ACA plans for 2015

[AllDone]

Tell me about it... If we just kept it the way it was where only healthy people could get insurance, my premium wouldn't be jumping from $88 to $375!


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. Good plan! Don't get old and stay healthy! That was my plan too, but somehow, I messed it up!

 

[audreyh1]

We switched from one bronze plan to the other yesterday, since the one we were on suddenly changed features to make it HSA incompatible (aargh!).

Got the online app done about 5:30pm. Seemed to flow more smoothly than last year.

By 6pm got email that first payment had been scheduled.
By 8pm got email application had been received.
By 10pm got email about acceptance of the application with new member ID and group number.

That was fast!

 

[John Galt III]

The unsubsidized monthly premium went up from $380 to $480 per month for my ACA PPO, but HC.gov site tells me my subsidy also went up $100 per mo, so I will probably stick with the same PPO in 2015. Haven't actually tried to enroll yet, though. I have spent a lot of time checking out Medicaid, since at my current income I would qualify, but I'm not getting a warm and fuzzy feeling about Medicaid, no matter what HC.gov says.

 

[explanade]

For those who got HSA-eligible plans, are you finding that the premium is slightly higher than the equivalent non HSA plans?

Not enough to really matter much, just a couple of bucks.

But I'm looking at two Bronze plans on Covered CA from the same carrier. The deductibles are $5000 and $4500 for the HSA plan.

But for Doctor Visits, the regular plan is $60 copay after deductible is met while the HSA plan is 40% Coinsurance. So if the doctor charges $200 (don't know what they charge), you'd be paying $120 under the HSA plan or double the amount?

Though I do see that for things like lab tests, it's 30% coinsurance vs. 40% coinsurance in favor of the HSA.

 

[audreyh1]

For those who got HSA-eligible plans, are you finding that the premium is slightly higher than the equivalent non HSA plans?

Not enough to really matter much, just a couple of bucks.

But I'm looking at two Bronze plans on Covered CA from the same carrier. The deductibles are $5000 and $4500 for the HSA plan.

But for Doctor Visits, the regular plan is $60 copay after deductible is met while the HSA plan is 40% Coinsurance. So if the doctor charges $200 (don't know what they charge), you'd be paying $120 under the HSA plan or double the amount?

Though I do see that for things like lab tests, it's 30% coinsurance vs. 40% coinsurance in favor of the HSA.

The premiums are slightly lower for our HSA plan compared to the non-HSA bronze. Of course the up front medical costs will be slightly higher as copays are not allowed.

Coinsurance does not kick in until the deductible is met for the year. You'll be paying $200 in the above HSA example.

 

[explanade]

I mean once I met the deductible.

But if I was going to the doctors that much, I guess the difference between $60 and $120 isn't that grand in the scheme of things. Or for that matter paying $200.

Though it would get me close to the OOP max, after which I guess I wouldn't pay.

 

[audreyh1]

I mean once I met the deductible.

But if I was going to the doctors that much, I guess the difference between $60 and $120 isn't that grand in the scheme of things. Or for that matter paying $200.

Though it would get me close to the OOP max, after which I guess I wouldn't pay.

That's right.

And I suspect the $60 copay for Drs visits are limited to X per year. They usually are.

 

[MBSC]

For those who got HSA-eligible plans, are you finding that the premium is slightly higher than the equivalent non HSA plans?

But I'm looking at two Bronze plans on Covered CA from the same carrier. The deductibles are $5000 and $4500 for the HSA plan.

But for Doctor Visits, the regular plan is $60 copay after deductible is met while the HSA plan is 40% Coinsurance. So if the doctor charges $200 (don't know what they charge), you'd be paying $120 under the HSA plan or double the amount?

Though I do see that for things like lab tests, it's 30% coinsurance vs. 40% coinsurance in favor of the HSA.

The lower deductible on the HSA plan ($4500 vs $5000) would explain the slightly higher premium.

I do not have access to an equivalent non-HSA plan. The HSA plan I chose has a $5000 deductible and the closest non-HSA plan available has a $6350 deductible.

The 40% coinsurance is applied to the insurer's allowed amount (ie. fee schedule rate), not the provider's billed charge. The provider and insurer may have negotiated a rate lower than the charge. For example, the charge for an office visit is $200, the insurer's allowed amount is $125, and you are responsible for $50 (40% of $125) after the deductible is met and before the maximum OOP is reached.

 

[MichaelB]

For those who got HSA-eligible plans, are you finding that the premium is slightly higher than the equivalent non HSA plans?

Not enough to really matter much, just a couple of bucks.

I'm not seeing that at all. In fact, BCBS Fl HSA plans are less expensive than the non-HSA when adjusting for deductible. Looks to me as if they are pricing to market.