2025 ACA Rate Changes Discussion

SecondCor521 said:
Is that the increase in the subsidized or unsubsidized premium?
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I think I may have misunderstood question and answered incorrectly, SecondCor521. I think my answer should have been "subsidized". The premium increase we received was from FloridaBlue under the ACA program. Our new monthly payment is estimated to be $654 vs. $467. This is assuming our premium tax credit in 2025 stays exactly the same. We obviously won't know the exact amount of our tax credits until Nov 1, but the policy itself has gone up 40% on its own. Crazy!
 
FLSUnFIRE said:
12.5% Increase for my BCBS HDHP here in FL. Part of that is due to me getting older... not sure the break out as it's not on the marketplace yet but I got the renewal notice.
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Is there a reason you didn't go for a marketplace plan? Is your income too high?
 
ACA is extremely cheap for me. Medicare will be a huge increase in costs, with or without a supplement. I wish I could just keep ACA forever.
 
I finally figured out why I had never gotten any ACA subsidies other than the single year after retirement. After that one year, my husband started SS and another year later, he was subject to RMD. I played around with the ACA website. The issue lies in that ACA is using household income for 1 person, even though there are 2 of us, but my husband had already been on Medicare when we retired. I played around with the site using various numbers and at $185K for 2 people, the subsidy is about $250 per month. But since it's only one person, there is no subsidy. We now make more than that due to various income streams kicking in through retirement.
 
JohnC12 said:
I think I may have misunderstood question and answered incorrectly, SecondCor521. I think my answer should have been "subsidized". The premium increase we received was from FloridaBlue under the ACA program. Our new monthly payment is estimated to be $654 vs. $467. This is assuming our premium tax credit in 2025 stays exactly the same. We obviously won't know the exact amount of our tax credits until Nov 1, but the policy itself has gone up 40% on its own. Crazy!
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Being in the ACA subsidy zone isolates you from age rating increases and general increases in premiums. The formula is a set percentage of income, all the increases are absorbed and your subsidy would increase to cover the increase.
 
JohnC12 said:
I think I may have misunderstood question and answered incorrectly, SecondCor521. I think my answer should have been "subsidized". The premium increase we received was from FloridaBlue under the ACA program. Our new monthly payment is estimated to be $654 vs. $467. This is assuming our premium tax credit in 2025 stays exactly the same. We obviously won't know the exact amount of our tax credits until Nov 1, but the policy itself has gone up 40% on its own. Crazy!
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That's why I asked. 40% does seem a bit crazy for something that is now regulated at the state level. The most likely explanation I can think of is that the SLCSP changed in your area and therefore affected your subsidy and thus your premium. But your answer seems to imply that it's just the price of the policy increasing by that much.

Only 6 out of 324 providers have even proposed increases of 25% or more in 2025 per How much and why ACA Marketplace premiums are going up in 2025 - Peterson-KFF Health System Tracker.

According to https://floir.com/docs-sf/life-heal...iums-for-plan-year-2025.pdf?sfvrsn=32ca0453_2, FloridaBlue's average increase is 9.8%.

I wonder if something else unusual happened. Possibilities I can think of: You moved, you reported a higher estimated income to the exchange, you changed policies, or you added an additional person to your policy.
 
I appreciate the feedback!

I wish there was an easy explanation for the steep increase, but nothing has changed on our end. We haven’t moved, same exact Silver policy, our income hasn’t changed and it’s still just the two of us on the policy. I’m planning on calling this week to see is anyone can explain the increase, but I doubt I’ll get anywhere with a call center agent. Maybe they’ll let me talk to someone in actuary, but I doubt it. LOL

I’ll report back what I learn. Again, thanks!
 
JohnC12 said:
I appreciate the feedback!

I wish there was an easy explanation for the steep increase, but nothing has changed on our end. We haven’t moved, same exact Silver policy, our income hasn’t changed and it’s still just the two of us on the policy. I’m planning on calling this week to see is anyone can explain the increase, but I doubt I’ll get anywhere with a call center agent. Maybe they’ll let me talk to someone in actuary, but I doubt it. LOL

I’ll report back what I learn. Again, thanks!
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Why not wait till Nov 1st when you have all the information?
 
As SecondCor521 has mentioned it must be because the Silver benchmark (SLCSP) in your county has a new low cost entry that drives down the subsidy (the calc hinges on the SLCSP).

SLCSP = second lowest cost Silver plan.
 
Pennsylvania just release the 2025 plan pricing in crude format -- meaning they have released the insurance companies' filing documents that have been approved by the state. If you search through them, you can determine plan pricing for 2025 with a little work.

My current HSA PPO plan will be offered again in 2025 with the same basic details. If I would not be aging, the premium increase (without any subsidies) would be rising 6.67%. When I add in my age increase, the premium will rise 9.06% over what I pay in 2024.

There are no new insurers in my zip code and there are no additional plans. Things seem to be pretty similar between 2024 and 2025. So I'm not expecting any surprises with a new entry drastically changing the SLCSP structure. Unfortunately, the documents provided at this point don't make it very easy to determine the pricing of the SLCSP, so I can't yet determine how my subsidy is going to look for next year.

All-in-all, I'm not too worried about 2025 health insurance.
 
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While Pennsylvania's exchange website isn't open yet to see all the plans and pricing, they just notified me via a letter (as they do each year) what my subsidy will be (if my planned income remains the same as 2024). They also automatically mapped me to the same plan as last year and have revealed the pricing to me. I now have all the facts and figures for my monthly payment.

As I mentioned above, the premium for my current (and future) plan has risen 9.06% (including my increase in age). Nicely, my 2025 APTC subsidy rises by 13.38%. So my resulting premium for 2025 will be about $30 less per month than in the current year if I leave the income estimate the same as it was in 2024.

In reality, I suspect my 2025 income will be noticeably higher, so I'll probably raise my estimate some and pay a little more each month.
 
aaronc879 said:
ACA is extremely cheap for me. Medicare will be a huge increase in costs, with or without a supplement. I wish I could just keep ACA forever.
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This was true for me at first, but now about even.
I understand your plight.
 
Also just got a letter, in Florida. Says the premium for the plan I'm on now (gold tier) is going up 11.4%. So, I guess we'll see, next week, how my planned slightly higher income next year, the 2nd highest silver plan, and whatever other factors, will effect my payment amount.

I did the gold this year so I'd pay something to have some skin in the game (silver would have been free). If I don't like my new monthly amount, I can back down to a silver plan policy, though I'm presuming the silvers went up, too.

eta-
There's also an interesting note on this letter, that I'm not sure what to make of yet, that says:
"Important: This isn't a Silver plan in 2025. This means you can't get financial help to lower your out-of-pocket costs if you stay in the plan. To get these savings if you qualify, you must go back to the Marketplace and enroll in a Silver plan. If you don't, any financial help you currently get to lower your out-of-pocket costs will stop on December 31."

What's confusing is that a) it wasn't a silver plan last year either, b) the beginning of the letter gives me explanation as to how much my payment for this Gold plan will change if I qualify for the same amount of financial help as last year, and c) if they want to say it is no longer a Marketplace plan, why don't they just say so. Or, did they change the rules so I can't bump up my plan to a Gold. Maybe the Marketplace will help me understand.
 
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Dalton said:
eta-
There's also an interesting note on this letter, that I'm not sure what to make of yet, that says:
"Important: This isn't a Silver plan in 2025. This means you can't get financial help to lower your out-of-pocket costs if you stay in the plan. To get these savings if you qualify, you must go back to the Marketplace and enroll in a Silver plan. If you don't, any financial help you currently get to lower your out-of-pocket costs will stop on December 31."

What's confusing is that a) it wasn't a silver plan last year either, b) the beginning of the letter gives me explanation as to how much my payment for this Gold plan will change if I qualify for the same amount of financial help as last year, and c) if they want to say it is no longer a Marketplace plan, why don't they just say so. Or, did they change the rules so I can't bump up my plan to a Gold. Maybe the Marketplace will help me understand.
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They're pointing out to you that it's not a Silver plan and therefore you're not eligible for CSRs. And if you're getting CSRs this year (i.e., you're on a Silver plan now), you won't get them next year if you stay with the Gold plan.

You probably already know, but there are sort of two different kinds of subsidies with the ACA: There is (1) the premium tax credit, which you seem to know about, and (2) CSRs, which only apply to Silver plans and folks with income under 250% of FPL and generally reduce deductibles and/or copays.

If you're not aware of or don't understand CSRs, they're worth understanding how they work.
 
Thank you, that makes more sense. Seems like it'd be a little clearer if they'd use the specific term (CSR) in their text, instead of calling it "financial help" (isn't it all). I did look at the Silver plans and got the rundown on the CSR's last year, but it was a year ago so need to refresh my memory. As I recall, the BCBS silver plans didn't include my PCP (seeing him >20 years) and several of my specialists.
 
Is it possible to have a plan be CSR eligible and HSA eligible? I thought it was, but I do not have any option for both?

Edit: Also, I see some plans with high deductibles (not silver) that don't say HSA eligible. Shouldn't any high deductible plan be HSA eligible?
 
qwerty3656 said:
Is it possible to have a plan be CSR eligible and HSA eligible? I thought it was, but I do not have any option for both?
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I think I saw one plan once that was both. But typically HSA eligible plans are Bronze plans, and Bronze plans are not CSR eligible. So almost always no.

qwerty3656 said:
Edit: Also, I see some plans with high deductibles (not silver) that don't say HSA eligible. Shouldn't any high deductible plan be HSA eligible?
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Not necessarily. The requirements to be HSA eligible are basically a high deductible and no benefits (other than preventative stuff like vaccines) before the deductible is met. The high deductible plans you are looking at probably don't meet the second criterion.
 
qwerty3656 said:
Is it possible to have a plan be CSR eligible and HSA eligible? I thought it was, but I do not have any option for both?

Edit: Also, I see some plans with high deductibles (not silver) that don't say HSA eligible. Shouldn't any high deductible plan be HSA eligible?
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No, it's not possible. HSAs require a high deductible and CSR plans have tiny deductibles if not no deductible.
 
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