Help! My health Ins is about to double!

[DawgMan]

This frankly has me pissed off beyond belief, especially when I think back to Obama's promises on Health Ins. Like many, my policy goes away this year and I need a replacement. The closest policy I can find that is similar to what I had (new policy is actually inferior) is almost double what I have in 2015!! Just pisses me off!!

Ok, now that I have had a cocktail and settled down, I know some of you have navigated this BS system and found a program that works cost effectively. My situation....
- make too much $$, no discount
- mom & dad (me) are healthy 51 yr olds
- still have 2 kids on the policy, healthy

I have always been a catastrophe policy kind of guy, pay for the little stuff, protect on the big stuff, keep premium low. Now it appears my premium will almost double and my policy covers less. I have yet to meet anyone who says Obamacare is a better program for them, but maybe I am just a rich bastard who needs to be taxed more!! Any suggestions??

 

[zesty]

I haven't found any way around it, short of paying the penalty and forgoing insurance altogether. It would be nice if catastrophic policies still existed.

My parents are just over the ACA credit limit, and as a result they have to pay 17% of their GROSS income on health insurance. With a $13,500 deductible.

 

[easysurfer]

That's pretty much the trend. For myself, a couple of years ago, I had a cheaper policy but limited network (found out later during the year, my doctor must have dropped out of network as he was in when I signed up). So last year, I signed up for a better policy (PPO) with my doc in-network, but the premium was about twice as much as the year prior. Now this policy is dropped in 2016 and the default is to a watered down policy, limited coverage, but at a price close to what I paid for the good PPO plan.

 

[WestcoastRN]

Our deductible is $10K, out of pocket is $13,900. It's a Bronze HDHP, and it's awful. Nothing even close to what we had with our employer policy. And why? It's the same hospitals, same doctors, same everything. Ugh, makes me absolutely crazy.

We no longer have a health care plan, all we have is a health insurance plan.

 

[zesty]

We no longer have a health care plan, all we have is a health insurance plan.

Exactly, with costs like that people treat it as insurance and not care.

 

[daylatedollarshort]

I have yet to meet anyone who says Obamacare is a better program for them

I think some of the 16.5 million people now insured might be happier with health insurance than none at all:

"The number of American adults without health insurance fell 16.5 million from five years ago, when Obamacare was signed into law, the largest drop in four decades, a new report says."

Uninsured rates drop dramatically under Obamacare

Our premiums are much lower, even pre-subsidy amounts for a better policy than we had before with a much lower deductible.

 

[AllDone]

I think some of the 16.5 million people now insured might be happier with health insurance than none at all:

"The number of American adults without health insurance fell 16.5 million from five years ago, when Obamacare was signed into law, the largest drop in four decades, a new report says."

Uninsured rates drop dramatically under Obamacare

Our premiums are much lower, even pre-subsidy amounts for a better policy than we had before with a much lower deductible.

We're happy too.

Just got back from a little emergency laser retina surgery* for DH, you never know when bad stuff is going to happen.

* And when you play tennis on a cloudy day, wear goggles.

 

[Buckeye]

Prior to Obamacare, you might not have been able to get insurance at ANY price if you had had even a small health event. It didn't take much to get denied coverage on the individual market. Guaranteed access to coverage is a godsend to many.

 

[Mulligan]

Prior to Obamacare, you might not have been able to get insurance at ANY price if you had had even a small health event. It didn't take much to get denied coverage on the individual market. Guaranteed access to coverage is a godsend to many.

I going to take a guess and say Dawgman was used to underwritten policies. The reason why it was so much cheaper Dawgman was because they didn't accept unhealthy people which kept premiums down. BTW- Mine TRIPLED in price. But there were a lot of games insurance companies could play even with underwritten plans that could have got you eventually in a worse bind than ACA premiums.


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[daylatedollarshort]

Many here would not even be able to retire early without the ACA and removal of the pre-existing conditions clause. How many households with adults ages 40 - 50+ do not have at least some medical condition they would have been denied coverage for in the past, like high blood pressure? Ironically, a friend of ours with medically controlled high blood pressure had to go back to work and cut his ER plans short when he could not get health insurance at any price, pre-ACA.

 

[MRG]

Many here would not even be able to retire early without the ACA and removal of the pre-existing conditions clause. How many households with adults ages 40 - 50+ do not have at least some medical condition they would have been denied coverage for in the past, like high blood pressure? Ironically, a friend with high blood pressure had to go back to work and cut his ER plans short when he could not get health insurance, pre-ACA.

You're are describing my situation. I could not get health insurance at any price because of blood pressure and cervical spine issues. I would be stuck working to medicare age without aca.

Health insurance costs have and continue to skyrocket. One thing I know, insurance companies seldom go broke.

 

[WestcoastRN]

Don't get me wrong, I am very, VERY, grateful the United States has finally some semblance of a health care program that doesn't punish/deny people insurance coverage for cancer, diabetes, heart disease, or any other diagnosis to no fault of their own. It's a start, and something that should have happened a long time ago.

 

[W2R]

After reading the above posts, I'm just so glad that I qualify for Medicare now.

Getting old is not so great, while better than the alternative, but at least we get Medicare.

 

[Rosie]

Health insurance costs have and continue to skyrocket. One thing I know, insurance companies seldom go broke.

Maybe insurance companies should be taken out of the equation?

 

[ejman]

This frankly has me pissed off beyond belief, especially when I think back to Obama's promises on Health Ins. Like many, my policy goes away this year and I need a replacement. The closest policy I can find that is similar to what I had (new policy is actually inferior) is almost double what I have in 2015!! Just pisses me off!!

Ok, now that I have had a cocktail and settled down, I know some of you have navigated this BS system and found a program that works cost effectively. My situation....
- make too much $$, no discount
- mom & dad (me) are healthy 51 yr olds
- still have 2 kids on the policy, healthy

I have always been a catastrophe policy kind of guy, pay for the little stuff, protect on the big stuff, keep premium low. Now it appears my premium will almost double and my policy covers less. I have yet to meet anyone who says Obamacare is a better program for them, but maybe I am just a rich bastard who needs to be taxed more!! Any suggestions??

Well, meet me as someone who KNOWS that Obamacare is a much better program, for the simple reason that I could not find a private health insurance plan that would insure me or my wife due to pre existing conditions. And believe me, I tried. High blood pressure in my case, carpal tunnel in my wife's case. It sounds kind of silly for those two simple conditions but such was the case in the pre Obamacare world.

 

[walkinwood]

Our experience is the opposite of the OP even though we had no pre-existing health issues.

We lived in NJ when we ER'd and got individual policies. NJ was a community rating state, but did not mandate insurance for everyone. While everyone qualified for insurance and paid the same age-adjusted premium, only the sick and those with wealth to protect (and no company insurance) were in the pools. The result - high premiums.

I just checked 2016 plans in NJ (since we now live in CO), and premiums for a bronze plan (similar to the plan we had back then) are a little less than we paid in 2010 and we're 5 years older.

Suggestions?

Get a bronze plan. If you look around these forums, there was a spreadsheet that someone created that showed what your total cost (premiums + out of pocket) would be for various medical expense totals for the year. For healthy people with low predicted medical needs and no subsidy, the bronze plans always came on top.

 

[wanaberetiree]

Our deductible is $10K, out of pocket is $13,900. It's a Bronze HDHP, and it's awful. Nothing even close to what we had with our employer policy. And why? It's the same hospitals, same doctors, same everything. Ugh, makes me absolutely crazy.

We no longer have a health care plan, all we have is a health insurance plan.

i think it's comparing apple and oranges...

 

[easysurfer]

After reading the above posts, I'm just so glad that I qualify for Medicare now.

Getting old is not so great, while better than the alternative, but at least we get Medicare.

I remember a time planning for ER and the discussion was "Who knows if Medicare and Soc Security will be around?" Those were the days I guess of hoping to stay long enough at a company to get retirement health insurance from megacorp. Now, medicare is sort of considered the gold standard .

I do see the two points about pre vs post ACA. I'm one of the folks who don't have a pre-existing condition so was fortunate enough to get affordable, good coverage insurance when I FIRE'd even with underwriting. So, for me, in comparison, the coverage and rates are worse than the good old days. Yet, at the same time, I'm happy those who couldn't get any insurance in the past now can.

 

[WestcoastRN]

i think it's comparing apple and oranges...

Sorry, I had not meant to insinuate I was comparing the two. You can't compare a Bronze HDHP to an employer HDHP. They are two totally different animals.

 

[Mulligan]

I remember a time planning for ER and the discussion was "Who knows if Medicare and Soc Security will be around?" Those were the days I guess of hoping to stay long enough at a company to get retirement health insurance from megacorp. Now, medicare is sort of considered the gold standard .



I do see the two points about pre vs post ACA. I'm one of the folks who don't have a pre-existing condition so was fortunate enough to get affordable, good coverage insurance when I FIRE'd even with underwriting. So, for me, in comparison, the coverage and rates are worse than the good old days. Yet, at the same time, I'm happy those who couldn't get any insurance in the past now can.

I also enjoyed very low premiums. Never used it the four years I owned it before ACA kicked in. However on this forum I learned several tricks insurance companies did even when approved for an underwritten policy. Although we use the term individual plans, we were actually assigned a "group". They could close the assigned group down, for new people and let the existing group start to age out and thus increase claims that would result in higher premiums. You could then reapply for new coverage to get the current market low premium, but if something health wise happened to you prior, you were stuck in "the group" with escalating premiums. The healthy ones would flee into a "new group" by undergoing underwriting again. Very sneaky...I never got that far along to find out if it would ever hit me, but buried in the paperwork I did see that I did indeed was assigned a "group" in my individual policy.
This could have been problematic. I could write a whole page on some of the tools they used that I have since read about.


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[Katsmeow]

Get a bronze plan. If you look around these forums, there was a spreadsheet that someone created that showed what your total cost (premiums + out of pocket) would be for various medical expense totals for the year. For healthy people with low predicted medical needs and no subsidy, the bronze plans always came on top.

It definitely pays to run the numbers. We are buying a plan off exchange (DH's megacorp is subsidizing part of the chost. We don't qualify for an ACA subsidy).

For the network we want there are 3 choices:

Bronze with high deductible with high coinsurance and copays - Lowest premium

Silver with highish deductible ($10,000 for family) with low coinsurance and copays - Lowest premium

Silver with lowish deductible ($5500 for family) with coinsurance and copays between the two plans above - Highest premium

If we need little to no medical care then the Bronze plan works out the best. On the other hand if we had a year where we would max out the $13,400 out of pocket max then the Bronze plan would also end up being the cheapest.

Between those 2 extremes, however, one of the Silver plans works out better. If we had the same health care needs we had in 2014, for example, the highest premium plan ends up with our overall costs the lowest. That would be because that year we would have met the $5500 deductible and would have had several thousand dollars are costs after that where we would have to pay the coinsurance but most of it would be covered. Under the bronze plan, we would have been paying that out of pocket.

There is even a narrow spending band where the middle Silver plan (higher deductible, low co-insurance and copays works). This is mostly where we would have lots of prescriptions (so longer drug copay is great) and saw a lot of physicians (low copays again), but didn't have a lot of other expenses (that is, no hospital charges and no lab/imaging costs).

I was quite surprised to see that I could find a situation where each of the 3 plans would end up being cheapest.

 

[Texas Proud]

You're are describing my situation. I could not get health insurance at any price because of blood pressure and cervical spine issues. I would be stuck working to medicare age without aca.

Health insurance costs have and continue to skyrocket. One thing I know, insurance companies seldom go broke.

But some do.... and some have a plan they lose money, but are covered by other plans..... which is what happened to BCBSTexas..... so now I get a different plan.... but still looking right now..


And I am one who is glad for the pre-existing condition clause in the ACA...


Yes, having just one problem would boot me out, even though the meds I take are less than $20 per month.... and no other complications... so any proposed plan that does not include this is a non starter with me...

 

[DawgMan]

I going to take a guess and say Dawgman was used to underwritten policies. The reason why it was so much cheaper Dawgman was because they didn't accept unhealthy people which kept premiums down. BTW- Mine TRIPLED in price. But there were a lot of games insurance companies could play even with underwritten plans that could have got you eventually in a worse bind than ACA premiums.


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Yes! It was an underwritten plan and I understand that there are certain groups (i.e. Pre existing conditions, those who qualify for ACA credits), I just frankly haven't run into anyone yet who is happy about ACA. My frustration lies within the the lies sold to many of us from our President when Obamacare was presented. As a self employed person/family, I have been able to navigate a plan all these years that has been relatively reasonable. Well, now the gig is up and I am just now feeling the pain/frustration! I guess I am not a big fan of Socialism. Ok, it's now out of my system, moving forward. My hope was there might be some more of you out there with a similar profile to mine that have found the best product/angle to minimize cost. So far, Bronze is all I can find, but it still doubles my premium. This will be an issue for me even when I ER in hopefully 4 yrs. Don't get me wrong, I am happy for those of you that are getting a benefit. Just realize there is another group out there who is paying for it by the force of our government. Ok, now I'm really off the soap box....

 

[jesaco]

I will be retiring this year and have started looking for Health insurance starting Jan 2016 thru ACA plans. Checking available NYS plans, premiums with the deductibles and OOP costs are really sky high. really have to do a lot of research to find the best plan depending on your situation.

Still, It scares the hell out of me to think if something catastrophic happens to me or my family requiring major medical care and having no insurance at all. So I have no choice but to get health insurance.

 

[rayinpenn]

This frankly has me pissed off beyond belief, especially when I think back to Obama's promises on Health Ins. Like many, my policy goes away this year and I need a replacement. The closest policy I can find that is similar to what I had (new policy is actually inferior) is almost double what I have in 2015!! ........

The Who: Me 61, the Mrs 58, Daughter 21, Son16.
The story: Priced cost of similar ACA plan to the one I have with my employer. Roughly $2200 a month or over $26,000 a year. I am grand fathered into a plan at work where they will pay a portion- cost to me $1750 a month or $21,000 per year. I guess it will drop when I hit 65 or daughter graduates and gets a job with her own insurance. When I tell the aforementioned to my younger buddies in the office they say "$2200 a year?" I tell that it is a month. They say OMG.


ACA
the pros
1) Can't turn you down for pre existing condition Huge!
2) low income people can and do have insurance

The cons
1) penalizes people who were thrifty their entire (us) life or those who made big money.
2) deductibles keep people out of the doctors office - a tragedy
3) did nothing to reduce costs. I'm betting my knee surgery will cost $40k - I could fly to Belgium get the surgery a week or 2 of rehab and come back for maybe $12 grand - all in.
Huge!
4) affected part time employment - employers push to keep hours down to avoid mandatory employee insurance.
5) pays for treatments that some might not want to fund.
6) forces religious organizations to fund things contrary to their teachings
7) Many couldn't keep their doctor as promised, savings obviously didn't materialize

The facts
1)As long as Doctor salaries in the US average double other countries don't expect to see improvement soon.

http://www.forbes.com/sites/theapothecary/2013/05/28/are-u-s-doctors-paid-too-much/

I suspect/know the cost of health insurance will keep ER as just a dream for many.