Health Care notice for 2017

[GTFan]

everyone says obamacare is cheap because the subsidy takes care of the increases, but who is paying the subsidy? insurance companies as far as I can tell must be cleaning up on the taxpayer dime whether or not you have obamacare.

How The Affordable Care Act Pays For Insurance Subsidies : Shots - Health News : NPR

 

[hankster]

My company's retiree medical premium was just increased 16%.

Sigh! Just when I thought I was immune to OMY syndrome.

 

[ducky911]

Where is this money going? Like to find the end of the trail and cash in. Healthcare stocks? It's got to be going somewhere! Are doctors driving Bentley's ?

before Obama care wife and I (now62/64) total cost $9,000
2017 quote for an EPO is $29,000

Glad I am going on medicare next month.

 

[RetireAge50]

Where is this money going? Like to find the end of the trail and cash in. Healthcare stocks? It's got to be going somewhere! Are doctors driving Bentley's ?

before Obama care wife and I (now62/64) total cost $9,000
2017 quote for an EPO is $29,000

Glad I am going on medicare next month.

Using your numbers you are paying $9,000 for you and your wife's healthcare plus another $20,000 in charitable giving to cover about 4 other people.

 

[Walt34]

Where is this money going? Like to find the end of the trail and cash in. Healthcare stocks? It's got to be going somewhere! Are doctors driving Bentley's?

My Dr. drives a 17-year-old Subaru 4WD. This concerns me because he may be a candidate for early retirement and then I'd have to find a new Dr.

 

[Options]

I just got my annual enrollment worksheet for my Health & Welfare Plan provided by Aetna today. The Aetna Select plan for my wife & I increased from $804 this year to $1014 for 2017. I figured it would go up, but I didn't think 25%! What's the answer?

This thread and too many others as well the quagmire that the ACA has turned into is exactly why I am going back to work in the spring for less than 30 days just long enough to get on an employer's health plan and then quit. COBRA and thereafter CALCOBRA will then bridge the gap to Medicare. Even without the uncertainty imbroglio surrounding the ACA's future (which I have no intention of being subject to), the monetary difference between my plan to COBRA/CALCOBRA and going on the ACA is about an additional $10K (or more!) which I can't justify paying. I'd like to say I feel guilty for doing it but I don't given the current state of the insurance/healthcare cartels.

 

[pb4uski]

.... insurance companies as far as I can tell must be cleaning up on the taxpayer dime whether or not you have obamacare.

Google "minimum loss ratio".

A basic financial measurement used in the Affordable Care Act to encourage health plans to provide value to enrollees. If an insurer uses 80 cents out of every premium dollar to pay its customers' medical claims and activities that improve the quality of care, the company has a medical loss ratio of 80%.

What this means is that at least $657 of the $821/month you pay must be spent on claims, but it could be more. So, at most, $164 is available to the insurer to cover non-claim expenses, overhead and profit. If they spend less than $657 a month in claim costs, then they have to pay policyholders a refund and we have seen a few of those a couple years ago.

Also, if you look at returns on equity of health insurers they are far less than many other industries.. so empirical evidence refutes any claim that they are as you say, "cleaning up".

 

[rodi]

I guess I need to look at Kaiser Permanente. I understand KP covers emergency and urgent care when traveling. We're healthy, so that's likely more than enough.

As a long time Kaiser member... they definitely cover emergency and urgent care. We've used it 3 times that I can think of. I called the 1-800 #, explained my situation, and they advised us what to do/where to go as follows:
1) Son had croup that sounded like an asthma attack when we were visiting SB. The nurse on the hotline was concerned at the wheezing sound and advised us to call an ambulance.
2) Other son got a bad ear infection, came on quick, while we were in Palm Springs. Kaiser hotline advised us to go to a specific urgent care clinic.
3) I was PG with son #2 and in Vegas with friends. A bad UTI caused a stenosis... No way I could get on a plane - horrible pain from not being able to pee. Hotline nurse advised me to go to a specific hospital's ER. (Never so grateful for a catheter!!!!)

All 3 cases were covered in full even though they were handled by non Kaiser Permanente facilities.

 

[LiveBelowMeans]

My Blue Choice HMO HSA Bronze plan for 3 people (ages 54 and 21 year old daughter) went from $669.82 per month to $1170.27 per month. This includes $6,550 deductible per person. I'm in Maryland. $75% increase. Insane, something has to give.

 

[CRLLS]

Our BCBSIL Precision HMO plan for 2 (age 64) before credits goes up from 1358 per mo to 1869 (~37%); deductible goes up by 30%; MOP goes up another 4%; outpatient surgery increases from 20% copay to 40% copay. So much for "affordable" care. I am glad 2017 will be our last year on ACA!

 

[broadway]

I am glad 2017 will be our last year on ACA!

I wouldn't be jumping for glee yet unless you are "healthy".

 

[CRLLS]

Please explain further.

DW just filed this week for Medicare Parts A and B starting in Feb. I do the same in November. We plan on a Part D policy and a Medigap policy, possibly a "Plan F". Not exactly sure which plan yet due to 2020 implications. We are fairly healthy with only 1 ongoing medication. I see the premium costs in Medicare at < ACA costs and 100 % coverage with no co-pays. What am I missing?

 

[audreyh1]

I wouldn't be jumping for glee yet unless you are "healthy".

Right - I immediately new he/she meant they were moving onto Medicare.

Still too far for us. DH is a little over three years away, but I am eight years away!!!

 

[broadway]

Right - I immediately new he/she meant they were moving onto Medicare.

Still too far for us. DH is a little over three years away, but I am eight years away!!!

Ah! Medicare. Good for him/her.

Even further away for me.

 

[CRLLS]

Ah! Medicare. Good for him/her.

Even further away for me.

Sorry to mislead you. I really don't know what I'd do if I had more years 'til Medicare. The future beyond 2017 is more tentative after Tuesday than in years prior. Still BCBS is really hitting us all in the meantime, IMO. I will be weighing our options and make a plan for next year before the end of the month.

 

[Brat]

A fellow in my paddling group was on a motorcycle outside of Bellingham when hit by a pickup truck and badly injured. Kaiser NW subscriber.

Immediate treatment at local emergency room then he (or his family) was given the option of life-flight to Harborview in Seattle or OHSU in Portland (both level 1 trauma centers). He was at OHSU for about a month then moved to a Kaiser managed SNF/Rehabilitation facility in Portland.

Kaiser requires that they be notified ASAP when a subscriber requires emergency treatment outside their service area (always carry your card). They have staff to assure appropriate treatment and transfer to their facility when stable.

 

[Mr._Graybeard]

I just enrolled in my 2017 Obamacare plan, basically renewing what I have now -- a Bronze HDHP for two with HSA. $6000 individual deductible went to $6550.

We got a letter from the insurer several days ago saying our premium would increase from about $227/mo to $405 after subsidy, assuming our subsidy would stay the same.

Instead, the subsidy went up. by about $300/mo. New monthly premium is $106 after subsidy. Our monthly premium is gonna drop by over 50%.

BTW, our agent said he expected ACA coverage to continue through 2017 and at least part of 2018. One man's opinion.

 

[easysurfer]

I just enrolled in my 2017 Obamacare plan, basically renewing what I have now -- a Bronze HDHP for two with HSA. $6000 individual deductible went to $6550.

We got a letter from the insurer several days ago saying our premium would increase from about $227/mo to $405 after subsidy, assuming our subsidy would stay the same.

Instead, the subsidy went up. by about $300/mo. New monthly premium is $106 after subsidy. Our monthly premium is gonna drop by over 50%.

BTW, our agent said he expected ACA coverage to continue through 2017 and at least part of 2018. One man's opinion.

Way too early to speculate about possible changes to the ACA. I'm gonna sign up for my 2017 plan tomorrow. Premium before any subsidy (I do the find out at tax filing time) goes up from about $400 to $700 a month for me.

 

[Mr._Graybeard]

My plan, unsubsidized, went from $1,015/mo this year to $1,194. Not a huge jump, but they also raised the deductible $550. Doesn't matter much to us, since we don't use the doctor much and won't come close to spending either amount.

 

[Walt34]

Doesn't matter much to us, since we don't use the doctor much and won't come close to spending either amount.

It would be wise to not count on that. It can change, and quickly, as I and many others know from experience.

 

[Mr._Graybeard]

It would be wise to not count on that. It can change, and quickly, as I and many others know from experience.

Yeah, I could step off a curb and get hit by a truck tomorrow. If I get sick, $6500 will pass through the system in an eyeblink. At that point DW and I are 100% covered with no copays.

I'm living right now with a prostate cancer diagnosis, a condition I'm addressing by a strategy the cancer folks call "watchful waiting." That is, I know it's there, but I'm not doing anything about it unless it becomes more aggressive.

The urologist who diagnosed it gave me a hard sell for surgery, but two other specialists I consulted recommended the approach I'm taking. One of them observed, "It seems like Dr. So-and-so may not have given you the entire picture." That was about four years ago. I get an annual physical with PSA test to detect any changes. For a while I was getting PSA tests every 3 months to make sure the condition was stable.

BTW, while searching court records later I found a malpractice case against urologist No. 1 (no pun intended!) that he settled just as the case was going to the jury. I presume his prospects for winning didn't look good. The plaintiff was another physician!

The guy was giving off some weird body language to me (leaning forward, excessive throat clearing) when he was trying to convince me to go under the knife. I felt like he saw me as a participant in his revenue stream (heh!).

 

[Mr._Graybeard]

PPS -- that bit about stepping off the curb happened to a friend of mine. He stepped off the curb just as a guy made a sudden right turn. The impact broke his leg in several places and he was out of work for a month. The driver was homeless, had been living in his car and (of course) had no insurance of any kind.

 

[Stillninetofivin]

My plan is no longer offer offered. Cheapest new plan is $1000.00 higher.
So what's the IRS penalty for doing without?

 

[LRDave]

Yeah, I could step off a curb and get hit by a truck tomorrow. If I get sick, $6500 will pass through the system in an eyeblink. At that point DW and I are 100% covered with no copays.

I'm living right now with a prostate cancer diagnosis, a condition I'm addressing by a strategy the cancer folks call "watchful waiting." That is, I know it's there, but I'm not doing anything about it unless it becomes more aggressive.

The urologist who diagnosed it gave me a hard sell for surgery, but two other specialists I consulted recommended the approach I'm taking. One of them observed, "It seems like Dr. So-and-so may not have given you the entire picture." That was about four years ago. I get an annual physical with PSA test to detect any changes. For a while I was getting PSA tests every 3 months to make sure the condition was stable.

BTW, while searching court records later I found a malpractice case against urologist No. 1 (no pun intended!) that he settled just as the case was going to the jury. I presume his prospects for winning didn't look good. The plaintiff was another physician!

The guy was giving off some weird body language to me (leaning forward, excessive throat clearing) when he was trying to convince me to go under the knife. I felt like he saw me as a participant in his revenue stream (heh!).

Thanks for sharing that story, although it made me throw up in my mouth a little bit. Greed plus a vulnerable group of consumers must lead to this situation playing out more often than we know.

 

[MBSC]

My plan is no longer offer offered. Cheapest new plan is $1000.00 higher. So what's the IRS penalty for doing without?

The following assumes you entered your income on the exchange and do not qualify for a premium subsidy. There are many exemptions from the penalty (list). The CBO estimates 80% of those without creditable coverage are exempt. A common exemption that may apply in your case is if the cheapest Bronze exchange plan is more than 8.16% (2017 figure) MAGI.

If you do not qualify for an exemption, you can use this penalty calculator: Calculate Your 2017 Obamacare Penalty | Obamacare Fine Calculator

If you are healthy, you may want to look into a non-compliant Short-Term Medical (STM) plan. The premiums are lower because they do not cover pre-existing conditions but you still owe the penalty if not otherwise exempt. If purchased before 4/1/17, the plans can last until 12/31/17 depending on the insurer and state regulations.