Preview 2017 ACA plans now active

[niven]

I see many people are saying they can get a silver or bronze plan for just a few hundred dollars a month. I had UHC in Florida but UHC pulled out of ACA. When I looked at the cheaper silver plans NONE of my doctors were in network. The only plans that have my 6 doctors are $2,000 a month before the subsidy. UHC covered all my doctors and was $1200 a month before subsidy.
So my question is to those going for the $200 plans are you finding your doctors in network or you just go the closest doctor in your plan? Are you not worried about the quality of the doctor or the huge backlogs in the waiting rooms?

As I said in another post, you may need to check on the doctors in network again after the official Nov.1 start of enrollment. I've already seen in my area that data is still being changed.

 

[Sue J]

I see many people are saying they can get a silver or bronze plan for just a few hundred dollars a month. I had UHC in Florida but UHC pulled out of ACA. When I looked at the cheaper silver plans NONE of my doctors were in network. The only plans that have my 6 doctors are $2,000 a month before the subsidy. UHC covered all my doctors and was $1200 a month before subsidy.
So my question is to those going for the $200 plans are you finding your doctors in network or you just go the closest doctor in your plan? Are you not worried about the quality of the doctor or the huge backlogs in the waiting rooms?

The first year of ACA we used the same insurance company that we had been with on DH's retiree plan so we were able to keep all of our doctors. The 2nd year of ACA our previous insurer got much more expensive so we changed insurers but it was a big enough network that all our doctors were still there. For the 3rd year of ACA (2016) the premium prices went up so much and our subsidy went down, so that to keep our doctors would have cost us $200-$300 more per month. DHs doctor was retiring so he would have a new doctor in any case so we switched insurers. It hasn't been bad at all, we both like our new doctors and the new practice and so far it looks like we will stay with our current insurer Bronze plan for 2017 with a $30/mo increase (and a benefit decrease, of course) for 2016.

 

[FUEGO]

I see many people are saying they can get a silver or bronze plan for just a few hundred dollars a month. I had UHC in Florida but UHC pulled out of ACA. When I looked at the cheaper silver plans NONE of my doctors were in network. The only plans that have my 6 doctors are $2,000 a month before the subsidy. UHC covered all my doctors and was $1200 a month before subsidy.
So my question is to those going for the $200 plans are you finding your doctors in network or you just go the closest doctor in your plan? Are you not worried about the quality of the doctor or the huge backlogs in the waiting rooms?

I'm debating between a $56/mo plan that includes zero of our 2 current doctors (and no dental) vs a $135/mo plan that includes our primary care doc that all of us see but we lose 1 other doctor. I could pay closer to $150-200 to keep that 2nd doctor but the other plan features get worse.

I don't mind switching docs to save $1000/yr since we rarely visit more than 1x/yr for a physical and rx renewals, plus maybe 1-2 sick visits (except that $1000 delta buys us a much more comprehensive plan with nationwide network and out of network coverage apparently, so it's more complicated than access to 1 doctor). So far no serious health issues so we aren't major consumers of medical care.

 

[NW-Bound]

I see many people are saying they can get a silver or bronze plan for just a few hundred dollars a month. I had UHC in Florida but UHC pulled out of ACA. When I looked at the cheaper silver plans NONE of my doctors were in network. The only plans that have my 6 doctors are $2,000 a month before the subsidy. UHC covered all my doctors and was $1200 a month before subsidy.
So my question is to those going for the $200 plans are you finding your doctors in network or you just go the closest doctor in your plan? Are you not worried about the quality of the doctor or the huge backlogs in the waiting rooms?

Eh, per suggestion by TexasProud, I looked at all 4 plans offered by the sole insurer in my area: two Bronze, one Silver, and one Gold. None had my doctor, from the $1,800 "cheapo" Bronze to the $3,300/month Gold plan.

I don't believe my doctor is that picky. I believe he takes Medicare, Medicaid, anybody who has a buck.

So, I calmed down and am now betting that the Web site database is not up-to-date. In any event, I am not going to sign up until early December. It's not going anywhere, and who knows, with such juicy premiums some other insurers may have a change of heart.

PS. My wife asked the clerk at the doctor's office. She didn't know! Nobody knows anything anymore.

 

[Packman]

I am in AZ and the premium for two of us is going up 169% for 2017, from $682/mo. to $1,834/mo. before subsidy (lowest cost bronze plans). One problem is that there is only one provider in the Phoenix area. I see millions of dollars spent by insurers advertising Medicare policies. Why can't the states simply say "if you can't write policies for people under 65, you can't write them here for those over 65"?

This will be our third insurer in three years of ACA coverage. New doctors every year, takes 6 months to get an appointment, by the time we get in to the doctor s/he isn't there any more and we end up with an assistant. It's lucky we are healthy.

I know a person on Medicare that had a hip replacement and she paid "zero" for the entire procedure. Huh?

 

[Texas Proud]

It would show us where the money goes, and what we get in return. It does not solve the problem, but helps us define it.

Maybe after understanding the benefits, we will all say "it's really worth it", and become willing to spend all our own assets (not somebody else's, mind you) down to zero to get "it". But we do not really know what "it" is that costs so much.

Right now, in my area, the health insurance has gone up to more than double in just one year. Per law, insurers have to pay most of it out and not to keep it as profits. So, am I correct in saying that the healthcare cost has doubled? I assume that auditing has been done to see that insurers did not cheat on their books.

What has doubled then? Hospitals have racked up their rates to double? Drugs now cost twice as much? People are now twice as sick?

What is it? Nobody does anything. Just let Uncle Sam keep on paying. He can print more money.

Well, we do know that drug companies are raising the cost of many drugs.... some that have been on the market for many years.... look at EpiPen...

All the stories I read about the ones that get the headlines usually have a list of others that have gone way up... plus, the cost of NEW drugs seem to be much higher....

 

[NW-Bound]

As I mentioned in an earlier post, nobody addresses the question of why the premium goes up more than 100% in AZ, while the nation's average is 25% for ACA. Do people use more expensive drugs here?

 

[audreyh1]

that in the acronym list?

SWAG - Wild Ass Guess is part of it.

 

[MrPotatoChip]

That's a nice attitude because someone willl pay more because you don't want to pay anything . It will be higher bills for those of us who do pay or more taxes for everyone.

No, it is the correct attitude.

Remember how this hypothetical scenario started, the doctor wanted to charge me the rack rate (2 or 3 times higher than a person with insurance) so if he or she wants to act like a thug and charge me more, I will declare bankruptcy with a great big smile on my face.

 

[MichaelB]

No, it is the correct attitude.

Remember how this hypothetical scenario started, the doctor wanted to charge me the rack rate (2 or 3 times higher than a person with insurance) so if he or she wants to act like a thug and charge me more, I will declare bankruptcy with a great big smile on my face.

If that works for you, fine, but it does not help people interested in financial independence, and it also isn't really relevant to this thread topic. If your interested in joining our forum why not tell us a little about yourself over here? Hi, I am... - Early Retirement & Financial Independence Community

 

[HadEnuff]

In 2017, both I and DW will be retired. I am looking at the option of living more off of my already taxed assets, and keeping MAGI low enough to get subsidized. The only fly in the ointment that I have discovered, SO FAR, is that there are no ACA plans offered here that allow any coverage for "out of network" care.
At first this alarmed me, and DW. She has had breast cancer treatments, and travels 100 miles for her treatment, and I am fighting a back problem that may lead to surgery.
As it turns out, all of DW's treatment, out of town, has all been "in-network" anyway.

Also, as I ponder this, I am thinking that it's probably not that big of a deal, since if we were to be treated OON, the benefit would only be the deeply discounted rate anyway. So if I spent 50K on OON back surgery, the benefit I would lose would not be 50K, but whatever the INSCO would have knocked it down to, probably more like 5 or 10K (WAGs).
The subsidy would likely save me as much as 7K anyway.

I'm still looking into this. I have only 2 years until I'm 65, but DW has 6.
The other nefarious issue with "In Network" and "Out of Network" is that it aims at a very swiftly moving target. As fees get cut, more and more caregivers are going to give the INSCOs the middle finger and move OON.

 

[Looking4Ward]

I'm starting to see others post the cost of 2017 plans on social media and the responses many of these posts are getting are disappointing.

They illustrate how terribly uneducated many people are about ACA with comments such as:

"Those are the high premiums for people with pre-existing conditions"

"That's what it costs before credits, nobody pays that much"

"It's based on your income so the more you make the more you pay" (somewhat true but I'm positive the person who made this comment doesn't understand true cost versus taxpayer funded subsidies)

"You can thank the states that didn't participate in Medicaid reform for the higher rates"

I'm afraid it's going to take more than what many appear to believe are phantom costs to fix this. Just as many mistakenly grew to believe that the cost of a doctor's visit was nothing more than their copay, many will still believe that total health care costs are the equivalent of their subsidized monthly premium.

This year I'm in the peculiar position of considering tax-loss harvesting so I can reduce the taxable dividend and CG distribution amount of my taxable accounts in order to avoid paying substantially increased healthcare premiums next year. What a ridiculous math exercise to perform, especially since I'm not (yet) a high utilizer of health care. This year I actually struggled to meet my $2K deductible but didn't even come close because there just wasn't that much wrong with me.

 

[BuysToys]

It would show us where the money goes, and what we get in return. It does not solve the problem, but helps us define it.

Maybe after understanding the benefits, we will all say "it's really worth it", and become willing to spend all our own assets (not somebody else's, mind you) down to zero to get "it". But we do not really know what "it" is that costs so much.

Right now, in my area, the health insurance has gone up to more than double in just one year. Per law, insurers have to pay most of it out and not to keep it as profits. So, am I correct in saying that the healthcare cost has doubled? I assume that auditing has been done to see that insurers did not cheat on their books.

What has doubled then? Hospitals have racked up their rates to double? Drugs now cost twice as much? People are now twice as sick?

What is it? Nobody does anything. Just let Uncle Sam keep on paying. He can print more money.

Part of the problem is how ACA is set up in most states. For Texas, the insurance is by county. So a county with more population will have lower costs and more choices because there are more customers looking for coverage and a larger base to spread the costs over. (BTW, this will also impact your Medicare secondary coverage costs as I learned last month when I started looking for DH.) My county has only one insurer and only HMO plans to choose from. There are 13 total plans. When I look at Dallas, there are 32 plans, three insurers, and selections of HMO and EPO. I'm about an hour away from Dallas so it's a pretty significant difference for a drive I might have to make to see a specialist anyway.

When you have fewer people to spread the costs amongst, the per person cost will be higher. Remove any competition and there's nothing holding the costs back.

 

[ShokWaveRider]

Having lived in may places over our working life, being "Married" to your Doctors was a luxury we never had and never missed. We were always looking for new doctors when we moved.

Having to find a new doctor because of a plan shift, as long as they are not a prohibitive distance from our home, does not really present a problem, at least not a permanent one.

Doctor evaluation in the USA is easy as there are lots of reviews, and pretty much most doctors that have been around in an area for a while are reputable and easily reviewed. With EMR they have your info at their fingertips. I have also found that the Specialists tend to be on all of the plans in our area, but the GPs less so. We see GPs 1 or 2 times a year so that issue is somewhat moot. Typically we only use them for referrals.

Now that said where we live in St. Augustine you walk out the door and trip over doctors offices. There are 5 on my street and it is not that big a street.

So simply find another doc that is on the list call them make an intro apt for January and move on.

Oh, in this years GP search, I had to change GPs and I asked their billing people why they did not take the most prolific plans. Their answer was that they had not applied to yet. So they either are not up on the plans for do not need or want additional business. Finding a new GP took all of 15 minutes including the phone call. The BIGGEST problem I came across was that the Insurance Doc list was for the most part not up to date.

 

[RunningBum]

No, it is the correct attitude.

Remember how this hypothetical scenario started, the doctor wanted to charge me the rack rate (2 or 3 times higher than a person with insurance) so if he or she wants to act like a thug and charge me more, I will declare bankruptcy with a great big smile on my face.

I don't think you understand how bankruptcy really works. You get to keep very little. What you have gets distributed to the people you owe money to, including that doctor.

My FIRE plan doesn't work well if I go bankrupt. That would keep me from having a great big smile.

 

[RunningBum]

As I mentioned in an earlier post, nobody addresses the question of why the premium goes up more than 100% in AZ, while the nation's average is 25% for ACA. Do people use more expensive drugs here?

Maybe more high risk people who used to be uninsured and now are insured, and adding higher costs to your insured pool?

 

[ivinsfan]

No, it is the correct attitude.

Remember how this hypothetical scenario started, the doctor wanted to charge me the rack rate (2 or 3 times higher than a person with insurance) so if he or she wants to act like a thug and charge me more, I will declare bankruptcy with a great big smile on my face.

And you somehow think the doctor who is taking care of you has any control over this situation? So in your scenario, the correct thing to do is to never seek medical care, I'm fine with you deciding not to use medical care, it's your taking the care and then thumbing your nose at the people who took care of you that's a problem for me.

 

[Sue J]

My PCP up until this year took a couple of the ACA plans including the narrow network PPO plan that I had last year. In late 2015 I found out that for 2016 they would only accept the larger network version, not the narrow network (less expensive) one.

I asked the business manager for the practice why they would not be accepting the narrow network plan and she said they didn't drop it, instead the insurer told them they would not be included in the narrow network. They did not have a choice on the matter.

So we switched insurances and doctors. I liked my doctor but when it costs me an monthly increase the size of a car payment to stay with her, I become flexible.

 

[NW-Bound]

Maybe more high risk people who used to be uninsured and now are insured, and adding higher costs to your insured pool?

Yes, most likely. Then, here's that map again, that I linked to earlier.

What's the common demographics between these black-sheep states?

 

[MichaelB]

As I mentioned in an earlier post, nobody addresses the question of why the premium goes up more than 100% in AZ, while the nation's average is 25% for ACA. Do people use more expensive drugs here?

Using this as an example of premiums in Az, I compared them with my own zip code. A 30 year old male in Az faces a premium of $421, in South Fl the premium for the same policy (Ambetter Balanced Care 4) would be $256. That is a big difference in price. We know that the MLR requirement limits the total profit, so either the cost of administering the policy is much different, or as R-Bum suggests, in Az there are fewer policyholders that require proportionally more care.

Edit to add - one easy difference between the two locations is S Fl has a much higher population density.

 

[MichaelB]

One final request to stay on topic - please.

 

[Murf2]

I see many people are saying they can get a silver or bronze plan for just a few hundred dollars a month. I had UHC in Florida but UHC pulled out of ACA. When I looked at the cheaper silver plans NONE of my doctors were in network. The only plans that have my 6 doctors are $2,000 a month before the subsidy. UHC covered all my doctors and was $1200 a month before subsidy.
So my question is to those going for the $200 plans are you finding your doctors in network or you just go the closest doctor in your plan? Are you not worried about the quality of the doctor or the huge backlogs in the waiting rooms?

I am one of those considering a $30 per month HMO. Of course, I am keeping my income at the minimum.

Like you, I am very concerned about the quality of care. I have some heart issues. About 150K worth last year but I had a 4K OOP max, thank God.

I spent a lot of time comparing plans last night. In my case all of my doctors are in the HMO that are in my current PPO. Both plans are BCBS.

Like you, I am very wary of the change. BCBS dropped PPO in my area. I had great luck with BCBS so far. I don't know if I want to spend 5K more a year for a higher OOP with a different carrier. The one thing I really worry about is " no out of network coverage." We are wanting to do some RV' ing.

Sorry for the ramble but you wanted to here from " us". I am very concerned as to how it will work out for us but the nearly 5K in premium savings plus a 500/100 OOP is hard not to try.

I just don't understand how the provider saves much money with a HMO with lower premiums and OOP max over a PPO with basically the same network.

Murf

 

[HadEnuff]

I am one of those considering a $30 per month HMO. Of course, I am keeping my income at the minimum.

Like you, I am very concerned about the quality of care. I have some heart issues. About 150K worth last year but I had a 4K OOP max, thank God.

I spent a lot of time comparing plans last night. In my case all of my doctors are in the HMO that are in my current PPO. Both plans are BCBS.

Like you, I am very wary of the change. BCBS dropped PPO in my area. I had great luck with BCBS so far. I don't know if I want to spend 5K more a year for a higher OOP with a different carrier. The one thing I really worry about is " no out of network coverage." We are wanting to do some RV' ing.

Sorry for the ramble but you wanted to here from " us". I am very concerned as to how it will work out for us but the nearly 5K in premium savings plus a 500/100 OOP is hard not to try.

I just don't understand how the provider saves much money with a HMO with lower premiums and OOP max over a PPO with basically the same network.

Murf

I'm not sure I understand all of this, but, I think most plans will have a provision for coverage if you are traveling and can't find anyone in network.
I would love to hear from someone with more knowledge.

 

[JoeWras]

I'm starting to see others post the cost of 2017 plans on social media and the responses many of these posts are getting are disappointing.

There's something afoot on social media regarding this. People came out of the woodwork on Nextdoor.

Appreciate the frank discussion here.

 

[MichaelB]

I'm not sure I understand all of this, but, I think most plans will have a provision for coverage if you are traveling and can't find anyone in network.
I would love to hear from someone with more knowledge.

All plans must provide emergency care coverage, even if the provider is out of network. The policy holder is still subject to balance billing, which means the policy holder is still liable for excess charges not covered by the plan. In addition, the ER service must meet the insurer's requirements for coverage.

Any care that is "non-emergency" must be in-network and meet all other eligibility criteria. For health insurance, it is critical to understand the insurer's network of providers.