive medical bills last year (kids sports injuries) we didn't hit either the individual or family deductibles or OOPs.

That said - if we hadn't had the insurance negotiated rates - we would have blown right through the deductibles in January. We have our plan to get the HSA tax benefit and to get the negotiated rates... and we'll be paying a lot for the privilege.

 

[Mulligan]

I read an interesting article today in local newspaper concerning the local exchange plans. The various completing plans seem to have narrow networks and generally out of the 3 major hospitals, they are in one but not other insurance plans. One hospital was "getting the word out" they would not accept patients as an out of network option unless prior payment plans were arranged.
Article was kind of implying this as a negative. I personally think its a positive if no one would touch me if I was not in network. That way I will not get stuck with an unwanted bill.


Sent from my iPad using Tapatalk

 

[ziggy29]

Article was kind of implying this as a negative. I personally think its a positive if no one would touch me if I was not in network. That way I will not get stuck with an unwanted bill.

For the most part, except for serious emergencies, I agree. And in that case, treat me until I'm stable enough to be transported to a hospital in the network. If anything financial keeps me awake at night it's the thought of having a catastrophic emergency and being treated by out-of-network ER docs and others even in an in-network hospital -- and winding up with a large 5- or 6-figure "balance bill".

 

[48Fire]

Try this one -
https://www.healthcare.gov/see-plans/

I just checked this, thanks. My megacorp retiree insurance jumped from $669 to $982 per month. However, still beats all but two of 34 plans recommended, and those two have high deductibles. Disappointing, but guess I should be happy

 

[utrecht]

I just checked this, thanks. My megacorp retiree insurance jumped from $669 to $982 per month. However, still beats all but two of 34 plans recommended, and those two have high deductibles. Disappointing, but guess I should be happy

I said this before...the sad thing about your post and a million others is that if you wait one year and search back to this post you will be wishing you could get insurance for $982 per month. It makes me sick.

 

[photoguy]

Received our renewal packet in the mail today. Stunned to see the rack rate for our BS PPO decrease 6%.

 

[John Galt III]

My ins co is discontinuing my plan in Pa for 2016.

The HC.gov website is telling me that with MAGI income of $16,xxx my premuium and my copay and my max oop will be way up for 2016, and I will have to drop from PPO to HMO to get the cheapest deal.

For 2015 I had a PPO with $500 max oop, $250 deductible, and premium of only $20 a month. Nothing like that this year. More like $150 premium, $250 deductible, and $750 max oop, and that's for an HMO.

 

[marko]

This again?

Healthcare hasn't been affordable in the US for decades, as costs have risen at more than 2X the rate of inflation since 1970. Most folks haven't paid directly for their insurance, they receive it as a benefit and don't see the price. The Affordable Care Act brings the price out into the open for all to see.

US employers are paying similar prices, but at least get the benefit of a tax deduction. The only thing new about the high cost of healthcare in the US is the new-found awareness, and it is far too late in the cost cycle to expect this cost to decline.

Michael, I was being a bit snide on my comment that you're referencing, however my hope (maybe I misunderstood) was that HC would become more affordable based on 'everybody' required to now be in the pool and so on.

I agree that HC hasn't been affordable --regardless of who is paying for it--but the "A" in the ACA had me hoping for a better outcome --at the very least, holding the line on rates-- than the examples I'm reading here in this thread.

 

[utrecht]

My ins co is discontinuing my plan in Pa for 2016.

The HC.gov website is telling me that with MAGI income of $16,xxx my premuium and my copay and my max oop will be way up for 2016, and I will have to drop from PPO to HMO to get the cheapest deal.

For 2015 I had a PPO with $500 max oop, $250 deductible, and premium of only $20 a month. Nothing like that this year. More like $150 premium, $250 deductible, and $750 max oop, and that's for an HMO.

You're complaining about a $250 deductible and $750 max OOP? I havent seen those numbers since 1990

 

[karen1972]

Been poking around the NC site and it appears only HMOs are available, though in RTP, almost everyone works for Duke so covered in the HMOs so no biggie for us.

Interesting that mine went up about 25% but I found a different plan for my boyfriend that will save him about $300 from last year and covers more.

BF still working, no subsidy for him, bought direct last year, but looked through the exchange just to see so was surprised to find an option cheaper even without subsidy.

Though my premium went up, since I retired in 2015, 2016 will be the first year I can claim a subsidy which since I will only have dividend income and a tiny pension, the subsidy will nullify the increase.

 

[brewer12345]

The Colorado exchange got its stuff sorted out so my broker shot me some quotes. 2016 will be a lower income year for us, so at a hair under 250% FPL we can put the kids on a state-sponsored freebie plan with no deductibles and tiny copays. DW and I would get our own policy with pro rata subsidies. It would be the same high deductible HSA eligible bronze plan we have now, but the premium for the two of us would be $285/month. That is much better than the no-subsidy alternative that would have run us $670/month for the 4 of us.


I am having the broker run quotes to see what the story would be if we had a hair under 150% FPL just to see what I leave on the table by showing more income.

 

[ivinsfan]

The Colorado exchange got its stuff sorted out so my broker shot me some quotes. 2016 will be a lower income year for us, so at a hair under 250% FPL we can put the kids on a state-sponsored freebie plan with no deductibles and tiny copays. DW and I would get our own policy with pro rata subsidies. It would be the same high deductible HSA eligible bronze plan we have now, but the premium for the two of us would be $285/month. That is much better than the no-subsidy alternative that would have run us $670/month for the 4 of us.


I am having the broker run quotes to see what the story would be if we had a hair under 150% FPL just to see what I leave on the table by showing more income.

Interesting info about how it all works, just wondering if you are comfortable having your kids on the state plan. I think in my case I would want all doctors and hospitals available if a kid problem arose. I'm hearing more and more stories about drs not accepting state subsidized plans...I wonder if they are true or urban legend.