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Old 10-27-2015, 01:27 AM   #61
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Originally Posted by EastWest Gal View Post
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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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.


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Old 11-01-2015, 02:22 PM   #62
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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
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Old 11-01-2015, 02:30 PM   #63
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Try this one -
https://www.healthcare.gov/see-plans/
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Old 11-01-2015, 02:58 PM   #64
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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
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.
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Old 11-02-2015, 09:13 AM   #65
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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.


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Old 11-02-2015, 12:37 PM   #66
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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".
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Old 11-02-2015, 06:50 PM   #67
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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
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Old 11-02-2015, 07:36 PM   #68
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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.
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Old 11-02-2015, 09:07 PM   #69
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Received our renewal packet in the mail today. Stunned to see the rack rate for our BS PPO decrease 6%.
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Old 11-03-2015, 07:37 AM   #70
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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.
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Old 11-03-2015, 08:40 AM   #71
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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.
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Old 11-03-2015, 08:56 AM   #72
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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
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Old 11-03-2015, 09:46 AM   #73
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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.
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Old 11-03-2015, 11:01 AM   #74
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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.
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Old 11-03-2015, 11:47 AM   #75
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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.
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Old 11-03-2015, 02:07 PM   #76
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You're complaining about a $250 deductible and $750 max OOP? I havent seen those numbers since 1990
Thanks. I feel a little better now.
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Old 11-03-2015, 04:27 PM   #77
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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.
In this case, the state sponsored plan is your choice of various HMO offerings. Since our existing plan is already a Kaiser HMO offering, I do not anticipate any issues.
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Old 11-03-2015, 04:47 PM   #78
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Originally Posted by brewer12345 View Post
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.
The biggest step up in saving is when you can get your income below 200%, there is another, smaller savings amount when you get below 150%.

This is based on income projection. If you run over, the premium assistance must be partially paid back but the cost sharing is not.

This KFF paper explains cost sharing beginning on page 14 http://www.fas.org/sgp/crs/misc/R41137.pdf but uses the 2014 numbers. This page gives another explanation and has 2016 numbers http://obamacarefacts.com/insurance-...subsidies-csr/
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Old 11-03-2015, 04:51 PM   #79
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You're complaining about a $250 deductible and $750 max OOP? I havent seen those numbers since 1990
You forgot to mention the $150 premium.

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Old 11-03-2015, 05:25 PM   #80
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The biggest step up in saving is when you can get your income below 200%, there is another, smaller savings amount when you get below 150%.

This is based on income projection. If you run over, the premium assistance must be partially paid back but the cost sharing is not.

This KFF paper explains cost sharing beginning on page 14 http://www.fas.org/sgp/crs/misc/R41137.pdf but uses the 2014 numbers. This page gives another explanation and has 2016 numbers Cost Sharing Reduction Subsidies (CSR) - Obamacare Facts
Understood. We have a structural problem of way too much of our assets being in traditional IRAs rather than Roth or after tax. Either be earning it or converting it from traditional to roth, we need to beef up non-trad IRA assets or face a tax bomb down the road (plus difficulty tapping funds before 59.5). I am also uncomfortable with intentionally cheating (claiming a lower income knowing I can have more and only have to pay back a small amount of what I should not have gotten in the first place). There may be no penalty for doing so currently in place, but I am leery of how it may be viewed in the future especially when my profession requires me to be in a position of trust much of the time.
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