ACA 2020 Plan Previews started today

[SecondCor521]

Huh. Mine appears to be $238 cheaper per month on a before-subsidy basis and $25 cheaper per month on an after-subsidy basis. Although my estimated income probably changed somewhat from this year to next year (I can't remember what I reported and they don't make it easy to find that information online.)

Silver CS87 for me at age 50 plus my DD17.

I do recall that the plans jumped in price a fair amount last year due to the government's change in how they reimbursed states for Silver plans. Maybe the insurance companies overestimated the effect of that and this year is more a return to normal. Maybe it's something else.

 

[ShokWaveRider]

My HI Broker said nothing is really accurate until November 1st. Everything is simply estimates as of now. She even does not have the final numbers.

 

[Dtail]

My HI Broker said nothing is really accurate until November 1st. Everything is simply estimates as of now. She even does not have the final numbers.

Agree. My premium appeared to go up close to 100% (apples to apples compared to last year), but the letter I received showed a decrease.

 

[ExFlyBoy5]

Here in Georgia, rates continue to skyrocket. The cheapest plan available to me for next year (that includes my primary care doctor in network) is $510/month. This year I've been paying $440/month. So that's a 16% increase for 2020. My passive income puts me over the limit for subsidies, so it's all out of pocket.

I remember that in 2014, when I first had to get insurance in the private market, it was something like $250/month for a similar bronze-level plan. Now it's over 100% more. It boggles the mind to think that these gargantuan price increases could just keep going.

A self-employed fella I know in Atlanta (4 kids) would have an annual premium of $16,200 for the cheapest plan available (with a $15,000 deductible and $16,400 OOP max). If I recall, the renewal notice he got for his current plan was almost $40,000 a year. How is this sustainable for those that don't get the subsidy?

 

[dvalley]

They ask you for your 2019 income. What if the 2020 income will be less? do you input that instead? Also, if I'm getting the insurance with a projected income of say $30k but say mid 2020 I end up getting a high paying job and get insurance through work do I have to pay back all the subsidy and is there a penalty for that too? I'm confused.

 

[ShokWaveRider]

Honestly, I just give the minimum to get the maximum subsidy and pay the difference at the end of the year. That has worked since ACA inception. Yes, you make up for it at the end of the year with a one time premium top up payment. But during the year you enjoy No Deductible, lowest doc and specialist copays and low MOOP. At the end of the year one only has to pay the difference in premium NOT the other nickels and dimes that insurance companies love to levy on people.

 

[Dtail]

They ask you for your 2019 income. What if the 2020 income will be less? do you input that instead? Also, if I'm getting the insurance with a projected income of say $30k but say mid 2020 I end up getting a high paying job and get insurance through work do I have to pay back all the subsidy and is there a penalty for that too? I'm confused.

You do have to effectively true the tax subsidy at tax time if your MAGI ended up higher.
However if you choose a Silver plan, technically some of your savings are due to cost sharing and those monies do not have to be paid back.

 

[dvalley]

Thanks guys. I've been on the company plans all these years but I might be switching jobs with a few months of time off in between so I was wondering how that will work out.

 

[Smitty700]

They ask you for your 2019 income. What if the 2020 income will be less? do you input that instead? Also, if I'm getting the insurance with a projected income of say $30k but say mid 2020 I end up getting a high paying job and get insurance through work do I have to pay back all the subsidy and is there a penalty for that too? I'm confused.

For 2020 coverage, Healthcare.gov asks for your estimated 2020 income, not 2019.

If you project $30K of 2020 income, your subsidy is based on that. Say half way through the year you get a high paying job with health insurance, you must report that to Healthcare.gov. If you can get health insurance through your new employer, then you will no longer be eligible for further ACA coverage, but you won't have to pay the subsidies back immediately. If your MAGI for 2020 now goes over 400% of the federal poverty level, you will lose eligibility for all subsidies, and you'll repay those subsidies back at tax time.

When you do your 2020 taxes, all of this is worked out on Form 8962. If your income went up from your estimate, then you'll have to repay the difference in subsidy at tax time. Conversely, if your income went down, your subsidy goes up, and you'd get a tax credit for the difference of what you received during the year and what you were eligible for.

Very complicated.

 

[GTFan]

Here in Georgia, rates continue to skyrocket. The cheapest plan available to me for next year (that includes my primary care doctor in network) is $510/month. This year I've been paying $440/month. So that's a 16% increase for 2020. My passive income puts me over the limit for subsidies, so it's all out of pocket.

I remember that in 2014, when I first had to get insurance in the private market, it was something like $250/month for a similar bronze-level plan. Now it's over 100% more. It boggles the mind to think that these gargantuan price increases could just keep going.

That's strange given that Ambetter (as an example) just gave us a big Medical Loss Rebate for the last 3 years of premiums that were in excess of their required 80% min payout for claims. Premiums should be about the same or cheaper for some carriers, in other words.

Our Silver CSR plan is about the same for 2020 as this year, without subsidy it's about $50 less per month. Of course max OOP has gone up as it does every year.

 

[orchid55]

Our experience is Georgia is the same as Sojourner. Our Bronze HSA premium is increasing by 15% to $1680 per month, with a deductible of $6850 per person. The least expensive bronze policy is $1549 per month with a deductible of $8100 per person- that premium is $104 per month more than our current Bronze HSA plan.

 

[newmillionaire]

Subsidy dropped 25%

How can my subsidy drop 25%? I estimated my income in 2019 to be 45K and in 2020 estimated it to be 48K. Subsidy went from $1,432 to $1,064. Anyone know what might have happened? Should I contact healthcare.gov to appeal?

 

[orchid55]

What may have happened is that the Second lowest cost silver plan upon which your subsidy is based decreased in price from 2019 to 2020. If the SLCSP premium is lower then your subsidy, which is a percentage of that premium, will be lower.

 

[Trawler]

How can my subsidy drop 25%? I estimated my income in 2019 to be 45K and in 2020 estimated it to be 48K. Subsidy went from $1,432 to $1,064. Anyone know what might have happened? Should I contact healthcare.gov to appeal?

Take a look at the 2nd lowest priced silver plan price w/o subsidy in your area and compare it to last years. Did it drop? The 2nd lowest silver plan is bell weather for determining subsidy. In addition you may have crossed one of the FPL thresholds that increase the percentage on income that is your contribution to how much you must pay as a percentage of income. Did number of people in household change?

 

[Rianne]

We're going with the least expensive Bronze HSA approved plan. $13,600 family/out of pocket deductible. This with the hopes our health remains good. Somehow, the discounts the insurance co negotiated with the hospital/docs are great. And if we hit the maximum deductible all else is $0.

Also, put maximum in HSA which keeps our income under the ACA cliff. The HSA savings is building, so we look forward to paying our medicare premiums from that account in 3 years, tax free. Kind of like a healthcare Roth plan.

 

[newmillionaire]

orchid55 and trawler - thank you so much. This gives me something to go on. Looks like I will just get a lower subsidy...nothing I can do. At least I know now not to appeal because it's just how the system works. You saved me a lot of time!



The number of people in the household did not change. Our 2 kids were put on chip in 2019 after we sold our business. Trawler, I will look to see if the silver plan dropped to be sure...

 

[Eucerin]

A self-employed fella I know in Atlanta (4 kids) would have an annual premium of $16,200 for the cheapest plan available (with a $15,000 deductible and $16,400 OOP max). If I recall, the renewal notice he got for his current plan was almost $40,000 a year. How is this sustainable for those that don't get the subsidy?

I agree. People usually say that because he makes too much money that is why the premium is high.
But how much money do you have to make a year to sustained such large amount of premium? Life is not only about health care insurance, they are other living expenses too. How does a middle class or in this case, even a middle to high income family can offered such premium?
It is so sad and so broken

 

[SecondCor521]

orchid55 and trawler - thank you so much. This gives me something to go on. Looks like I will just get a lower subsidy...nothing I can do. At least I know now not to appeal because it's just how the system works. You saved me a lot of time!



The number of people in the household did not change. Our 2 kids were put on chip in 2019 after we sold our business. Trawler, I will look to see if the silver plan dropped to be sure...

Silver plan pricing has been volatile over the past few years because of how the government reimbursed states for cost sharing reductions, which are only available on Silver plans. It could be that you are seeing volatility in your Silver plan pricing in your area (specifically the SLCSP, as people above have noted) due to this reason.

 

[Z3Dreamer]

I skimmed through the posts and didn't see anything like this so let me give you the numbers for the mountains of NC. These figures are rounded to the nearest $100. DW is 64 and I am 62.

Our HDHP is renewing at $2,100 per month. $6,900 per person deductible with 100% coverage after that. Slight increase over last year.

Only Gold is $3,300 per month. Co-pays are great - $5 and $30. Deductible of $3,000 per person. After meeting deductible you pay 20% up to max-out-of-pocket of $8,150.

One of the two silvers is $3,100 per month. Co-pays are $10 and $50. Deductible of $4,500 per person. After meeting deductible you pay 30% up to max-out-of-pocket of $8,150.

I have run the potential claims using low-mid-high. Due to low premiums and a MOOP of $6,900 the bronze plan is cheapest under all scenarios.

I have 3 other plans to choose from. Those 3 are similar.

That's right. Premiums start at $25,000 per year and go up to $40,000. Anyone have premiums this high?

P.S. I spend my free time looking for ways to qualify for PTC.

 

[ncbill]

I skimmed through the posts and didn't see anything like this so let me give you the numbers for the mountains of NC. These figures are rounded to the nearest $100. DW is 64 and I am 62.

Our HDHP is renewing at $2,100 per month. $6,900 per person deductible with 100% coverage after that. Slight increase over last year.

Only Gold is $3,300 per month. Co-pays are great - $5 and $30. Deductible of $3,000 per person. After meeting deductible you pay 20% up to max-out-of-pocket of $8,150.

One of the two silvers is $3,100 per month. Co-pays are $10 and $50. Deductible of $4,500 per person. After meeting deductible you pay 30% up to max-out-of-pocket of $8,150.

I have run the potential claims using low-mid-high. Due to low premiums and a MOOP of $6,900 the bronze plan is cheapest under all scenarios.

I have 3 other plans to choose from. Those 3 are similar.

That's right. Premiums start at $25,000 per year and go up to $40,000. Anyone have premiums this high?

P.S. I spend my free time looking for ways to qualify for PTC.

Pension or other income driving MAGI too high?

Annual spend too high to "manage" your income?

If the latter can you borrow, e.g. a HELOC, to lower MAGI?

Y'all don't have too long until Medicare.

 

[Smitty700]

Also, put maximum in HSA which keeps our income under the ACA cliff. The HSA savings is building, so we look forward to paying our medicare premiums from that account in 3 years, tax free. Kind of like a healthcare Roth plan.

Rianne, you may be already familiar with this concept, but I repeat for others who may not be aware. And I think it's such a good deal, I can't help myself.

One does not need to take out the money immediately for HSA-eligible expenses. I've been keeping tab of all of my HSA eligible expenses, including my COBRA payments, since 2009. I've not yet paid any of those expenses out of my HSA. I can take that $40K anytime, which I'm now finding useful for avoiding taxable income that would put me over the the FPL limits.

 

[Z3Dreamer]

Pension or other income driving MAGI too high?

Annual spend too high to "manage" your income?

If the latter can you borrow, e.g. a HELOC, to lower MAGI?

Y'all don't have too long until Medicare.

Yes, I have become quite good at staying below the cliff. Roth withdrawals, H.S.A withdrawals, and the like. Weekly, I visit my spreadsheet where I have OMAGI for computed out to 2023.

 

[golfnut]

Here in Illinois, 2020 aca is only offering one plan that's hsa eligible. Is this common for other states?

 

[Mulligan]

Here in Illinois, 2020 aca is only offering one plan that's hsa eligible. Is this common for other states?

Next door neighbor here in MO. This year is the first time in 3 years an HSA has been offered. Previous two years had no HSA availability.

 

[4legsgood]

Here in Illinois, 2020 aca is only offering one plan that's hsa eligible. Is this common for other states?

In my county in Washington state (different plans for different counties), they offer just one HSA plan. I'm hoping they always offer at least one.