Preview of 2018 ACA plans is LIVE

[RockyMtn]

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Originally Posted by zinger1457 Not much changes next year for me, still only one provider (BCBS-AZ) with 4 plans to choose from. Premium for the same Bronze HSA plan I currently have went up about 1%, looks like the subsidy went up the same amount.

Looks like the same for GF here in Az. One provider (Ambetter) with five plans to choose from. Same Silver plan as last year shows premium up small amount, tax credit and cost sharing up slightly as well. Net/Net small increase from last year.

Now to make sure all of her Dr's are still in network.

[Mr._Graybeard]

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Originally Posted by ivinsfan That lower tax bill could be completely negated by the 13k OOP ....

We've had the Bronze 13K OOP plan for the last three years ... This year the premium has been $106/month after subsidy. We're reasonably healthy and liked having the HSA option, so the high-deductible plan gave us the catastrophic coverage (and negotiated rates we've had to pay) that we were looking for.

I was not aware that the subsidy tax credit was non-refundable. All the more reason to go for the gold this year ...

[kevdude]

Not a big surprise here, Washington's marketplace (Washington Healthplan Finder) will not have any pricing available until Open Enrollment begins. At which point I'm pretty confident the site will be down for a number of days, as has happened in the past. It's a good thing this state is not known for having talented software programmers...

[RockyMtn]

Quote:

Originally Posted by RockyMtn Looks like the same for GF here in Az. One provider (Ambetter) with five plans to choose from. Same Silver plan as last year shows premium up small amount, tax credit and cost sharing up slightly as well. Net/Net small increase from last year. Now to make sure all of her Dr's are still in network.

The flip side is that my retiree health benefits from former employer are increasing 25%! Five more years till medicare.

[BrianB]

We're in MN and just got our renewal info. MN has a state exchange and did expand Medicaid. DW & I are MFJ, early retired, and have no other dependants. We use Health Partners because their clinic is ony 1/2 mile from our house and the affiliated hospital is less than 5 miles from our house.

For 2017 we had
"$2250 Silver Cost Share Reduction Plan": $2250 deductible each; $11400 family max OOP; monthly premium for both of us (57 / 58 yrs old) = $1416.83

For 2018 we are being offered
"$2200 Silver Cost Share Reduction Plan"; $2200 deductible each; $13200 family max OOP; monthly premium for both of us (58 / 59 yrs old) = $1318.86

So, a slightly lower deductible for each but a slightly higher max OOP, with monthly premium $97.97 LESS each month.

All of these premium numbers are before tax credits.

[Texas Proud]

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Originally Posted by Sue J The subsidy credit is not a refundable tax credit but maybe he's talking about the tax refund for reduced income from the HSA contribution.

OK, that makes more sense...

[HGTVfan]

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Originally Posted by MichaelB Your specialist is in the BCBS BlueOptions network for 2017 but not in network for 2018? I have that same network and have not been advised of any changes. Something else to look into.

I think something might be weird with the BlueOptions and other FloridaBlue networks. Maybe with this early look. I put in the main hospital I would use and my primary care doctor and neither is in network.

[jarts98]

We're in VA. Our income is too high for a subsidy.

Our premium is going up 86%. We are losing access to any HSA-compatible plan. We are losing insured access to 3 of the 4 doctors our family currently uses.

[MichaelB]

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Originally Posted by HGTVfan I think something might be weird with the BlueOptions and other FloridaBlue networks. Maybe with this early look. I put in the main hospital I would use and my primary care doctor and neither is in network.

For individual plans there are only 3 options - HMO, restricted network, and expanded network. BlueOptions is the expanded nationwide network. Their tool to see if a provider is in network is not the friendliest. It might be worth a phone call.

[RunningBum]

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Originally Posted by wrl11 My maryland bluecross bronze 6550 ppo is going up from $1600 month to $2700 month for family of 5 (too much investment income for subsidies). Crazy. We are going to have to switch to the BCBS HMO bronze (will be $1700 month now). The maryland site says 90% of people who apply are eligible for subsidies, so under the obamacare act we are paying for probably 10-20 maryland families healthcare costs. [mod edit]

I understand your frustration and that's a crazy premium, but that last paragraph is not at all accurate. The full amount goes to the insurance company, whether it comes from the insured or insured+govt subsidy. Whether that rate is fair is another question, but you aren't paying the insurance company extra so that someone else can pay them less. The subsidy comes from the government. I'm not sure exactly how that is funded, but it's not from money you are paying directly to the insurance company.

I find it hard to believe that the cliff is getting higher yet remains in place. I guess not enough people have gone over the cliff to be a significant force to demand change.

[HGTVfan]

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Originally Posted by MichaelB For individual plans there are only 3 options - HMO, restricted network, and expanded network. BlueOptions is the expanded nationwide network. Their tool to see if a provider is in network is not the friendliest. It might be worth a phone call.

Something is wrong with the provider search for all of the FloridaBlue plans on healthcare.gov early preview. Nothing I’ve tried, including all the hospitals, shows as being in network. I’ll wait until Nov. 1 and if it still looks strange I’ll call. But I’m still reeling from the fact that my premium would more than double with my BlueOptions plan. All of the other Florida Blue plans look reasonable.

[wrl11]

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Originally Posted by RunningBum I understand your frustration and that's a crazy premium, but that last paragraph is not at all accurate. The full amount goes to the insurance company, whether it comes from the insured or insured+govt subsidy. Whether that rate is fair is another question, but you aren't paying the insurance company extra so that someone else can pay them less. The subsidy comes from the government. I'm not sure exactly how that is funded, but it's not from money you are paying directly to the insurance company.

You are right technically, but in reality my statement is accurate. The gov't is funding the subsidies, but they would have to pay more subsidies if people like me didn't pay the full rate on the 80% premium increase. [mod edit]

[pb4uski]

I don't think that you are right at all.... your premium is based on expected claims for your cohort and provisions for administration, overhead and contribution to surplus (aka profit) so the premium that you pay is no different than it would be if there were no subsidies at all... that is the construct and if you look at a premium rate filing it is quite clear.... the rest is just a matter of where the premium dollars come from.

[zinger1457]

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Originally Posted by wrl11 You are right technically, but in reality my statement is accurate. The gov't is funding the subsidies, but they would have to pay more subsidies if people like me didn't pay the full rate on the 80% premium increase. [mod edit]

If your goal is to get this thread locked you may soon succeed but some of us do find it useful.

[wrl11]

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Originally Posted by pb4uski I don't think that you are right at all.... your premium is based on expected claims for your cohort and provisions for administration, overhead and contribution to surplus (aka profit) so the premium that you pay is no different than it would be if there were no subsidies at all... that is the construct and if you look at a premium rate filing it is quite clear.... the rest is just a matter of where the premium dollars come from.

You would be correct if the government did not cap certain rates and allowed market pricing. But the government does dictate pricing. Why do you think companies are pulling out of obamacare markets or going bankrupt (like evergreen in maryland)? Do you think they are doing that because the government is allowing free market pricing accross the board? No, they are sticking it to people like myself to pay the bills for others.

[ivinsfan]

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Originally Posted by wrl11 You would be correct if the government did not cap certain rates and allowed market pricing. But the government does dictate pricing. Why do you think companies are pulling out of obamacare markets or going bankrupt (like evergreen in maryland)? Do you think they are doing that because the government is allowing free market pricing accross the board? No, they are sticking it to people like myself to pay the bills for others.

Come on dude, please stop the political comments they aren't useful. You are not the only person upset about the price of health insurance, but this isn't the time or place for ranting.

[MichaelB]

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Originally Posted by HGTVfan Something is wrong with the provider search for all of the FloridaBlue plans on healthcare.gov early preview. Nothing I’ve tried, including all the hospitals, shows as being in network. I’ll wait until Nov. 1 and if it still looks strange I’ll call. But I’m still reeling from the fact that my premium would more than double with my BlueOptions plan. All of the other Florida Blue plans look reasonable.

Why not check directly with the Florida Blue “find a doctor” tool? It’s here https://providersearch.floridablue.c.../pub/index.htm

[HGTVfan]

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Originally Posted by MichaelB Why not check directly with the Florida Blue “find a doctor” tool? It’s here https://providersearch.floridablue.c.../pub/index.htm

Gee, I thought this thread had been deleted yesterday afternoon. I must have overlooked it.

Yes, I've checked the provider database on FloridaBlue's site and everything looks OK.

Looking at the plans further on healthcare.gov, my best option looks like the BlueOptions Bronze plan which is MUCH less expensive for me - about $275 compared to $975 for Silver. Higher deductibles and co-pays but that is fine.

[pb4uski]

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Originally Posted by wrl11 You would be correct if the government did not cap certain rates and allowed market pricing. But the government does dictate pricing. Why do you think companies are pulling out of obamacare markets or going bankrupt (like evergreen in maryland)? Do you think they are doing that because the government is allowing free market pricing accross the board? No, they are sticking it to people like myself to pay the bills for others.

There is a backasswards constraint on rates with the 80% medical loss ratio limit, but the reality is that a lot of policies were about that ratio before Obamacare went into effect so Obamacare mostly codified what was common practice at the time... we know this since the magnitude and frequency of rebates was fairly modest.

Companies are not pulling out of Obamacare because of the MLR constraint (which in your parlance "caps" rates), but rather due to other factors.

Ironically, because of the MLR contraint that you loathe, the insurers can't "stick it" to anyone since the MLR effectively caps overhead and profit at 20%.... what is causing the price increase that we are seeing are increases in medical costs driving up claims... since claims are 80% or more of premium costs by law.

[Z3Dreamer]

Early 60's couple, subsidy at $64,960 is $2,399, cost of only bronze HSA is $2,178. No other bronze is available. Cost of lowest silver is $2,808. Silver has co-pays of $25 for primary and $75 for specialists, but otherwise deductible and OOP maximum are not too different.

I ran a scenario where I pretended we had a bunch of specialists and primary visits and what the differences would be. Looks like the silver would save us about $2,200 OOP, however, the premiums would cost us a rounded $4,800. Net is that the bronze is about $2,600 cheaper before I consider HSA savings.

I do not see a scenario where the silver makes sense for me. Anyone in a similar situation?