Another vent on 2018 renewal premium

[rodi]

You could look at your actual claims experience over the last couple years and demonstrate that you would have been better off with a bronze plan and see what the savings would have been.... then you (and your ex) will know how much warm fuzzy costs and you (collectively) and make a more informed decision.

Yeah - I had warm fuzzies and felt great about going on Bronze HSA... based on past use. Bwa ha haha.... Laugh was on me. I've posted here several times about my HDHP HSA Bronze fun the last two years. Knock on wood - this year is going ok.... Of course I said the same thing last year - and ended up with older son having $7k worth of jaw surgery over thanksgiving week.

Just like the market... past performance (healthcare spending) does not guarantee future performance (healthcare spending).

 

[LakeRat1]

It will be interesting to hear from you after you have used the sharing system for some costs.

Hopeful, I will not have any health issues or accidents ..... More to come

 

[Murf2]

I've got 2 silver choices. Both EPO's the HDHP is cheaper, of course, but with my cost sharing the deductible is very low. 1000/1000.

Is there some gotcha I need to be aware of as far as HDHP? We live in a rural area and all my doctors/ hospital are in the EPO.

Thanks
Murf

 

[jim584672]

My SLCSP is $453, Long Island, NY. Any age (NY does not age rate).

 

[littleb]

I've got 2 silver choices. Both EPO's the HDHP is cheaper, of course, but with my cost sharing the deductible is very low. 1000/1000.

Is there some gotcha I need to be aware of as far as HDHP? We live in a rural area and all my doctors/ hospital are in the EPO.

Thanks
Murf

We've had HDHP for years and the only thing is most dr's now require you to pay a small amount upfront against your deductible.

 

[Murf2]

Thanks, This on seems to require us to meet our deductible first, which it shows as being the same as our max OOP. That is $1000. Seems too good to be true but we do get a large cost sharing price reduction.

Thanks again!
Murf

 

[spncity]

Well, darn.

The premiums are not lower after all. Not sure what I saw that made me think they were. Maybe it was wishful thinking....

 

[pb4uski]

Yeah - I had warm fuzzies and felt great about going on Bronze HSA... based on past use. Bwa ha haha.... Laugh was on me. I've posted here several times about my HDHP HSA Bronze fun the last two years. Knock on wood - this year is going ok.... Of course I said the same thing last year - and ended up with older son having $7k worth of jaw surgery over thanksgiving week.

Just like the market... past performance (healthcare spending) does not guarantee future performance (healthcare spending).

Yup... its a calculated risk that one takes their eyes wide open.... sometimes you win and sometimes you lose If it makes you feel any better it has worked out for us every year for the past 8-10 years.

 

[spncity]

An email came today from the state people - here is the first paragraph:

We've updated 2018 plans and costs

We are notifying you that we updated 2018 plans and costs today, October 26. If you browsed plans this month, you should come back to see the updated rates and get a new estimate of your 2018 financial help.​

​

​

 

[kevdude]

What happened to the thread started by Sue J (I believe) about 2018 ACA rates?

 

[spncity]

An email came today from the state people - here is the first paragraph:

We've updated 2018 plans and costs

We are notifying you that we updated 2018 plans and costs today, October 26. If you browsed plans this month, you should come back to see the updated rates and get a new estimate of your 2018 financial help.​

​

​

Can anyone top these rates?

All prices listed for two people, 63 and 61, without subsidy, and way more expensive than last year. Last year was way more expensive than the year before.

Keep in mind this is the Carefirst PPO plan (most expensive and broad national coverage for if you travel a lot). But, wow...

For 2018-

Bronze is $2704.45 per month = 32,453.40 yr. Deductible and Max OOP are the same: $6,550/$13,100 for in network.

Gold is $3429.14 per month = 41,149.68 yr. Deductible is $1,000/$2,000 and Max OOP is $6,500/$13,000 for in network.

Silver went up beyond the price of Gold to $3556.71 per month = 42,680.52 yr. Deductible is $3,500/$7,000 and Max OOP is $7,350/$14,700 for in network.

I still think there are a couple of goofs on the state website for Gold and Silver where it lists individual OOP maxiumums for out of network as "less" than in network - since out of network has traditionally always been higher.

One can find some less expensive plans with high deductibles - i.e., Kaiser Permanente. Cigna is gone from this market for 2018.

From the article linked on another thread about Maryland approving hikes on Wednesday:

CareFirst's PPO plan up 76 percent.

CareFirst BlueCross Blue Shield HMO plan up 58.2 percent.

Kaiser Permanente up 43.4 percent.

That's why the website changed yesterday.

https://www.nbcwashington.com/news/...-Higher-Health-Insurance-Rates-453271593.html

 

[ivinsfan]

spncity wow just wow, are you able to buy 2 individual plans to at least lower the OOP total for the two of you. what are you thinking of doing?

 

[pb4uski]

You can do that but IIRC a couple years ago regulations were enacted that require that deductibles be stacked (per person) rather than aggregate.

 

[Senator]

The last time I purchased insurance was in 2016, and it was ~$425 a month for an individual, with a $1,500 deductible. Then a co-sharing of insurance of 25% until you hit the maximum OOP of $5K. Pharmacy was included in that, but you paid $100% of the cost of the drugs until the deductible was met.

As a single, no dependents, I paid $68.19 every two weeks, my employer paid $126.81. That is according to my 2016-07-15 pay advice. That was in MN.

Why is the healthcare so much more expensive now? Is it the lack of group coverage? Or people buying better coverage with lower deductibles and lower OOP? Shortage of Doctors? (there seemed to be enough 2 years ago).

 

[spncity]

spncity wow just wow, are you able to buy 2 individual plans to at least lower the OOP total for the two of you. what are you thinking of doing?

Well, exploring all options. I reread the news release - and the off-exchange prices are supposed to be lower, but can't get that info until Nov. 1st. I thought about sending DH back to work for a year... Yeah, that's the ticket... LOL.

 

[pb4uski]

The last time I purchased insurance was in 2016, and it was ~$425 a month for an individual, with a $1,500 deductible. Then a co-sharing of insurance of 25% until you hit the maximum OOP of $5K. Pharmacy was included in that, but you paid $100% of the cost of the drugs until the deductible was met.

As a single, no dependents, I paid $68.19 every two weeks, my employer paid $126.81. That is according to my 2016-07-15 pay advice. That was in MN.

Why is the healthcare so much more expensive now? Is it the lack of group coverage? Or people buying better coverage with lower deductibles and lower OOP? Shortage of Doctors? (there seemed to be enough 2 years ago).

Health care costs are the main reason for higher premiums because health care costs are 80% or more of what we pay in premiums by law. Also some of it may be that the pool for group insurance is much bigger and probably somewhat older than the pool for individual insurance.

My state offers a policy similar to what you describe above... $1,550 deductible then 10% co-pays to max of $6,400 for $571/month in 2018.... cost of the same policy in 2016 was $469.... and it is pretty apples-to-apples because my state does not allow age rating so it is similar to more group insurance.

 

[Senator]

My state offers a policy similar to what you describe above... $1,550 deductible then 10% co-pays to max of $6,400 for $571/month in 2018.... cost of the same policy in 2016 was $469.... and it is pretty apples-to-apples because my state does not allow age rating so it is similar to more group insurance.

How are people seeing almost $2K a month? What kind of policies are those? Are people just trying to get a Cadillac plan for the price of a Yugo?

 

[ivinsfan]

You can do that but IIRC a couple years ago regulations were enacted that require that deductibles be stacked (per person) rather than aggregate.

You can do it in this state MN....each person buys their own policy but I don't know if its an option on the exchange.

 

[ivinsfan]

How are people seeing almost $2K a month? What kind of policies are those? Are people just trying to get a Cadillac plan for the price of a Yugo?

no it's a Yugo plan for the price of a Cadillac ...

 

[pb4uski]

You can do it in this state MN....each person buys their own policy but I don't know if its an option on the exchange.

We bought our policies on the exchange and bought individual policies. This was before the change to stacked deductibles and we have just renewed each year since. We were not getting subsidies so I don't know if it is different if you are getting subsidies.

 

[ivinsfan]

We bought our policies on the exchange and bought individual policies. This was before the change to stacked deductibles and we have just renewed each year since. We were not getting subsidies so I don't know if it is different if you are getting subsidies.

So you have a stacked family deductible it's not clear to me?

 

[pb4uski]

No, I have a policy and DW has a policy. At the time we bought, deductibles were aggregate, so if we bought one policy for the two of us with a $12k deductble and one of us had a $10k claim then we would have paid the entire $10k. With separate policies with a $6k deductible (same premium since premium for a couple was twice that of a single) and one of us with a $10k claim we would have only paid $6k and the insurer would pick up the $4k excess.

I had an interesting discussion on this with the BCBS CSR because I wanted to make sure that I understood it correctly and they confirmed it... at which point I said I think we'll go with separate policies.. I think the idea was new to the CSR too.

 

[Senator]

no it's a Yugo plan for the price of a Cadillac ...

That is your opinion and doesn't help the conversation without examples and comparisons.

I see HMO policies are shunned by some, but they are cheaper and probably very close to what I have at the VA. And similar to a network of doctors on many plans. And it seems to work fine.

Since insurance companies price their products without regard to what assistance people are getting, I assume that people paying large premiums pick an expensive policy because they want many bells an whistles.

I assume Group plans are cheaper because of volume buying, and with insurance mandated, it should be similar to a group plan. Once you get to the hospital, or clinic, treatment doesn't depend on the amount you paid for the policy. The difference in my plan at my former employer is my employer paid much of it for me.

I am trying to empathize with the high premiums of some people, but it seems you get what you pay for, and there are many other cheaper options and plans? Or now a person has to pay the premium all by themselves, rather than an employer paying it for them?

 

[ivinsfan]

That is your opinion and doesn't help the conversation without examples and comparisons.

I see HMO policies are shunned by some, but they are cheaper and probably very close to what I have at the VA. And similar to a network of doctors on many plans. And it seems to work fine.

Since insurance companies price their products without regard to what assistance people are getting, I assume that people paying large premiums pick an expensive policy because they want many bells an whistles.

I assume Group plans are cheaper because of volume buying, and with insurance mandated, it should be similar to a group plan. Once you get to the hospital, or clinic, treatment doesn't depend on the amount you paid for the policy. The difference in my plan at my former employer is my employer paid much of it for me.

I am trying to empathize with the high premiums of some people, but it seems you get what you pay for, and there are many other cheaper options and plans? Or now a person has to pay the premium all by themselves, rather than an employer paying it for them?

Respectfully since you have been on either employer plans and now the VA,so your empathy isn't very empathic.. in West Central MN we have 2 options a BC HMO that literally doesn't have one specialist in network and a Medica plans with broader coverage. Why don't you float over to the MNSure site and enter some age and income level and see what your premiums and potential OOP would be at your income level?

I've purchase insurance either on the open market or in our small family owned business plan for over 40 years. Your many other cheaper plans that are ACA compliant do not exist. Just challenging those of us buying plans that we want to go cheap or saying it can't be that bad is incorrect.

 

[ivinsfan]

No, I have a policy and DW has a policy. At the time we bought, deductibles were aggregate, so if we bought one policy for the two of us with a $12k deductble and one of us had a $10k claim then we would have paid the entire $10k. With separate policies with a $6k deductible (same premium since premium for a couple was twice that of a single) and one of us with a $10k claim we would have only paid $6k and the insurer would pick up the $4k excess.

I had an interesting discussion on this with the BCBS CSR because I wanted to make sure that I understood it correctly and they confirmed it... at which point I said I think we'll go with separate policies.. I think the idea was new to the CSR too.

This seems like a no brainer and we have done this for years, why would you pay the same money for double the OOP. I don't know if this works for people getting premium subsides on the MNSure they seem to do everything by family size.