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Old 10-25-2015, 10:40 PM   #41
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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!

You guys must be young. I still have a grandfathered plan with BCBS of MS and pay 3 times that for a 10k ded plan. Plan to take another look at the ACA plans for next year.
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Old 10-25-2015, 10:49 PM   #42
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You guys must be young. I still have a grandfathered plan with BCBS of MS and pay 3 times that for a 10k ded plan. Plan to take another look at the ACA plans for next year.

MooreBonds is younger than me, but at age 50 last year mine was still only $88 a month for a $5500 deductible before they cancelled it this past January. Live in MO. It did seem ours was considerably cheaper than other states. I really never knew why...Maybe they rejected everybody who ever admitted having a headache the previous 10 years on the application.


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Old 10-26-2015, 01:32 AM   #43
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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...
In NY the rates do not change with age, we are a community rated state.
This is good for the old and bad for the young.
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Old 10-26-2015, 01:46 AM   #44
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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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Thanks for the info.... maybe I will type in this years ages and see what the premium is so I can split it between age and just a price increase...
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Old 10-26-2015, 06:10 AM   #45
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I don't have ACA coverage any more but for grins and "just in case" I checked. There seem to be NO PPO plans available for my zip code any more; I pull up 18 options, ALL are HMOs. Hmm.
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Old 10-26-2015, 07:35 AM   #46
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MooreBonds is younger than me, but at age 50 last year mine was still only $88 a month for a $5500 deductible before they cancelled it this past January. Live in MO. It did seem ours was considerably cheaper than other states. I really never knew why...Maybe they rejected everybody who ever admitted having a headache the previous 10 years on the application.

$88 was an incredible deal. When I retired at 53(now 61), my rate was $145 for the same 10k ded I have today. I just checked the new ACA rates net estimated subsidy and the cheapest bronze plan is a little less($50). But not enough to hassle with imo. I know what I have and it has worked for me to this point.

Oh well......3.5 more years and I will be in the medicare bracket anyway. Just suck it up until then.
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Old 10-26-2015, 07:49 AM   #47
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I don't have ACA coverage any more but for grins and "just in case" I checked. There seem to be NO PPO plans available for my zip code any more; I pull up 18 options, ALL are HMOs. Hmm.
In Florida it looks as if some of the insurers are keeping their HMO offerings on the exchanges and limiting their PPOs to direct sales. Not sure why.
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Old 10-26-2015, 07:52 AM   #48
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In Florida it looks as if some of the insurers are keeping their HMO offerings on the exchanges and limiting their PPOs to direct sales. Not sure why.
What is the website you use for the Florida exchange? Ive been looking at HealthSherpa but cant find the official State exchange.
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Old 10-26-2015, 08:23 AM   #49
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Well, I've found the 2016 plan selection and rates at https://www.healthcare.gov/see-plans/ this morning. Just for grins, comparing to an age 1 year less than actual I am seeing a 2.5% increase for age. Bad news is the non subsidized premium for the same plan as last year shows a 27.4% increase (24.4% if using same age as last year). That stumps me for now, as the rate request was for 18.67% with as far as I could tell, 18.25% being approved.
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Old 10-26-2015, 04:58 PM   #50
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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
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Old 10-26-2015, 05:08 PM   #51
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Originally Posted by ERD50 View Post
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.
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Old 10-26-2015, 05:39 PM   #52
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Originally Posted by ERD50 View Post
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.


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Old 10-26-2015, 05:59 PM   #53
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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.
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Old 10-26-2015, 06:02 PM   #54
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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.
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Old 10-26-2015, 06:33 PM   #55
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Originally Posted by ziggy29 View Post
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
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Old 10-26-2015, 06:38 PM   #56
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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
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Old 10-26-2015, 07:11 PM   #57
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Originally Posted by ERD50 View Post
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
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Old 10-26-2015, 08:07 PM   #58
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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.
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Old 10-26-2015, 08:45 PM   #59
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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
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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
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Old 10-27-2015, 12:49 AM   #60
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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...
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