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Open Enrollment Begins - ACA Individual Coverage
Old 11-01-2015, 06:28 AM   #1
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Open Enrollment Begins - ACA Individual Coverage

Yup, it's time to choose and enroll in a 2016 health care plan. Our insurer is leaving the market so we need a new policy. I just checked, and Humana offers a policy with a provider network that is probably 85%-90% as big with the same national coverage, which is fine with U.S. The premium was the same as our BCBS policy 2 years ago, but since then BCBS has risen more than 50% while Humana is up 10%. I'll check the other insurers, but at least I have our fallback policy for 2016.

At the Humana website they also offered a catastrophic policy - first time I've seen that. There are many policies being offered directly by insurers. They're not eligible for premium assistance but for folks that can forgo that, there are more options available.
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Old 11-01-2015, 07:46 AM   #2
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I've got a private plan with Coventry and they sent me a letter saying that they'll no longer be offering the policy I have in 2016. They included a link to an alternative I "might like". I looked at the coverage summary and there's ZERO out-of-network coverage. Oh, yeah, the premium is 10% higher than I'm now paying. So, I called a friend who's an agent and he found a BCBS policy comparable to my current coverage. When I'm safely switched over I'm going to send Coventry a blistering letter.

On Medicare (DH has Medicare): our agent told us that if you select Medicare Advantage and then later want to go with Medicare Supplement plans they can underwrite you- meaning they can look at your medical record and choose whether or not they want to insure you. OTOH, a friend has BCBS Medicare Advantage and loves it. He said that they pay everything and if he gets bills from providers for amounts that supposedly aren't covered he just tells them to go deal with BCBS.
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Old 11-01-2015, 07:52 AM   #3
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Retired with employer subsidized high deductible policy BCBS, with HSA. This year rates did not go up.
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Old 11-01-2015, 08:30 AM   #4
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If you don't hear from me for a few days, it means I am lost down the ACA rabbit hole. I think proving low income in 2016 is going to be a nightmare.
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Old 11-01-2015, 08:35 AM   #5
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Wow, healthserpa is going downhill. Harder to use and giving me less accurate results. I hope they fix it!
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Old 11-01-2015, 08:54 AM   #6
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Washington Healthplanfinder is temporarily unavailable during scheduled maintenance by the following:
  • Social Security Administration
  • Department of Homeland Security
  • DSHS Eligibility Service


REALLY? On the first day of open enrollment you schedule maintenance?


This country is doomed I tell ya, doomed!
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Old 11-01-2015, 08:56 AM   #7
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Originally Posted by MichaelB View Post
Yup, it's time to choose and enroll in a 2016 health care plan. Our insurer is leaving the market so we need a new policy. I just checked, and Humana offers a policy with a provider network that is probably 85%-90% as big with the same national coverage, which is fine with U.S. The premium was the same as our BCBS policy 2 years ago, but since then BCBS has risen more than 50% while Humana is up 10%. I'll check the other insurers, but at least I have our fallback policy for 2016.

At the Humana website they also offered a catastrophic policy - first time I've seen that. There are many policies being offered directly by insurers. They're not eligible for premium assistance but for folks that can forgo that, there are more options available.
That's good. I'm hoping Humana will save my ass as my main doctors have been in their network in the past. I won't have time to delve into this until later this week, so appreciate some insight.
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Old 11-01-2015, 09:57 AM   #8
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Looks like I'm going to have to pay 50% more just to get a similar plan. Cheapest plan is 25% more. This can't continue at this pace.
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Old 11-01-2015, 10:31 AM   #9
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I got a letter from BCBS saying the current plan I'm in is going away, but there's a new plan offered that is similar (but looks like less coverage as in permission needed for seeing specialists).

With open enrollment, I'm hoping to say bye-bye to BCBS, but after the initial browse of what's out there, the choices for me are slim pickens. Variables like keeping my doctor and HSA eligibility really narrow down my options.

I may end up with a crappy BCBS bronze plan again. At least the premium actually is about $20 less per month than last year.
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Old 11-01-2015, 11:33 AM   #10
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Finally got on the site.

The income levels are so tight!

For a $22,000 income you can get a silver plan with a $300/$600 deductible and $500/$1000 max out of pocket for $280 a month (combined for a couple)

If you change the income to $24,000 it jumps to $500/$1000 dedutible and $1500/$3000 max out of pocket for $305 a month.

The $2000 increase in income is entirely eaten up by the $2000 extra max out of pocket, and you actually lose a few hundred in tax credit on the premium.

Going to need pinpoint precision on Roth conversions to bring income to exactly $22,000 (any less and you are on Apple health).
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Old 11-01-2015, 11:34 AM   #11
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I renewed my insurance with Covered California yesterday. Once again I had to misrepresent my income to above premium tax credit level in order to enroll my husband on a separate plan than myself and the kids. Annoying that I have to pay up front and get it back as a refund - but the coveredCA website still doesn't allow a family to split carriers if you qualify for subsidized premiums. (I was told last year it would be fixed for this year. sigh.)

My husbands coverage went up 2% - $10/month. I was pleased with that.

My kids and my plan went up a bit more - 10% - $58/month higher. I assume some of that increase was me being a year older. Can't escape aging...

I explored the options of enrolling for dental through CoveredCA. After a lot of research, soul searching, inquiries to our dentist as to what insurance they take, etc... We opted not to get the PPO that would have included his practice (too expensive), and not to get a DHMO plan (change dentist) - but will self insure this year. I'm really hoping that this isn't a financial mistake. If we get hit with massive dental bills this year we'll sign up for a DHMO next year and change dentists.

Full price for our family of 4, on HSA qualified HMO's (bronze - really high deductibles) is $1216/month. I just hope I don't have as many ER visits for broken bones etc... We paid $8600 OOP between my husband, and my 2 kids (all had ER visits.) I am the only one who avoided any OOP...
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Old 11-01-2015, 01:01 PM   #12
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Mods, is there any way to separate this thread into a thread for Medicare open enrollment and regular under 65 and family enrollment.

My DH is over 65 and I am 62 so I am interested in both subjects, but I am having trouble following along on either subject because of the co-mingling.
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Old 11-01-2015, 02:33 PM   #13
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Mods, is there any way to separate this thread into a thread for Medicare open enrollment and regular under 65 and family enrollment.

My DH is over 65 and I am 62 so I am interested in both subjects, but I am having trouble following along on either subject because of the co-mingling.
Threads split. The Medicare thread is here Open enrollment for Medicare
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Old 11-01-2015, 02:47 PM   #14
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That's good. I'm hoping Humana will save my ass as my main doctors have been in their network in the past. I won't have time to delve into this until later this week, so appreciate some insight.
I hope the best for you, but options in Texas are not looking all that inviting right now. Not sure why. The Humana PPO network I'm seeing is the National POS/Open Access, which is the most comprehensive NW for their individual policies.

This is only good for one more year, as Aetna is buying Humana, and Aetna is a high price option. This time next year we'll be back to the drawing board once again.
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Old 11-01-2015, 02:56 PM   #15
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After a lot of aggravation the last couple of years dealing with the wonky state exchange website and finding out that the state is not even showing correct subsidy calculations at this point, I decided to use a broker and let them hopefully cut through some of the manure.
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Old 11-01-2015, 03:11 PM   #16
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Threads split. The Medicare thread is here Open enrollment for Medicare
Thank You
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Old 11-01-2015, 03:25 PM   #17
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In my geography, we have two healthcare "chains", and the offerings on the exchange for 2014 and 2015 coverage was from two insurance companies. Blue Cross Blue Shield covered one hospital/medical chain "A" and Coventry covered the other hospital/medical chain "B". A huge fraction of the healthcare community was in one or the other, not both. So if you wanted your same doctors, you had "no choice" with insurance providers.

A couple of good news points for this year:
This year, we got two new players: United Healthcare, for chain "A" (my chain), and Aetna for chain "B". BCBSNC is offering policies for both chains. Coventry, last year, was for chain "B", but don't see them offering anything on the exchange now. So, I think this is accurate for HSA eligible policies (the only thing I shopped).

And no surprise: the bronze has the least expected total cost (premiums plus out of pocket) if our medical expenditures remain low.

The income I expect for 2016 is about 250% FPL (similar to this year), family size 3, but buying for self and spouse only on the exchange. The cost to us (self and spouse) will probably be 40% higher (that's a guess because I didn't price-out the spouse yet), but still in the ho-hum category because that only equates to $45/mo.
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Old 11-01-2015, 04:24 PM   #18
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I hope the best for you, but options in Texas are not looking all that inviting right now. Not sure why. The Humana PPO network I'm seeing is the National POS/Open Access, which is the most comprehensive NW for their individual policies.
In my Texas zip code, BCBS is, and has been, the only insurer on the Marketplace. And they have been going up 30% a year or so, and in 2016, forcing everyone into an HMO. Of course, BCBS tends to have the largest network, so being in a BCBS HMO is almost like being in a PPO anyway, especially if all of your doctor, pharmacy and hospitals are in the HMO network.

It appears that the only way to hold down costs these days is to have an extremely restrictive network, and restricting it more every year. Looking at all my FEHB options, this year, it seems like the most affordable options have lousy networks and if you want a decent network of providers, even with a high deductible it will cost quite a lot.
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Old 11-01-2015, 04:32 PM   #19
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I hope the best for you, but options in Texas are not looking all that inviting right now. Not sure why.
Even though I now have the enrollment papers for my retiree insurance I decided to enroll in healthcare.gov and get some quotes to compare. The options are terrible for me in that there are no PPO options and all the HMO and EPO options are a lot more expensive that my company PPO plan and don't include our current doctors.

Also, the website insists that as Naturalized citizens we must provide the A numbers from our certificates but then won't accept them saying that they are the wrong format (an A followed by a series of digits which is exactly the format displayed in their field example). If I do choose to enroll then by Feb 15 I have to produce a copy of either the certificate or a US passport. Why they don't recognize the A numbers or allow me to enter our US passport details is beyond me. I don't even know why being a citizen as opposed to being a resident alien matters when buying health insurance.

At least I could see the quotes for our exact circumstances.
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Old 11-01-2015, 04:41 PM   #20
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Even though I now have the enrollment papers for my retiree insurance I decided to enroll in healthcare.gov and get some quotes to compare. The options are terrible for me in that there are no PPO options and all the HMO and EPO options are a lot more expensive that my company PPO plan and don't include our current doctors.

Also, the website insists that as Naturalized citizens we must provide the A numbers from our certificates but then won't accept them saying that they are the wrong format (an A followed by a series of digits which is exactly the format displayed in their field example). If I do choose to enroll then by Feb 15 I have to produce a copy of either the certificate or a US passport. Why they don't recognize the A numbers or allow me to enter our US passport details is beyond me. I don't even know why being a citizen as opposed to being a resident alien matters when buying health insurance.

At least I could see the quotes for our exact circumstances.
I don't recall healthcare.gov asking for naturalization papers last year. Is that new?
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