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Old 12-05-2014, 09:32 AM   #21
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Originally Posted by wanaberetiree View Post

(PS: I think that PPOs are waste of money frankly)
PPOs are definitely more money BUT .... I have Wet Macular Degeneration and have a recurring 6 week checkup with my retina specialist. I also go "as needed" when I see a change in my eyesight. I have 12 appointments a year. I believe an HMO would only approve a visit for changes in eyesight AFTER my PCP approved seeing the specialist. If that is incorrect please let me know, since the HMOs are definitely less expensive.
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Old 12-05-2014, 09:34 AM   #22
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Originally Posted by Earl E Retyre View Post
Scary to think that costs could continue to escalate with very few options to avoid.
If its any consolation, the ACA plans in my area between last year and and this year have only increased by a percent or two.
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Old 12-05-2014, 09:53 AM   #23
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Just a personal perspective on your situation: I've long since learned to live with having to find new doctors every few years. Doctors do retire, and they do move to other states, or distant parts of your state.
That's true. Still, even though I'm not that crazy about my doctor, I dread the day he retires. He's in his late 50's I think, and is dreaming of retirement so it may not be long.

Finding another doctor in New Orleans that is well qualified and has the time for a new Medicare-aged patient could be a difficult task these days.
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Old 12-05-2014, 09:55 AM   #24
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I believe an HMO would only approve a visit for changes in eyesight AFTER my PCP approved seeing the specialist. If that is incorrect please let me know, since the HMOs are definitely less expensive.
That's generally correct.

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Old 12-05-2014, 10:04 AM   #25
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What's also scary is finding a new dentist (I have separate dental insurance which pays about 40% of the retail costs). Fortunately, when my long-time dentist retired, her replacement was better (old dentist had been forced to retire due to "issues" which she was successfully disguising, but which became obvious to me after two of her crowns fell out!) But I dread having to find a new dentist in another state.

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That's true. Still, even though I'm not that crazy about my doctor, I dread the day he retires. He's in his late 50's I think, and is dreaming of retirement so it may not be long.

Finding another doctor in New Orleans that is well qualified and has the time for a new Medicare-aged patient could be a difficult task these days.
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Old 12-05-2014, 10:38 AM   #26
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I believe an HMO would only approve a visit for changes in eyesight AFTER my PCP approved seeing the specialist
I can only give one example from personal experience. With Kaiser N. California, I did need a referral to see a dermatologist. However, after the first appointment, I could go directly, providing it was less than a year from the first visit.

FWIW I liked Kaiser. Only changed because they were no longer offered on DW's work plan.
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Old 12-05-2014, 10:52 AM   #27
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That's a steep increase and hard to plan for.

Just as a data point - we were paying $1100/month for medical COBRA for a low copay, no deductible plan at Kaiser SoCal. Starting Jan 1st we'll be paying a similar price for an ACA high deductible, HSA qualified plan - 3 of us (Me and 2 minor kids) on Kaiser, 1 on Sharp.

We looked at PPOs and it added about $400/month.

Also - our premiums are definitely age/gender related. My husband's premium is the same as the TOTAL of the rest of us. Age and gender matter in premiums.
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Old 12-05-2014, 09:04 PM   #28
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My DH will be retiring in Feb. 2015. I am estimating about $1300 a month for the both of us. That is for his employer health plan which they don't pay any towards but it has a really low deductible so...


I did look at the ACA plan and it was about the same amount of money but has a very high deductible.


Not an easy choice. Good luck with the new charges. You just can't do without the health insurance and boy doesn't the industry know it.
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Old 12-05-2014, 09:48 PM   #29
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Old 12-06-2014, 08:35 AM   #30
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The price of freedom (from working).
Is it possible that employer provided healthcare was never actually free, but just diverted wages?
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Old 12-06-2014, 07:03 PM   #31
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My wife and I bought a high deductible PPO plan ($6000/each, $12,700/family) on healthcare.gov in December 2013. We had been buying private health insurance since 1999. Recently we got a letter saying that assuming nothing had changed (same plan, same income) then we were going to have our premium increased by 68% on 1/1. Our income has gone up a bit since 12/2013 though (a little more in dividends and interest) so it is going to be more than a 68% increase, I think quite a lot more.

Right after we got that letter my sister told me that my nephew who also bought a plan on healthcare.gov received a similar letter. His premium is going up 105%! His income is slightly up since 2013 too though so he is looking at a more than 105% increase.

My wife and I are trying to figure out what to do now. We already have the cheapest PPO plan available. We spend lots of time out of state, after all we are FIRE, so it seems like an HMO, which is about the same price in 2015 as the PPO was in 2014, would be pretty much pointless.

All of our choices seem horrible.
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Old 12-06-2014, 10:33 PM   #32
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PPOs are definitely more money BUT .... I have Wet Macular Degeneration and have a recurring 6 week checkup with my retina specialist. I also go "as needed" when I see a change in my eyesight. I have 12 appointments a year. I believe an HMO would only approve a visit for changes in eyesight AFTER my PCP approved seeing the specialist. If that is incorrect please let me know, since the HMOs are definitely less expensive.
With my HMO, I was referred to a specialist once. After that the specialist and I decide how often to meet.
I've 4 specialist who I see know, 2 regularly. I have never needed to get approval a second time.

To the OP, sorry about the sticker shock.
We pay about $11k/year for two of us. My wife's went up this year (new age bracket), mine actually went down. Overall, in was a slight increase. Hopefully it will be more stable for you in the future.
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Old 12-06-2014, 10:37 PM   #33
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My wife and I bought a high deductible PPO plan ($6000/each, $12,700/family) on healthcare.gov in December 2013. We had been buying private health insurance since 1999. Recently we got a letter saying that assuming nothing had changed (same plan, same income) then we were going to have our premium increased by 68% on 1/1. Our income has gone up a bit since 12/2013 though (a little more in dividends and interest) so it is going to be more than a 68% increase, I think quite a lot more.

Right after we got that letter my sister told me that my nephew who also bought a plan on healthcare.gov received a similar letter. His premium is going up 105%! His income is slightly up since 2013 too though so he is looking at a more than 105% increase.

My wife and I are trying to figure out what to do now. We already have the cheapest PPO plan available. We spend lots of time out of state, after all we are FIRE, so it seems like an HMO, which is about the same price in 2015 as the PPO was in 2014, would be pretty much pointless.

All of our choices seem horrible.
If your health insurance will exceed 8% of your income you can buy a catastrophic policy. In my state they are substantially less expensive than a bronze plan (35-40% less) but I've heard that in other states the premiums are not much different. YMMV.

However, there is no subsidy for cat policies so it may not work for you since you are getting a subsidy.
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Old 12-06-2014, 11:17 PM   #34
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(PS: I think that PPOs are waste of money frankly)
I have multiple myeloma (a blood cancer) and my oncologist told me never to sign up for HMO coverage (vs PPO) because it's much more difficult getting cancer treatments covered, especially if you need a stem cell transplant like I had.

Most people don't plan on getting something like cancer. But if you do get cancer, you'll have wished you had signed up for the better coverage.

In my case, the PPO coverage was definitely worth it!
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