swakyaby
Thinks s/he gets paid by the post
Yes, it is. Although employees pay the entire premium. Believe it or not, the employer dropped California Blue Cross because the premium was even higher for 2014.
What do you pay for healthcare premiums
- Thread starter ripper1
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Yes, it is. Although employees pay the entire premium. Believe it or not, the employer dropped California Blue Cross because the premium was even higher for 2014.
ripper1
Thinks s/he gets paid by the post
Maybe lower rates with ACA but deductibles are like 5000 or 6000 an individual and co-pays and other expensives are sky high.
rbmrtn
Thinks s/he gets paid by the post
depends the "metal" level you choose. Gold level may have $500 deduct., platinum plans offer even lower deductibles. You trade that off with increased premiums. The maximum out of pocket expense helps control this now as they can not stack other charges on top of the OOPM
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
Once you hit the OOPM your are covered 100%. For me, to get a $500 deductible I would be paying a lot in premiums for something seldom used.
Member Anamorph shared a spreadsheet with us last year that compares the total cost of policies based on different health spending scenarios. Generally speaking, the least "total cost" policies were those with the highest deductibles and the most expensive were those with the highest actuarial value. The differences weren't huge, so effectively, if one uses substantial health care during the year one will pay a lot no matter what the deductible is.
Of course, in the cases of less healthcare need during any year the no or low deductible plans were considerably more costly that all other alternatives.
Of course, in the cases of less healthcare need during any year the no or low deductible plans were considerably more costly that all other alternatives.
ShokWaveRider
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
This is the way it SHOULD be.
Enrolling for medical coverage is mandatory for B.C. residents.
In B.C., premiums are payable for MSP coverage and are based on family size and income.
Effective January 1, 2014, monthly rates are $69.25 for one person, $125.50 for a family of two and $138.50 for a family of three or more. From January 1, 2013, to December 31, 2013 monthly rates are $66.50 for one person, $120.50 for a family of two and $133.00 for a family of three or more.
Note how it is NOT free as a lot of people think. Just affordable.
If these prices were similar in the USA everyone could NOT afford to NOT be covered.
Enrolling for medical coverage is mandatory for B.C. residents.
In B.C., premiums are payable for MSP coverage and are based on family size and income.
Effective January 1, 2014, monthly rates are $69.25 for one person, $125.50 for a family of two and $138.50 for a family of three or more. From January 1, 2013, to December 31, 2013 monthly rates are $66.50 for one person, $120.50 for a family of two and $133.00 for a family of three or more.
Note how it is NOT free as a lot of people think. Just affordable.
If these prices were similar in the USA everyone could NOT afford to NOT be covered.
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nun
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I get a plan from my ex-state employer. Medical and dental premiums are $463 per month for me as single 53 year old deferred retiree. The plan has no-deductible except the first $250 of tests. As I am not yet retired in the eyes of the state I have to pay the full premium, when I get official retiree status at 55 my premiums will be reduced to $115/month.
pb4uski
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But.... the deductibles and co-pays only come into play if you need to go to the doctor, hospital or whatever - if you don't have any health issues and just go in for a routine physical there is no cost other than the premiums. For those with chronic medical issues, at the end of the day it is a trade-off between paying higher premiums or paying health care costs.
nun
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My options when I stopped working at a state university at 53 were to go on ACA and pay $200/month for a high deductible plan or stay with my cadillac state plan and pay the full premium of $463/month until I reach 55 when my premium will go down to $115/month. I chose to stay in the state plan because of the high benefit level and to maintain continuity of my insurance. I would have changed plans right at the time the ACA was having its website difficulties and given that it will probably continue to undergo changes and attempts to phase it out I thought it best to go with a plan that I can rely on.
pb4uski
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I would have taken the $263/month savings, but i'm just cheap I guess. That $3,156 would more than cover our typical health care costs in a year.
I had HSA-eligible HDHI when I was working and we had already had BCBS HDHI HSA-eligible insurance for 2012 and 2013 so the transition to a BCBS ACA HDHI HSA-eligible bronze plan was pretty easy even though the exchange website was a POS.
On July 1 we changed to a catastrophic plan and that was a huge hassle, but now that we are on it things are going smoothly and actually even better than the bronze plan in that we can now pay the insurer directly and they have auto-pay capability whereas I had to write out and mail a check each month to the exchange for the bronze plan since they could not do auto-pay or even electronic payments.
I had HSA-eligible HDHI when I was working and we had already had BCBS HDHI HSA-eligible insurance for 2012 and 2013 so the transition to a BCBS ACA HDHI HSA-eligible bronze plan was pretty easy even though the exchange website was a POS.
On July 1 we changed to a catastrophic plan and that was a huge hassle, but now that we are on it things are going smoothly and actually even better than the bronze plan in that we can now pay the insurer directly and they have auto-pay capability whereas I had to write out and mail a check each month to the exchange for the bronze plan since they could not do auto-pay or even electronic payments.
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nun
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I went back and forth over the choice. I'm healthy and my healthcare costs are just my premiums...... apart from the dentist where the insurance just paid for 50% of a crown I needed. If I wasn't going to have my premium reduced to $115 a month in 2 years time I would have gone with ACA, but I figured $6k was worth it to avoid the hassle of changing insurance right at the time when the ACA was at its craziest. Also to get similar coverage with the ACA would have been significantly more expensive and that makes me feel like I'm getting a good deal, even if I'm not going to the doctor. If something nasty does occur I don't have to worry about any big deductibles or out of pocket charges before the insurance starts paying.
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utrecht, there are a few reasons. First, there is a small financial account at megacorp that I am using up that (modestly) helps defray a bit of this cost. Second, if I leave the plan, I can't go back in later. Third, when I looked at ACA plans in my state when I went off COBRA in June of this year, the costs were about the same for the same level of coverage (PPO plan with BCBS with a very wide network). It is a false assumption that the open market is cheaper, for the same level of coverage AND network. Also note that I am not eligible for any ACA subsides. And fourth, my wife is extremely persnickety about what doctors and hospitals are considered in-network, compared to the ACA plans. She has several medical issues whereas I have relatively few.
Cat-tirement
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After retiring earlier this month, I just received my my Megacorp notice on retiree health benefits today (such as they are). Age has no effect, other than the requirement to be between 55 and 65. My top choices are:
- COBRA continuation of my HDHP, which though it qualifies me for a HSA, I have to manage that myself. Monthly cost is $1055 for DW & I.
- A fairly traditional $400 deductible/20% copay PPO plan. Monthly cost is $878 for both of us.
nun
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That's what I found too. My employers plan is pretty rich....no deductibles etc and to get that level of coverage on the ACA I would have been paying a $800/month and even with the ACA subsidy I would be paying more than for my old employer's plan. The only way to save money would be to take a high deductible plan with a new insurer. So I'm paying more for far better coverage. Of course I might not use that coverage......I suppose those that go for low deductibles are optimists and those that go for cadillac cover are pessimists.
Late to the party.
Rates are for a family of 4. DH = 62, me = 53, 2 minor age kids.
Since I retired in June at age 52 we're paying 1127/month for medical (Kaiser Permanente, no deductable, $20 copays.... so a high metal plan). We're also paying 135 for dental.
My income was too high, this year, to qualify for ACA subsidies... and the group rates I get through cobra are about $500 less/month than I could get, unsubsidized... so I pay cobra.
Next year we'll qualify for ACA subsidies and our medical should be about $750/month.
From playing around with calculators/coveredca/healthsherpa/KP's website... my husband's age is a big factor in our price. He accounts for 45% of our total premium. Life will be good when he goes on medicare.
Rates are for a family of 4. DH = 62, me = 53, 2 minor age kids.
Since I retired in June at age 52 we're paying 1127/month for medical (Kaiser Permanente, no deductable, $20 copays.... so a high metal plan). We're also paying 135 for dental.
My income was too high, this year, to qualify for ACA subsidies... and the group rates I get through cobra are about $500 less/month than I could get, unsubsidized... so I pay cobra.
Next year we'll qualify for ACA subsidies and our medical should be about $750/month.
From playing around with calculators/coveredca/healthsherpa/KP's website... my husband's age is a big factor in our price. He accounts for 45% of our total premium. Life will be good when he goes on medicare.
aaronc879
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I pay $31/mo for a subsidized silver plan with a max OOP of $500/yr. If your pension is over $1500/mo then i'd trade with you any time. Still, if I planned for a healthcare cost of $750/mo I wouldn't expect it to go up more than 10%/yr.
flyingaway
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I am shocked by the numbers posted here. I was budgeting $4,000 per year for health insurance in retirement for a couple. It seems that I have to go back to the drawing table to work out a new budget.
W2R
Moderator Emeritus
Aaron, that is terrific! I am truly happy to read that you are getting such a great deal on health insurance.
As you grow older, of course it could increase dramatically due to the marked effect of age on insurance rates, but hopefully the subsidies would keep up with it.
aaronc879
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According to this subsidy calculator i'd pay the same premium at age 55 as I do at age 35.
Subsidy Calculator | The Henry J. Kaiser Family Foundation
pb4uski
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Doesn't work that way in most states. Go to healthsherpa.com
That's what I found too. Except for an ACA plan on the exchange and off the exchange (BC/BS of Va) the deductible was $6,000 instead of my current $3,500. The coinsurance was 80/20 instead of my current 0%. So basically the same monthly premium for potentially more out of pocket costs with the ACA plan. For now anyway.
The only health issue I have are my sinuses and yearly thyroid blood work (sisters have issues- I don't-I'm on "watch"). My GP routed me to an ENT. I found that every time they "scoped" my nose, they coded it as surgery. My first two visits cost me $500.00 each (deductible). When I told them this, they didn't charge me the third time.
Ive delayed the blood work for my thyroid as I know the symptoms and fee good. When or if I don't, I'll have the labs done.
Still...my point is anything outside of your yearly physical or what is deemed free such as paps and mammograms will go to the deductible (as you all already know).
daylatedollarshort
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I looked at Healthsherpa and I have some questions.
I looked at a subsidy plan with $174 in premiums ($2088) with annual family OOP of $12,500, yet their high costs were $27K. What am I missing? I thought high costs would be $2,088 premiums + $12,500 family deductible = $14,688?
I looked at a subsidy plan with $174 in premiums ($2088) with annual family OOP of $12,500, yet their high costs were $27K. What am I missing? I thought high costs would be $2,088 premiums + $12,500 family deductible = $14,688?
pb4uski
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Usually the max OOP is the premiums + the $12,500 family deductible. Is the $27k perhaps based on the unsubsidized premiums + the $12,500 family deductible? so the difference is the subsidy?
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
Yes, $4K is probably not going to happen. DW and I both have fairly generous employer-subsidized, pre-medicare, retiree health insurance. And our premiums will be about $6K per year once DW finally retires. We estimate total healthcare cost at $9-10K per year, including all out-of-pocket... deductibles, coinsurance, copays, dental, vision, prescriptions. And we estimate medical inflation at 6% per year.
But yes, I'm a little shocked at some of the numbers posted here as well, like $1.7K per month for a couple in their 50s. That just seems crazy high. My casual shopping around of non-subsidized options doesn't generate anything that high.
But I think premiums alone can be misleading without knowing a lot more details. I'd be more curious to know what other pre-medicare retirees are budgeting for total healthcare cost, and medical cost inflation? I think my $9-10K budget is a bit conservative, but 6% inflation may be too low.
That fits.
$640/mo for low deductible medical. Covers 2 adults & 4 kids.
$141/mo for dental. Somewhat covers 2 adults & 3 kids.
Premiums alone aren't enough - you also need to know state and metro area.
When I worked in suburban Philadelphia I had coworkers that lived across the river in NJ. Their insurance was close to double what the PA residents had to pay. Same group negotiation - but the residence state made a big impact.
When I moved to CA my insurance cut in half from the PA rates. (HMO vs HMO - so similar coverage). I suspect that had to do with CA's 80's era malpractice tort reform. That and competition. Kaiser Permanente is the largest insurer in the state - and they are aggressive about controlling costs and so it charges lower premiums... which forces the competition to charge less...
It's kind of like gas prices - where you live makes a HUGE difference in price.
