This just really surprises me as I'm not seeing high prices to stay in our PPO and it'll be quite a bit less that I was paying in the high risk pool.
There must be huge discrepancies between states.
I am in the same state you are.
But I'm not sure you are comparing the same thing I've comparing.
DH is in a group of retirees where Megacorp subsidizes the premium. However, a few years ago they limited the premium increases they would subsidized to 5% per year. When DH retired the cost for the coverage I have now (me and the kids) was about $180 a year for the $3000 deductible PPO plan (this was the high deductible plan). The regular non-high deductible plan (it is $750 a year) was a little over $1000 a month. The big premium increases were last year (up to $479 a month) and then now increased to $780 a month for next year.
I went to
ValuePenguin | Insuring Your Decisions With Data to find plans in my area to get an idea of what exchange plans would cost.
There are unsubsidized plans that are about the same as or cheaper than the $780 we are paying now but the deductible is vastly different. The family deductible we have now is $3000 while these call for family deductibles of $12700 a year. Big difference to the $3000 deductible we have now. (It is unclear on the exchange plans if the entire family deductible has to be met before anything is paid even if the individual deductible was met. On our HSA plan nothing is paid until the family deductible is met. Even so the individual deductibles on these exchange plans are higher than our current family deductible).
For example, Aetna bronze PPO plan was $764 a month with $6350 individual deductible and $12700 family deductible. After that most everything is paid for in network ($20 copay for primary visits). Out of network coinsurance is 50% (I have 60% now) with family deductible of $25,400 (now our out of network deductible is $5000).
Cheapest Silver non-HMO plan that was information online is Cigna at $864 a month (almost $100 a month more than we will be paying with DH's retiree coverage) with $2750 individual deductible and $5500 family deductible with 20% coinsurance. Coinsurance is similar to what we have now but the deductible is much higher with the premium higher.
So
for us with premiums subsidized by Megacorp we have a better deal currently with retiree coverage. (We are not eligible for exchange subsidies and getting our income to the level to be eligible would be challenging for the next few years while we still have kids in college).
Some retirees of Megacorp, however, get retiree coverage from Megacorp which is unsubsidized. For them, the coverage DH and I would pay $780 for next year would cost them $1242 a month. Exchange coverage could very well be a better deal for them.
, by then the problems may be fixed or not, but at least we'll have a better idea of what the options are.
