Healthcare increase 100%

[Earl E Retyre]

I cannot believe it but BCBS canceled the specific plan we were using last year. Signing up for an equivalent plan for next year and it is literally a 100% increase. Has anyone else experienced this much of an increase? The only way to save money (from what I can find) is to do an HMO instead of a PPO but I do not want to do that due to the doctor list. Even with the HMO, it is much higher than last year.

 

[gauss]

Was the original plan that you were on ACA compliant, or was it one of the grandfathered plans?

-gauss

 

[Earl E Retyre]

Gauss,
I am not sure the answer to your question. I think it was a grandfathered plan.

I noticed a thread that said if I have a grandfathered plan then I could sign up for a catastrophic plan claiming hardship. The problem is that the cost of the catastrophic plan is about the same as the bronze plan but does not allow me to do an HSA. So, that does not help me. Not sure if there is another reason you are asking me?
Thanks!

 

[wanaberetiree]

I cannot believe it but BCBS canceled the specific plan we were using last year. Signing up for an equivalent plan for next year and it is literally a 100% increase. Has anyone else experienced this much of an increase? The only way to save money (from what I can find) is to do an HMO instead of a PPO but I do not want to do that due to the doctor list. Even with the HMO, it is much higher than last year.

$4 vs $2 is 100% increase - how much in dollars ?

(PS: I think that PPOs are waste of money frankly)

 

[Earl E Retyre]

It went from $6,540 per year for a family of 3 adults to $13,620 for the same.


Why are PPO's a waste of money?

 

[wanaberetiree]

It went from $6,540 per year for a family of 3 adults to $13,620 for the same.


Why are PPO's a waste of money?

It's not fun to swallow 100% increase in premium, but your numbers are not too bad. You were lucky to have such a nice premiums

If I were to buy an individual insurance for 2 adults now, I'd be lucky to be ~14,000/year.

I pay for 2 adult now as part of my employment benefits ~600 per/month and that's only my part + my employer part (!)

RE: PPO - I paid for PPO for the same reasons as yours for many years and then decided to try HMO and found that most of my doctors were on the same list, but even if you have to change your doctor, I personally think it's not a bug deal. It is matter of perception - we are afraid of changes, especially unknowns and our screwed up health care system makes us (me) very uncomfortable, so we don't want to see anything changed.

 

[W2R]

Well, I know that others are trying to cheer you up about this, Earl E Retyre. But still, it's never fun to get a big increase in a necessary expense like that so it's probably very hard to feel cheery about it. My sympathies!

 

[Earl E Retyre]

OK. You make some good points. Even the HMO was over $10,000/year. We called our current doctors and neither of them would take the HMO plan but both took the PPO. Not sure why when both are BCBS plans. If the costs goes up a lot again the year following ... then I will switch and try the HMO. But I think we will stick the doctors we like for now. Yes, the healthcare system is screwed up. Scary to think that costs could continue to escalate with very few options to avoid.

 

[Earl E Retyre]

Thanks, W2R.

 

[Hyper]

13k + a yr health ins cost could possibly change my working (non) status. Last employer was about $150 mth up until 2011. Doubled in 2012. It was actually very good ins. 3 adults. At 13k + I wouldn't need health ins because I would have a heart attack and not need it anymore! We pay about $330 mth now 3 adults, for fairly decent ins. I'm feeling pretty fortunate hearing everyone else's HC cost.

 

[wanaberetiree]

13k + a yr health ins cost could possibly change my working (non) status. Last employer was about $150 mth up until 2011. Doubled in 2012. It was actually very good ins. 3 adults. At 13k + I wouldn't need health ins because I would have a heart attack and not need it anymore! We pay about $330 mth now 3 adults, for fairly decent ins. I'm feeling pretty fortunate hearing everyone else's HC cost.

Covered California bronze plan would be ~1200$/mon for 2 adults.
Just wondering what state are you in and what do you call decent ins for $330/mon?

Thx


Sent from my iPad using Early Retirement Forum

 

[gauss]

Thanks for the clarification on the grandfathered plan.

I was trying to figure out if your 100% change was purely due to inflation in premiums or if apples were being compared to oranges due to different coverage.

Going from a non-ACA plan to an ACA plan would hopefully be a one time increase.

The other scenario, year to year premium inflation, would be a much scarier scenario for me.

-gauss

 

[MichaelB]

That is a nasty increase, Earl E. Hopefully your budget can handle it.

My guess is Gauss is right, this is an increase from a grandfathered plan to one that is ACA compliant and guaranteed access. Prices will still rise for you, but since the average cost for a family plan is around $15.5k, future increases should be in line with the rest of the us.

 

[Senator]

It makes me think the $12 per month my DGF will have after she FIREs will not be too bad... It's $0 deductible, and it includes vision and dental too. And transportation to and from the appointments.

 

[Silver]

BCBS of Florida canceled my 2014 plan I had from the ACA marketplace. Their comparable ACA plan was 43% higher (from $364/mo to $521/mo), and they worked hard to try and get me to sign up for it. Three phone calls trying to make an "appointment" with them so they could walk me through the Marketplace sign up process. Plus several e-mails and two paper letters. I declined.

I did sign up for a very similar plan with Assurant for $455/mo. and have already received all my coverage info and cards.

Having worked in the health care industry for 35 years I would NEVER accept an HMO. They require prior authorization for just about everything except a potentially fatal injury, and some primary care physicians are unlikely to authorize referrals when needed. They are paid incentives from the insurance company to not refer in order to keep costs down.

 

[Texas Proud]

It's not fun to swallow 100% increase in premium, but your numbers are not too bad. You were lucky to have such a nice premiums

If I were to buy an individual insurance for 2 adults now, I'd be lucky to be ~14,000/year.

I pay for 2 adult now as part of my employment benefits ~600 per/month and that's only my part + my employer part (!)

RE: PPO - I paid for PPO for the same reasons as yours for many years and then decided to try HMO and found that most of my doctors were on the same list, but even if you have to change your doctor, I personally think it's not a bug deal. It is matter of perception - we are afraid of changes, especially unknowns and our screwed up health care system makes us (me) very uncomfortable, so we don't want to see anything changed.

An HMO is good IF they have enough doctors to handle the number of people and IF they have locations that are close to you....

Also, they are good if you are pretty healthy and do not need specialists... There was a guy I knew who was in an HMO and his wife had some kind of special breast cancer... needed to go outside the HMO... but they fought it for a long time... eventually they allowed it.... but, any time she needs to go back for a follow up they had to go through the same argument about the HMO not having that specialty....


I have preferred PPOs over the HMOs that I have been in... but I am only one data point....

 

[Texas Proud]

I am not getting my plan through an exchange..... but mine went up 80%....

I think that I lost my company match since my hours were low.... but cannot find out anything for sure....

 

[Alan]

My retiree PPO plan from my old employer is staying the same for 2015 ($383/mo for the 2 of us). I need the PPO because we don't live in the same State as the HMO offering plus we travel a lot.

The letter stated that they will re-evaluate ACA for 2016 so this may be the last year on employer group insurance before we have the adventure of exploring the ACA.

 

[Theseus]

Premiums for us will be down 49.3% in 2015 using ACA, and that is near the MAGI threshold. I had used COBRA for final 4 months of 2014 as we had already invested in the max OOP on that plan, so it made sense to stick with it for the duration of the plan year. Same plan would be $1,162.08/mo in 2015, ACA plan(s) I selected will have premiums of $588.94. End of year, after-taxes worst case scenario of each of us hitting MAX OOP is 26.4% better on ACA plan. HMO was better deal, every doctor we have seen in the last several years, from GP to specialty surgeons, etc, is on this plan. Out of HMO area travel medical is not much of a worry for me, would not be going there unless it was dire need anyway.

 

[Amethyst]

It's horrible to be hit with large unexpected expenses. Our house has been doing this to us lately.

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.

I'm fine with HMO's, within the parameters mentioned by Silver. I stayed with our old HMO until it disbanded, and my familiar, well-qualified doctors were scattered far and wide. Now we have a Fee for Service plan (BCBS Basic) which costs about $4,000 a year (co-pays and drugs extra) and does not include dental or vision coverage. To keep costs down, we are limited to "in-network" doctors. This has been tolerable, so far, since we are in a doctor-rich area, but I'd be a little concerned about moving to another state where the doctor pickings are slimmer.

Amethyst

 

[Live And Learn]

(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.

 

[Live And Learn]

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.

 

[W2R]

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.

 

[Gotadimple]

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.

-- Rita

 

[Amethyst]

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.

Amethyst

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.