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PPACA vs. ehealthinsurance Premium
Old 12-01-2013, 02:13 PM   #1
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PPACA vs. ehealthinsurance Premium

I searched the health care threads and I don't see this issue discussed so I'm starting a new thread.

I'd like to ask a question/favor of anyone who has applied for and received confirmation of insurance premium via healthcare.gov (PPACA). I want to understand if there are significant differences in the estimated and final unsubsidized premiums obtained via healthcare.gov and compare those premiums to the premiums shown on ehealthinsurance.com. I wanted to do this myself but stopped short because healthcare.gov wants personal information from me and I have no intention at this point of applying through them because I already have insurance and I'm happy with the policy.

So, if you've obtained estimated premiums, finalized premiums and are willing to check out ehealthinsurance please continue....

Provide the following dollar amounts:

1) What was the unsubsidized premium you saw initially on healthcare.gov?

2) What is the finalized unsubsidized premium obtained via healthcare.gov. I guess this is provided via a letter/email from the insurance provider.

3) Here's the extra favor... use ehealthinsurance.com to obtain a price for the same policy that you applied for on healthcare.gov. To do this you'll need to enter your birthday and zip code as well as clicking on the choice to see only 2014 plans. By clicking on 2014 plans you'll be ensured of seeing only PPACA eligible plans.

Feel free to provide additional information if you choose. Such as state, male/female, how many in household, etc. Keep in mind this information is optional.

Thanks.

on edit:

If you don't find your insurance carrier or exact policy on ehealthinsurance please consider checking the premium directly on the insurance carrier web site. Some insurance providers will allow you to check the 2014 premiums directly on their web site without providing personal information other than zip code, age, smoking status.

My main question is how the healthcare.gov estimated premium compares to the actual premium.
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Old 12-01-2013, 02:39 PM   #2
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I (finally!) got through healthcare.gov to get actual quotes (i.e. for my age & actual location). Quotes for what appeared to be same policies (Bronze, Silver w/same deductibles & OOPmax for same carriers) were very similar on ehealthinsurance.com as well as valuepenguin.com. However, as of now only HI plans issued via HC.gov (or its subcontractors) are eligible for subsidy.
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Old 12-01-2013, 03:19 PM   #3
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I tried valuepenguin.com - looks interesting but it's not working for me - I click the "calculate" button and nothing happens.

Here's the information I can obtain from healthcare.gov and ehealthinsurance.com regarding various Humana HMO policies. I arbitrarily chose Humana - I just wanted to see the differences in estimated premiums from healthcare.gov versus what I believe are actual premiums posted on ehealthinsurance.com. Unfortunately, healthcare.gov will not provide an actual premium until I register.

The information from ehealthinsurance.com is for male age 54 and female age 51

1) healthcare.gov - Humana Connect (HMO) Bronze, Silver, Gold and Platinum: $403.90, $458.02, $522.42 and $589.00 respectively. I believe all these are estimated unsubsidized premiums as I did not enter my age or my MAGI.

2) N/A - I didn't register at healthcare.gov so I don't have actual unsubsidized premiums.

3) ehealthinsurance.com - Humana Connect (HMO) Bronze, Silver, Gold and Platinum: $634.62, $719.66, $820.85 and $925.47 respectively.

So the difference between estimated premiums from the somewhat vague healthcare.gov and the much more detailed ehealthinsurance.com is on the order of $200 - $300! How's a person supposed to compare policies and make an informed decision if there is that much disparity?

If you have detailed information regarding your estimated and finalized, unsubsidized premiums from healthcare.gov and you're willing to compare them to ehealthinsurance.com I'd like to hear from you.

Thanks.
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Old 12-01-2013, 04:05 PM   #4
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I am a North Carolina female age 62. I got an HSA plan through Blue Cross, Bronze 5500 deductible through HelathCare.gov. My unsubsidized premium is $550, subsidized premium is $160, this has been confirmed in a letter from Blue Cross. When I went to ehealthinsurance, Blue Cross is not listed as an insurer in North Carolina, even though Blue Cross has 90% of the individual market in North Carolina. So, at least here in NC, ehealthinsurance would be worthless.

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Old 12-01-2013, 04:53 PM   #5
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Just tried to log back in to HC.gov to give OP some specifics, but site "could not find" my application. Guess I was the 50,001st person to use the site today
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Old 12-01-2013, 05:41 PM   #6
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Ehealthinsurance quoted me $912.30 and coveredca.com is also charging us $912.30. We don't qualify for a subsidy. This year we're paying $1257.
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Old 12-01-2013, 05:58 PM   #7
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Quote:
Originally Posted by golftrek View Post
I am a North Carolina female age 62. I got an HSA plan through Blue Cross, Bronze 5500 deductible through HelathCare.gov. My unsubsidized premium is $550, subsidized premium is $160, this has been confirmed in a letter from Blue Cross. When I went to ehealthinsurance, Blue Cross is not listed as an insurer in North Carolina, even though Blue Cross has 90% of the individual market in North Carolina. So, at least here in NC, ehealthinsurance would be worthless.

Jo Ann
Thanks for listing your unsubsidized premium but you didn't mentioned the estimated premium for your situation. For instance, when I use healthcare.gov and simply browse plans for NC, individual, over 50, using a Mecklenburg County zip code, I see Blue Cross Bronze plans for $358.68 and $394.15. And yet, your premium is $550. Your zip code will differ and that may affect the numbers.

What I'm frustrated with (and why I'm asking for information) is healthcare.gov shows estimated premiums if you simply browse the web site and only gives true/real premiums when you apply. That seems like the wrong way to approach this issue. Why isn't accurate data posted right up front? Why do you have to apply to obtain the information? ehealth doesn't require you to make an application. They show you the price right up front.

Consequently, I'm curious about how the estimated and actual premiums vary on healthcare.gov

That's interesting to see Blue Cross is not listed on ehealthinsurance.com for NC. Blue Cross is listed on ehealth for other states so I don't know why it wouldn't be listed for NC except that each BC affiliate is independent (I think) so I guess they can choose who represents them.

Going back to my original question, I'd like to know how the estimated premium differs from the actual premium on healthcare.gov.
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Old 12-01-2013, 06:04 PM   #8
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The estimated unsubsidized premiums I got via healthcare.gov they were very "optimistic" - that is too low. Over 50 is too general a characteristic. To get a more accurate quote you probably do have to create an account and provide more personal information.

Otherwise, the key is to look at the plans listed on healthcare.gov by this more general "quote", then go directly to the insurance company website to get specific quotes for your exact birth date and county. The companies don't require more information than gender, birth date, county and smoker status to provide specific quotes.
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Old 12-01-2013, 07:55 PM   #9
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The actual premium for my policy on the North Carolina Blue Cross website is $550 for a 62 year old female. The unsubsidized premium I was quoted on Healthcare.gov was exactly the same--$550. After my subsidy is applied my premium for this policy is $165.

There is a lot of difference between the premium for a 50 year old and a 62 year old (me).

I am grateful for the subsidy my husband and I will receive. It will save us thousands and give us much better insurance.
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Old 12-01-2013, 08:40 PM   #10
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Originally Posted by golftrek View Post
There is a lot of difference between the premium for a 50 year old and a 62 year old (me).
Your comment supports my point. When I'm browsing on healthcare.gov the only choice I have for age is less than 50 or older than 50. That doesn't provide much granularity for pricing. Users are forced to enter their personal data in order to get through the healthcare.gov "door" so they obtain more accurate pricing. So the estimated premium I'm referring to is the price that's shown when you click on "See Plans Before I Apply."

Other web sites such as ehealthinsurance.com (in my state) and the individual insurer web sites show you the actual premiums even when you're casually browsing around. So the data for premiums is available. Why can't the healthcare.gov web site just show the correct data right up front? Why the smoke and mirrors approach to premium disclosure?

These are rhetorical questions at this point. healthcare.gov is free to operate the web site however they choose - it's just not very convenient and I think some people will be surprised when the quoted premium is dramatically different compared to the estimated premium.

In the original post I asked for unsubsidized premium information in order to keep the data simple. Subsidies further cloud the subject. In the long run I think people will begin to think insurance only costs what they are paying for their subsidized plans. It didn't take long after copays came into existence that people began to say it only costs $20 to see the doctor.

I don't begrudge individuals receiving the subsidy but I wish that wasn't the way the law worked. I think we would be better served in the long run if everyone knows what it costs to buy insurance and what it costs to see a doctor and pay for other medical services.

Many of us FIRE types have the means to pay an unsubsidized premium. However, since much of FIRE money comes from capital gains and dividends people that are FIREd don't have much "income" so we are eligible for subsidies. Of course we want to pay less - almost everyone wants lower prices. I question whether subsidies as used in PPACA will really have the intended outcome. But that's probably best left to another thread.
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Old 12-01-2013, 09:00 PM   #11
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If you don't want to put your info into healthcare.gov, you can use healthsherpa.com. Ehealthinsurance.com, healthsherpa and coveredCA all give me the correct price, but I'm not eligible for a subsidy. However, when I browse healthcare.gov, it pretty clearly states that the prices may be lower with subsidies. There is no way to determine subsidy without your income data. I didn't have to enter anything other than age and a fictional location to browse.

There was a lot of concern when the PPACA was being debated that illegal residents might get access to health insurance through the exchanges so I think a few extra layers of access checking have been built in to the system.
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Old 12-02-2013, 03:57 PM   #12
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It's interesting to me that eHealthinsurance.com doesn't even show any policies available thrust BCBS .... Only thru Humana, Cigna, and United Healthcare. United doesn't offer policies here thru the exchange.

What's more interesting to me is that I currently have United Healthcare and am paying in excess Of $1900 per month. EHealthinsurance shows a very similar policy available, without subsidy, at just over $1100.

I've made the switch to BCBS thru the exchange (was one of the lucky few who was able to navigate the process early on) and, with taxable income being low, have a subsidy coming of over $900 per month.

Odd that BCBS isn't even an option on eHealthinsurance since they offer the largest variety of plans on healthcare.gov in this county.
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Old 12-02-2013, 06:24 PM   #13
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It's interesting to me that eHealthinsurance.com doesn't even show any policies available thrust BCBS .... Only thru Humana, Cigna, and United Healthcare. United doesn't offer policies here thru the exchange.

What's more interesting to me is that I currently have United Healthcare and am paying in excess Of $1900 per month. EHealthinsurance shows a very similar policy available, without subsidy, at just over $1100.

I've made the switch to BCBS thru the exchange (was one of the lucky few who was able to navigate the process early on) and, with taxable income being low, have a subsidy coming of over $900 per month.

Odd that BCBS isn't even an option on eHealthinsurance since they offer the largest variety of plans on healthcare.gov in this county.

The listings on ehealth must vary by state/county/zip code. There are several BCBS plans listed on ehealth for my area for 2014. On ehealth you have to choose the radio button for 2013 or 2014 - don't know if that's affected your situation or not but it definitely affects the available plans for my area.

There was a prior post that mentioned healthsherpa.com - I tried the site a few weeks ago and it was not working for me. I tried it yesterday and it worked fine. I like the fact that is helps people learn more about their situation but I don't think you can buy insurance through them - their web site is FYI only. I referred to ehealth because I know they have a long history of providing useful information and they focus on health insurance and have plans available in all 50 states and D.C.
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Old 12-02-2013, 11:44 PM   #14
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Originally Posted by nvestysly View Post

What I'm frustrated with (and why I'm asking for information) is healthcare.gov shows estimated premiums if you simply browse the web site and only gives true/real premiums when you apply. That seems like the wrong way to approach this issue. Why isn't accurate data posted right up front? Why do you have to apply to obtain the information?
The government knows that most people don't really read things all that carefully. So, if they let you do what healthsherpa, for example, does then they have two choices, neither of which appeal to them:

1. Show the unsubsidized premium amounts. They could say until they were blue in the face that these were the unsubsidized amounts but a lot of people would never even read it or would think that the ultimate subsidy was much lower than it would actually be. So someone finding out their premium is $1100 a month might be totally scared away from applying for coverage thinking they could never afford coverage.

2. Show the unsubsidized premium amounts and ask people their income and give an estimated subsidy amount. This is basically what healthsherpa does. But it very crude on healthsherpa and just asks for your household income. It doesn't ask you what year or if it will change. And, it doesn't define that is income. The problem, again, for the government is that people may put in the wrong year's income, may not count it properly (I didn't think of IRA withdrawals as income, or I thought you wanted this year's income not next year's income, etc.). So lots of people may get their income wrong so the subsidy amount shown is too low (see 1 above) or too high (angry when they apply and get a lower subsidy).

So - right or wrongly (I personally think wrongly even though I understand why) - they decided they wanted people to get accurate premium information with subsidy and that you couldn't get the info unless they had your accurate income information. I still think they could do the estimating thing better with more relevant age bands, but the fact is that they are afraid of scaring people off.
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Old 12-03-2013, 05:13 PM   #15
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The ehealthinsurance quote for the policy my wife and I purchased is $1,113. The price quoted for the the same Silver HSA policy through our state's exchange is $1100.00.
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Old 12-03-2013, 05:19 PM   #16
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So - right or wrongly (I personally think wrongly even though I understand why) - they decided they wanted people to get accurate premium information with subsidy and that you couldn't get the info unless they had your accurate income information. I still think they could do the estimating thing better with more relevant age bands, but the fact is that they are afraid of scaring people off.
Our state is running its own exchange and does exactly as you suggest - you enter all the relevant information such as number in household, ages and estimated income and the system comes back with gross and net (of subsidy) plan pricing. It's not rocket science. Either the decision makers for the federal site were attempting to obscure (as some suggest) or are incompetent. Neither option would surprise me.
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Old 12-03-2013, 07:08 PM   #17
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Interesting. Just for grins I went to healthcare.gov. I hadn't been since the time I did there shopping thing that gave you estimated rates that weren't necessarily very useful if you weren't the exact ages they used.

I was surprised to see that now (not sure when this started) they are finally letting you do full shopping to see unsubsidized rates. I went to healthcare.gov and just started looking without creating any account.


I put in my age and my children's ages (DH is on medicare) and it popped up with the same premiums as on healthsherpa (actually healthcare.gov rounds to the nearest dollar). Healthcare.gov also has a bunch more information available now than healthsherpa has. There are links to the plan brochure, summary of benefits and plan network. One thing I had been curious about was if the family deductible had to be met when a family was applying or if you could meet either (i.e. was the deductible embedded or not). I looked at a couple of brochures and each was very clear on this point (each one did it differently).

The only glitch I found was that Cigna sent me to their provider directory but it said there are no plans other than dental plans for my zip code which is totally contrary to the exchange listing.

To deal with the subsidy issue they had big language that people might be eligible for subsidies (that said, I think lots of people would miss this). They then had a link to the Kaiser calculator to help you see what subsidy you might be eligible for.

Anyway, this is how it should have been all along.
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Old 12-03-2013, 09:15 PM   #18
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Originally Posted by Katsmeow View Post
Interesting. Just for grins I went to healthcare.gov. I hadn't been since the time I did there shopping thing that gave you estimated rates that weren't necessarily very useful if you weren't the exact ages they used.

I was surprised to see that now (not sure when this started) they are finally letting you do full shopping to see unsubsidized rates. I went to healthcare.gov and just started looking without creating any account.


I put in my age and my children's ages (DH is on medicare) and it popped up with the same premiums as on healthsherpa (actually healthcare.gov rounds to the nearest dollar). Healthcare.gov also has a bunch more information available now than healthsherpa has. There are links to the plan brochure, summary of benefits and plan network. One thing I had been curious about was if the family deductible had to be met when a family was applying or if you could meet either (i.e. was the deductible embedded or not). I looked at a couple of brochures and each was very clear on this point (each one did it differently).

The only glitch I found was that Cigna sent me to their provider directory but it said there are no plans other than dental plans for my zip code which is totally contrary to the exchange listing.

To deal with the subsidy issue they had big language that people might be eligible for subsidies (that said, I think lots of people would miss this). They then had a link to the Kaiser calculator to help you see what subsidy you might be eligible for.

Anyway, this is how it should have been all along.
Thanks for the heads up. Agree wholeheartedly this should have been available on day one.
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Old 12-03-2013, 09:44 PM   #19
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Under PPACA, a premium for age 64 cannot be more than 3x age 21. So in the exchanges you will get that cap, in the regular market you might not.
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Old 12-12-2013, 02:17 PM   #20
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My wife signed up on the Washington State exchange. Her policy was 1.5% lower ($7.68) than the same Bronze HSA policy on eHealthInsurance. The subsidy estimate was $4 higher on eHealthInsurance.

According to this report from Kaiser Health News, eHealthInsurance was approved to sell ACA subsidized policies in the same states as the Federal Exchange. Separate approvals may have been made where there are state run exchanges.

Makes you wonder why eHealthInsurance was not better publicized as an alternative to the broken exchanges...
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