2022 ACA Exchange Experiences

[PaunchyPirate]

Now that 2022 Open Enrollment has opened, I thought I'd open up a nice, little, dedicated thread to those that want to share their experience with signing up for 2022 ACA Exchange healthcare.

I'm in Pennsylvania, so we use our own exchange called Pennie. Pennie does a nice job of assuming you want to keep the same (or equivalent) plan as you did last year if you were an existing customer, so I had already been notified a few days ago that they had done that for me. I could still make changes on or after November 1st if I wished.

I've been researching sources for the last month, so I already had an idea what the insurance companies were going to offer me and the pricing. Upon reviewing Pennie this morning, I see that my research was pretty much spot on.

If I wanted to keep my current Gold plan (from UPMC Health Plan), the unsubsidized rate increase was going to be $49 more per month. About 5.5% increase. However, if I didn't age, that same plan would only be going up by $9 -- about 1% increase. Getting old sucks.

The deductible didn't change. The max OOP went up $500. My PCP co-pays went down.

However, that plan is only an HMO. That provider does not offer a PPO in my county and still will not in 2022.

But, their competitor (Highmark BC/BS) has upped their game this year by extending their PPO plans into my county. Last year, they were not available. I much prefer the comfort of a PPO plan so that I have a better grasp on what my costs may be if I need healthcare while traveling around the country.

The BC/BS PPO is a little more expensive, but worth it to me. The co-pays are also better than the UPMC plan I was on. So this year, I will be signing up for the Gold PPO plan from BC/BS for a list price of $1022 per month. My tax credit subsidy will lower this cost significantly.

Pennie automatically carried over my income estimation from 2021. I wanted to change this, since I will likely make a few thousand less in 2022. So I had to edit my application and resubmit it. This triggered a need for me to justify my new (and lower) income. So I have uploaded my most recent tax return which, hopefully, will approve my application. This is the first time in 4 years on the ACA exchanges that I've had to provide estimated income documentation.

Anyway, all-in-all, my experience was good and as expected. Hopefully others are experiencing the same.

 

[erkevin]

I received a renewal letter from BCBS Tennessee. It showed the 2022 premium if I kept the same plan (increased 19%). However, when I completed my ACA application, the same plan was considerably cheaper than quoted in the letter.

 

[RunningBum]

All 20 of the plans offered to me are HMO. My current plan went up ~3%, and the subsidy went up a little more, so I'll be paying a little less in 2022.

I ran into one irritation. I thought I might be able to get my income down to 250% FPL and get CSRs with a silver plan, so I put that in as my estimated MAGI. Went to the plans, and realized since the silver wasn't an HSA eligible plan, I wouldn't be able to reduce my HSA by the $4650 contribution, so I'd be well over 250%. I couldn't find an easy way to update my income. I had to call it a life change event, and then it took me through all the questions about age, smoking, name, HRAs, etc. I didn't count but I think it was clicking thru at least 10 pages (and sometimes being forced to re-enter No and acknowledge some pfd document) to get to changing my income. And then I did it again because the income level wasn't going to use all of the subsidy, though I guess it didn't matter since it would all be resolved at tax time.

Comparison of plans was pretty easy since I set up a spreadsheet a few years ago and just have to plug in the new plans and make a few other minor mods. There is a range of expenses where a gold plan is cheaper, but it's not by much, which the bronze plan is much cheaper with low medical expenses.

 

[PaunchyPirate]

All 20 of the plans offered to me are HMO. My current plan went up ~3%, and the subsidy went up a little more, so I'll be paying a little less in 2022.

I ran into one irritation. I thought I might be able to get my income down to 250% FPL and get CSRs with a silver plan, so I put that in as my estimated MAGI. Went to the plans, and realized since the silver wasn't an HSA eligible plan, I wouldn't be able to reduce my HSA by the $4650 contribution, so I'd be well over 250%. I couldn't find an easy way to update my income. I had to call it a life change event, and then it took me through all the questions about age, smoking, name, HRAs, etc. I didn't count but I think it was clicking thru at least 10 pages (and sometimes being forced to re-enter No and acknowledge some pfd document) to get to changing my income. And then I did it again because the income level wasn't going to use all of the subsidy, though I guess it didn't matter since it would all be resolved at tax time.

Comparison of plans was pretty easy since I set up a spreadsheet a few years ago and just have to plug in the new plans and make a few other minor mods. There is a range of expenses where a gold plan is cheaper, but it's not by much, which the bronze plan is much cheaper with low medical expenses.

I feel your pain on adjusting the income. In order to adjust mine, I also had to re-answer every question in my overall application. Fortunately, the PA exchange remembers your answers from the last time you filled out an application. So I just had to quickly review then and the click “save and continue” until I got to the screen where estimated income was to be answered. Easily 10 or more screens of data to review. You’d think they would separate out the income question into a separate section, since it’s the most likely to change — possibly every year.

 

[Yarnstormer]

I’m still working a little from home but since I draw stores, covid really killed my small business for 2020-2021. Because I claimed unemployment I was able to switch plans late 2021 and get a HUGE subsidy and a $900 oop for only $150/mo. Really! I’m madly getting things done before the end of the year. I did a new application for 2022 looks like it will go up to $7k oop for $500/mo again. Oh well it was fun while it lasted.

 

[Dtail]

As mentioned previously, my same plan went up 40% for 2022 for the Florida Blue Silver plan.
The premiums are still great compared to others around the country at approximately a net 250 monthly after subsidies.
After 2022, two more years needing the ACA.
Interesting that using different MAGI levels, while staying under 150% FPL, produces the same premium, so clearly the calculations are different for 2022.

 

[EastWest Gal]

Have not yet applied but everything looks close to the same in Central PA. Between 2016 and 2017 our premium DOUBLED.

 

[Z3Dreamer]

Existing plan went up 4%, but a new HMO provider came into the marketplace. With the new lower priced plan in the mix, the SLCSP was reduced by $150. I looked into the HMO but it won't work for me, so I renewed my existing plan. Pretty easy. I will be paying about $150 but I am not complaining as ACA has worked out great for me. Better than great.

 

[tominboise]

I am not complaining as ACA has worked out great for me. Better than great.

Us too. Never imagined insurance would be this affordable.

 

[flyingaway]

May I know approximately how much is your estimated income that is used for the ACA estimate? $40,000? $60,000?

 

[PaunchyPirate]

I'm the OP who started this thread. I'm on the Pennsylvania exchange. My justification for lowered income this year was accepted last night. I had loaded my 2020 federal tax return which shows MAGI just below what I'm estimating my 2022 income to be. I also included a one paragraph explanation saying that my 2022 income will be about the same as shown on the tax return. No further explanation needed.

The next step is to pay my January premium to the new company (I am changing companies and plan this year). When I went to do that, the payment portal to Highmark Blue Cross/Blue Shield repeatedly errored out during the payment submit. I tried last night multiple times and again this morning. No dice. I tried multiple credit cards and multiple browsers with no success. They have an option to "Send me a bill", which I eventually selected. I'd prefer to have it done with, but I'll trust they will send me a bill fairly soon. For now, I'll just keep track of it as something that must be done before January 1st.

 

[Z3Dreamer]

The next step is to pay my January premium to the new company (I am changing companies and plan this year). When I went to do that, the payment portal to Highmark Blue Cross/Blue Shield repeatedly errored out during the payment submit. I tried last night multiple times and again this morning. No dice. I tried multiple credit cards and multiple browsers with no success. They have an option to "Send me a bill", which I eventually selected. I'd prefer to have it done with, but I'll trust they will send me a bill fairly soon. For now, I'll just keep track of it as something that must be done before January 1st.

With me, it takes a few days before the correct stuff (so I can pay) is transferred from Healthcare.gov to my insurer.

 

[Z3Dreamer]

May I know approximately how much is your estimated income that is used for the ACA estimate? $40,000? $60,000?

Before recent legislation you had to stay under 400% FPL to get any PTC. Mine is about in that range.

 

[PaunchyPirate]

With me, it takes a few days before the correct stuff (so I can pay) is transferred from Healthcare.gov to my insurer.

Interesting. I figured I'll keep trying to pay it via credit card now and then until I get a paper bill. I want credit card points for it! Haha. You may be correct that I was just too fast for "the system". However, the PA site immediately takes you to the Payment screen directly after enrollment, so you'd think that it should work. Oh well, I'm sure it will work out in the end.

 

[PaunchyPirate]

May I know approximately how much is your estimated income that is used for the ACA estimate? $40,000? $60,000?

I'm not sure who you were asking, but my estimated income that I used for 2022 is $40,000.

 

[GTFan]

Our current Ambetter Silver CSR plan went up $46/mo. before subsidy, so not much of an increase considering we're a year older.

 

[aaronc879]

I signed up yesterday morning. It took maybe 15 minutes for everything, very simple. I was able to get a Silver plan with $0 premium, $50 deductible, and $950 max OOP. It is HMO but it has what I need at the right price.

 

[scrabbler1]

After 2 difficult years renewing and reapplying for the same ACA policy with the same insurer here in New York (state-run exchange), I was hoping to have an uneventful time this year. But it doesn't look like it will totally uneventful. I got a letter last week from the exchange telling me they need proof of income once again.

This seems odd because by now they would have access to my 2020 state and federal income tax returns, returns which show my greatly reduced income after I liquidated at the end of 2019 a stock fund which had been generating (or, "vomiting," as a fellow member here once described) cap gain distributions. I moved it to an index fund which generated smaller and far more predictable distributions. My 2020 actual MAGI was within $2k of my 2020 predicted MAGI in the application.

I guess I can always upload the 1099s for the 2020 year I used in my income tax forms. Calling those people at the exchange is rarely helpful because they are pretty clueless, but I suppose I will have to try. How would they not have access to at least my state income tax return they can use to verify my income??

One small complication which won't affect any income verification is that I may sign up for a dental plan. My current IC doesn't offer them, but I can sign up for one through another company. I still have some work to do on that as far as which plan I should choose. I have already discussed this with my dentist and they are willing to help me find a plan which meshes well with my current dental needs.

 

[Z3Dreamer]

Interesting. I figured I'll keep trying to pay it via credit card now and then until I get a paper bill. I want credit card points for it! Haha. You may be correct that I was just too fast for "the system". However, the PA site immediately takes you to the Payment screen directly after enrollment, so you'd think that it should work. Oh well, I'm sure it will work out in the end.

Yes, I cannot pay, but at the same time I have messages that I need to pay to get coverage.

 

[SecondCor521]

The overall experience for me this year was a little different but overall went very well.

My state has its own exchange; it doesn't use healthcare.gov.

The first step this year, which was new compared to last year, was a reapplication where I got to / had to log in and confirm family size, income, income sources, etc. It took maybe ten minutes, and at the end it let me upload files to justify my income. I gave them a PDF of my taxes from last year showing similar income. About a week later I got a paper notification that my reapplication was approved.

The website makes it really very easy to shop plans. You put in your zip code, ages, and income plus a few other details. It tells you your subsidy amount and whether you qualify for CSRs. You then see a screen with all the plans, which you can filter by metal level, insurer, CSR eligibility, HSA eligibility, and a few other things. For each plan it shows the insurer, plan name, subsidized premium, and things like deductible and max OOP.

I stuck with my same plan, which was the default option. My insurer sent me a notice letting me know that they were planning on reenrolling me, with the price and a basic summary of benefits but I could change if I wanted to.

All of the above already happened by 11/1, so even though I have 45 days I'm already done. Of course it is typically easier if you're already signed up and not changing anything.

The only thing I need to do now is watch out to make sure they don't re-add my youngest kid back on my insurance plan. They did that by accident last year and it caused a bunch of hassle for me. I'm checking the notices more carefully and so far everything seems to be correct, but I also have a tickler for 12/8 to re-confirm.

 

[audreyh1]

I received a renewal letter from BCBS Tennessee. It showed the 2022 premium if I kept the same plan (increased 19%). However, when I completed my ACA application, the same plan was considerably cheaper than quoted in the letter.

Off marketplace here.

Got my plan renewal notice from BCBS TX. Up 9.75% which is quite a jump, but it only went up 2% last year, so I’m not complaining (much).

 

[PaunchyPirate]

My frustration with signing up with Highmark BC/BS continues. They sent me an email saying they had successfully received my application and processed it. The next step is to pay the first month’s premium. They provide a link to do that. The link takes you to a page where you have to first register your Highmark online account. No problem. I do that and can nicely sign in and see some basic details of my upcoming coverage. Looks as expected. It doesn’t automatically take me to a “pay premium” page (as one would hope, since I clicked on a link that specifically said “pay your first premium). But I see a nice Pay Premium icon at the top of the screen, so I click there. It takes me to a page that says “you must first Register for eBill. Enter the Bill ID from you paper statement.” And I don’t have one because I’m a new customer. If I have to wait for you to send me a paper bill, say that in the email or don’t send me that email until you’ve sent a bill.

You’d think with experience doing this year after year, they would have this part of enrollment from the exchange well thought thru. I sent a secure message telling them my situation and asked “what do you want me to do?”

 

[stargazer08]

I'm a first time aca applicant for 2022. I'm retiring early December 31, 2021. I live in Illinois and I'm in the process of filling out the application on healthcare.gov. There are questions about my current job related coverage. I've stopped the app at this point because I have no idea how I can indicate that my job ends December 31st.
I'm afraid to complete and submit my application not knowing if there will be a way to explain my drop in income and loss of health care coverage. I thought this was addressed in another thread but I can't find it. I'll keep looking but thought someone could shed some light.
According to the Guide to Confirming Your Income Information, I guess I just provide a written explanation and upload it as an application detail.

 

[RetiredAndLovingIt]

They will tell you what they need and they give you plenty time to upload the information. A letter attesting to your reduced income due to retirement is usually all they need but wait for them to ask which they won't do till you submit the application. You've got two months to deal with this, In my case I estimated to low and they tried to put me on Medicare. That was a real nightmare but all I had to do was an immediate Roth conversion to get me over the income bump and and they approved me immediately once they had the documentation.
Also you can call an approved ACA marketplace approved insurance agency in your area and they will fill out the application for you if you prefer and there is no cost to you.

 

[SecondCor521]

I'm a first time aca applicant for 2022. I'm retiring early December 31, 2021. I live in Illinois and I'm in the process of filling out the application on healthcare.gov. There are questions about my current job related coverage. I've stopped the app at this point because I have no idea how I can indicate that my job ends December 31st.
I'm afraid to complete and submit my application not knowing if there will be a way to explain my drop in income and loss of health care coverage. I thought this was addressed in another thread but I can't find it. I'll keep looking but thought someone could shed some light.
According to the Guide to Confirming Your Income Information, I guess I just provide a written explanation and upload it as an application detail.

As far as the question about coverage, since I had to apply for ACA while I still had my job and work health insurance, I just said I didn't have coverage. I can't remember now if that's just because that's what made sense to me, or whether I asked here, or whether I called the marketplace folks and asked.

If you're sure you're done 12/31 and won't have coverage on 1/1, it's my opinion that it's OK to just say you don't have coverage. That may not be literally true based on the wording of that question, but it's essentially true and it's what they're trying to ask.